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h e a l c a r d i o
SYSTEM ORIENTED DESIGN
A holistic solution for the cardiovascular
Yue Zou
Report yue
SYSTEM ORIENTED DESIGN
A holistic solution for the cardiovascular
h e a l c a r d i o
This project submitted to the Oslo School of Architecture
and Design for System Oriented Design Studio
cooperated with DNV GL
Yue Zou, author
Linda Blaasvær, Manuela Aguirre, advisor
Report yue
ABSTRACT
What is the future healthcare in future? Design itself is a
important power to make the healthcare system change a lot.
This project is aimed at exploring the future healthcare service
in system thinking to make a holistic process and assumption
of future system. Cardiovascular patients is a biggest group in
the world. I hope working with this group can bring a lot of
inspiration for other healthcare issue. In this project, I use
strategy design, service design and interaction design method
to create a hotlist service for cardiovascular patients out of the
hospital. Nowadays a lot of people are suffering from
longterm diseases and having high risk of cardiovascular. The
food is a good way to address this problem. The meaning of
the food and medicine are changing. The longterm medicine
cause a mental problem at the beginning. The industry of
medicine are struggling with their development, The goal of
this project is to discuss the touchpoint food and medicine to
address all the problems here, using system design
methodology.
Report yue
KNOWLEDGEMENTS
Thank you to my advisor Linda and Manuela for their
support and guidance on this project. Thanks also for
Mosse and Natalia for their tutoring of interaction
design and service design.
Thanks a lot for my partners, Marius, Stephen and other
people from DNV GL healthcare innovation center. We
had great workshops during this project.
CONTENTS
• research 1
• leverage points 23
• prototyping 44
First Giga-mapping
research
leverage
point
prototype
research
1
First Co-creation Workshop
2
WHY CARDIOVASCULAR
One in four deaths (12.9 million) was
from heart disease or strike in 2010.
Two in three deaths worldwide were
from chronic diseases in 2010
Most cardiovascular diseases can
be prevented by addressing
lifestyle - related risk factors.
It’s obvious that cardiovascular is the biggest groups which
means most important..There are two things for me. Firstly, I
hope other disease can also get some insight from my project.
Secondly,it’s easily to contact the patients easily.
3
RESEARCH PROCESS
4
MY PARTNER
My partner DNV GL is quite a world leading group which is famous for
give certification to organizations including hospitals. I’m working with
healthcare innovation in DNV GL. Safer, smarter and greener is a process
for the society to transformative. Sustainability needs transformative. This
three words is a good evaluation for my project. Digitalization,
localization are the good strategy for the branding.The main target
group is China, USA, European(Norway).The evolution part is valuable as
a starting point. Holistic care is necessarily.
5
DNV GL healthcare innovation center has done a lot of projects. They
are focusing on human centered care. These general principle of
patient centered care from DNV GL can give me a lot of inspiration to
imply in my project. The principle has many different levels
perspectives from individual level to system level.what is safety
culture? It’s a big question. I use giga-mapping to figure out the DNA
of safety culture. I found three words to support the DNA-SHARED
EFFICIENCY TRUST.
6
CO-CREATION WORKSHOP
This is first workshop in DNV GL. Because healthcare is a big image
and my client did not give me any limitation in direction at beginning.
I think I should find a start point to work with. This co-creation
workshop’s main goal is to find some general problem of the
cardiovascular in professional’s perspective.
7
Using timeline is a good way to find different problems in a holistic
perspective. I want to discovery which is more important in
healthcare system between in hospital or out of hospital. Iceberg
model is a good way to find a same solution to relevant problems.
The process aims at find ing the basic problem.
8
CO-CREATION WORKSHOP
We had 8 steps in the the workshop, but we just finished 2 steps in the
workshop. It is still meaningful. After the workshop, I collected the
problems and continued the iceberg model. This process is to find the
potential problems and from specific problem to new problem. Stand
on the system to form a system solution for the new general problem.I
use the iceberg model to find the basic and general problem. This is a
good way narrow my user research. Standard information system/
Suitable Diet/Money segment/Easy communication pipe/between
doctors7Good understanding between patients and doctors/Rescue
system/Bad rehabilitation quality/Family support
9
I interviewed with two patients deeply and a short random
access interview with Ten People. One was at his home for
3 hours. Another was in a cafe near his working place for
an hour. It is difficult for me to contact with patients in
Norway due to the protection policy.
USER RESEARCH
10
INTERVIEW A
I design an interview
based on problems
from the first
workshops, talking
about
overview,Things,Lifesty
le&Drug,Relationships(
community),family
support and rescue.
11
‘I believe my doctors.I don't need my children to support me. My children
visit me a lot, but I don't think they can support me for my troubles. They
just gave me some regular suggestions.’
‘I put this fitness equipment very close to my bed. It makes me feel safe,
when I do some excises.’
‘Healthy diet and nutrients work good for my trouble. 3 year ago, I followed
a healthy diet routine. The doctor told me my heart trouble was better after
that routine. I gave up, because it was a burden-money and a lot of steps,
and doctors gave me some new medicine.’
‘I use computer a lot. Mobile phone is important for me, because it means
communication.’
12
INTERVIEW B
‘I am afraid to take medicine and it make me feel like a
patient. Expect hypertension, I'm quite healthy.
Sometimes I forgot to take the medicine.’
13
Based on the deep interview, I choose what I am interested in to do a short
random interview. Two people is a small group for user research, but it is
difficult to go on deep interview many times.
9/10 people believe Norway’s healthcare system. They believe doctors
more than family members.Not like China, the healthcare are not very
good. The people are more relied on family
7/10 people believe good diet can treat disease and keep healthy, but it is
difficult to insist on a special diet.People can not insist on it because the
diet is expensive and with more steps to follow. People not address a lot
on diet.
9/10 people will forget to take medicine more than 4 times per month,
especially longterm medicine. The longterm medicine cause social
problem when they have medicine other people always ask their situation.
RANDOM ACCESS INTERVIEW
14
PROBLEM COMPARING MAP
Use this map to discover the problems.
Eg; the communications between doctors
Patient A agreed: he think it is not
necessary, he can be a bridge between
doctors.Patient B disagree: he told me
they just share information not discuss my
condition
15
I interviewed the leader of communication from LHL.LHL is
special organization, because they are not only an organization
but also owner of a hospital. They call this is a perfect healthcare
model. We had a 2 hour talk. Kristin told me some cases about
LHL- a social innovation for lung disease all around Norway
which is an activity for healing mental problem and the balance
between top-down structure and bottom up structure. They have
a project to develop an APP for cardiovascular patients.
I only know one doctor is my doctor in Oslo kommune,
Legevakten. She is always busy,but she sent me some paper
materials about healthcare system in Norway.
INTERVIEW WITH DOCTORS
16
GIGA-MAPPING HEALTHCARE SYSTEM IN NORWAY
General Process
Management System
Economic Process
After the interview, I used the insights and paper materials to
giga-mapping the healthcare system in Norway.
17
RESEARCH MAP
After finishing the research map, I put the potential problems in the whole
map and see their relationships in different levels, and think some
preliminary ideas.
18
DESIGN TREND
Based on structure in School of Design, CMU
Nowadays, design researcher divide the design area into three area.
Based on this structure, I work out three different preliminary ideas.
19
Good Understanding
between Patients and Doctors
Good understanding between patients and doctors is
potential area. Opposite opinions and some same views
make this area active. It can evolve in a long journey for
patients in existing system.
ARE
SYSTEM
PATIENTS
GOOD CASES
using risk based approach to redesign service
empower individuals
organize care for needs not diseases
payments on results not activity
integrating care across doctors and patients
long investment for system
invest in climate adaptation
standard
develop safety cases
creating cultures and midgets
manage risk locally
ED
decision making
incorporating their abilities
preferences
lifestyle
own treatment
patient engagement
sustainable hospital
mobile health
health alliance
digital appointment
measuring true value
knowledge sharing
Patients’ Journey & Existing System
moderate change
Medical Case Paper
Visual Communication&
Interaction Design
PRELIMINARY IDEA ONE
20
Culture Driven/
Professional Power
Service Design/
Interaction Design
ED CARE
SYSTEM
PATIENTS
GOOD CASES
using risk based approach to redesign service
empower individuals
organize care for needs not diseases
payments on results not activity
integrating care across doctors and patients
long investment for system
invest in climate adaptation
standard
develop safety cases
creating cultures and midgets
manage risk locally
OCIAL NEED
decision making
incorporating their abilities
preferences
lifestyle
own treatment
patient engagement
sustainable hospital
mobile health
health alliance
digital appointment
measuring true value
knowledge sharing
z
TY CULTURE VALUE SAFETY
BELIEFS
ATTITUDES
PERCEPTIONS
Communications founded on
mutual trust
Confidence in the efficacy of
preventive measures.
Shared perceptions of the
importance of safety
z
Patients’ Journey & Emerging System
significant change
Rehabilitation Based on
Community
PRELIMINARY IDEA TWO
21
Change Medicine Industry
Deign for Radical Change
There are lot of research about cardiovascular patient to map the
new system based on trend study. Create new scenario to
interact with people under patient centered care to promote the
new system.I hope to use design method to promote the
hospital or medicine industry can change their role in the system.
PRELIMINARY IDEA THREE
22
leverage points
23
First Co-creation Workshop
24
People
Resource
Interactions
Mechanisms of Change
Direction/
Idea
IDEA ONE IDEA TWO IDEA THREE
preliminary idea
Use PRISM to Improve Ideas
1
2
LEVERAGE
POINTS3
Improve Ideas
PRISM METHOD from InWithForward
PROCESS
25
26
Specialist
Nurse
Object/Display
in hospital
Patients
Interaction
APPiPhone
iWatch
Website
at home
Object
GP
collect
data
Visualization
Information
Mechanisms of Change
Contributing & Reciprocating
to increase meaning & purpose
Good touched visualization can increasing
the meaning for experience and increase
purpose frothier health.
Scale
Daily life/Hospital
The young/Middle-aged
Object/Environment
Interaction/Product
IDEA ONE
27
DAILY LIFE
Interaction Design
Product Design
IN HOSPITAL
Interaction Design
Product Design
it is a good Kickstarter project. It is a real digital object or some
object combined with iwatch or iPhone. In hospital maybe is a
screen connected to customer’s app and doctor’s system. This
is a holistic design involve in different scenarios.
IDEA ONE
28
Change the structure
of information flows
IDEA ONE
29
Frida is a middle age guy. He is crazy about
apple products. He has a great job in a band
which means he is super busy everyday.
One day he felt bad, and go to see doctor. He
was diagnosed with high blood pressure.
a was sad. He though he was too busy to notice
his health condition, Although he had some
apps for his health.
One day, he found a fabulous flower. He
brought it to home.
That’s a magic flower. The feel bad, The flower will also be in
super bad condition.That’s great visualization to make him
realize his health condition.
HEALTH
TIME
HEALTH
TIME
IDEA ONE
30
Resources
DNV GL
Research
Resources
(Standard of
Health)
LHL
(consultant)
People
Cardiovascular
Patients
General Doctors
Specialist
Nurse
Interactions
CHECKLIST
LIFESTYLE
GUIDE CHECKLIST
REHEBITATION
GUIDE
CHECKLIST
NOTICE MEDICINE STORY BOOK
OPERATION
PROCESS
his pack gift is a holistic interaction between
customers and professionals.
Scale
Daily life-Hospital
Male-Female
Service-Management
Mechanisms of
Change
Feedback
to increase validation
& motivation
The goal is to use
feedback to change
and promote the
experience during the
process.
IDEA TWO
31
For the design part compare form and function like app or paper is
important.
The movie should be cartoon which not creates new mental problem.
Medicine management can applied in the gift pack system.
CHECKLIST
LIFESTYLE
GUIDE CHECKLIST
REHEBITATION
GUIDE
CHECKLIST
NOTICE MEDICINE STORY BOOK
OPERATION
PROCESS
APP Paper
Paper Cartoon
PaperDigital
Explore best form/materials/techniques/
ideas for gift pack
Daily Medicine
IDEA TWO
32
The gain around driving
positive feedback loops.
IDEA TWO
33
Laura is 50 years ago. She usually go to visit GP. At
that time, she got a gift pack.
Yes, a gift pack for her current situation. A
checklist to manage her diet and
CHECKLIST
LIFESTYLE
GUIDE
When her condition got worse and
worse, she went to see her GP. The GP
referred a special examination. At this
time, she got a gift pack.
This gift pack has some CHECKLIST
NOTICE
MEDICINE
after the special examination, She need a surgery.
Before the surgery, she got a gift pack. This gift
pack have a story book to soft her emotion and a
movie of the operation process.
STORY BOOK
OPERATION
PROCESS
After the surgery, she also
got a gift pack.
In this gift pack, there is a check
list and rehebitation guide book
CHECKLIST
REHEBITATION
GUIDE
IDEA TWO
34
Diversity and deep understanding of food and medicine
change the role of food and medicine.Food can be a
treatment.Medicine is for keeping health, not for
treatment.More and more medicine companies evolve in
food industry.
Resources
DNV GL
Research Resources
(Standard of Health/
Patient Centered Care)
Designers
(consultant)
IDEA THREE
Mechanisms of Change
Taster Experiences
to shape preferences & goals
Barrier Busting
to manage stressors & increase
future orientation
This direction is aim at shaping
the preferences and goals also
increasing future orientation.
Trend
People
Cardiovascular
Patients
General Doctors
Specialist
Nurse
Hospital
Medicine Industry
DNV GL Research
Group
Government
http://www.kenko.com/product/
item/itm_6924185772.html
35
Food and medicine in future not just the object. It will will be with a lot of
information on itself and its package or people’s APP. Regard this, use the
food and medicine as a new touchpoint between the customers and
professors.This also change the role of supermarket and Pharmacy in
Future.Government should involve in it. DNV GL can be a certification
provider in new area
Scale
IDEA THREE
Trend
36
Change the rules of system
IDEA THREE
37
Co-design is a very interesting process based
on the background of DNV GL.
We can figure the form, function , techniques
and ideas for different stage.
It also will create other relevant design evolve
in this process, product and APP and service.
This is a good outcome to cause discussion of
the unclear Border between the food and
medicine.
IDEA THREE
38
CO-DESIGN WORKSHOP
39
We use the one way to identify the patients.
We ignore the identity for health for people.In
the workshop we used card sorting to do co-
design workshop.
Touchpoint: Medicine and Food
Card sorting for form/function/techniques/
idea in holistic process.
Based on human centered design.
SEVERAL MONTHS
PREVENTION VISIT GP MAKE A TENTATIVE DIAGNOSIS RECEIVING S EXAMINATION
REFERS TO AN S DEPARTMENT
GP/( PUBLIC HOSPITAL)
EXAMINATION
OPERATION
NECESSARY MEDICATION
SURGERY
PUBLIC HOSPITAL
PRIVATE HOSPITAL
REHABILITATION AT HOSPITAL
SHORT TIME
HELFO
GP
VISIT GP
A
B
C
D
CO-DESIGN WORKSHOP
40
T�ea���n� K��� He�l��
Fish Oil
Collagen
Te�
Ve�et����
Fi��
F��i�
J�i�� Nu����nt�
Nu����nt�G���i�
Me�i���� f�� L�n�-����
ACEI
Captopril/Enalapril//Perindopril/Benaz-
epril/Iimidapril/Fosinopril/Ramipril
Me�i���� f�� L�n�-����
ARB
Losartan/Valsartan/Olmesartan/Telmisartan/-
Candesartan/Iirbesartan
Me�i���� f�� L�n�-����
B blockers
Metoprolol/Bisoprolol/Atenolol/Esmo-
lol/Propranolol
Me�i���� f�� L�n�-����
Calcium channel blockers
Nifedipine/Felodipine/Amlodipine/Dilti-
azem/Verapamil
Me�i���� f�� L�n�-����
Diuretics
Furosemide/Hydrochlorothia-
zide/Indapamide/Spironolactone
Me�i���� f�� L�n�-����
Antiplatelet and anticoagulants
Aspirin/Clopidogrel/Tirofiban
Hydrochloride/Heparin/Warfarin
Me�i���� f�� ���p���n�
Coenzyme Q10
Me�i���� f�� ���p���n�
Cyclic Adenosine Monophosphate
Me�i���� f�� �h��-����
A blocker
Prazosin/Terazosin
Me�i���� f�� �h��-����
Anti-ischemic
Nitroglycerine/Isosorbide Dinitrate
Me�i���� f�� �h��-����
Thrombolytic
Urokinase/Streptokinase/rt-PA
Me�i���� f�� �h��-����
Lipid regulating
Atorvastatin Calcium/Rosuvastatin
Calcium
Me�i���� f�� �h��-����
Anti-arrhythmic
Quinidine/Propranolol/Amiodarone
/Verapamil
Me�i���� f�� �h��-����
Inotropic agents
Digoxin/Cedilanid/Milrinone
Me�i���� f�� �h��-����
Anti-shock
Dopamine/Adrenaline/Atropine
Treatment
Keep Health
NEW CLARIFICATION
41
IDEA FROM WORKSHOP
IT’S TIME TO HAVE A
IT’S TIME TO HAVE B
IT’S
For keeping health.
For keeping health.
For treatment.
(even through the chronic disease people have
same image with normal people)
Treatment Keep Health
One day
package
X days package
After x days, people will
have a examination
Interaction identity Package identity
IT’S
IT’S
IT’S
Health Map
good bad
Visual Report
42
DESIGN DEFINITION
A TOOL TO COMMUNICATE WITH
DOCTORS
REDESIGN THE
IDENTITY OF
MEDICINE AND
DIET IN SMART
NOT JUST
APPEARANCE
➤ Redesign the identity for medicine and food
➤ Design a professional way for people to
communicate with doctors outside of
hospital.
Norway has a good healthcare system. People believe the
professionals than other pipes. The professional communication tools
are necessary for people even through they are just at high risk of
cardiovascular patients. It difficult to change the identity of medicine
and food trough directly way package or appearance, but
digitalization still provides some opportunities to change the identity
of the medicine and food. All the things require me to regard App as a
touchpoint to connect the different touch points to make a holistic
service for customers. HELFO is making the patients information
standard which play an important role on the App which can be easily
set up in future. Design is increasingly important in healthcare system.
App is also a good factor to change the whole system,
43
prototype
44
TREATMENTKEEP HEALTHYPREVENTION
HOLISTIC PROCESS
45
MAKE APP WITH MODULAR FUNCTION
46
an easy way
to
keep you
from
cardiovascular disease
Dear Lily,
Depending on your current situation ( see your document ), I think you are at a high risk of
cardiovascular disease, but don't worry about it, it is not serious, if you follow these steps.
STEP ONE
Suitable Exercise and a Balance Diet as possible as you can, this is not just for prevention but
also a good daily life.
STEP TWO
Most important things for diet are salt and fat. I recommended the max daily amount of salt is
6.00g and the max daily amount of fat is 6.00g.
STEP THREE
Download this lovely APP - healcaedio. This is a important bridge between us.
1. It can help you to track fat and salt.
2. You can use it to manage your body data.
3. You can use it to communicate with me, and share the data you like to share. I can give you
feedback as soon as possible and make a future plan.
Sign up
Enter this code: 463284325324
Remember that we use healcardio together. Don't feel alone.
Your GP
PREVENTION
USER’S JOURNEY
Actually people can not have a talk about suggestion for their
future healthy life. Depending on the user research, people
prefer to listen to professional people suggestions. Due to this
reason, creating a very professional scenario is necessary for
people. This is easy way to make the people follow the
suggestion for prevention. They will begin their prevention
from GP., regarding the prevention process as a professional
treatment.
Visual report is a strategy for engaging doctors. Doctors is very
busy. Making a simple and meaningful image based on data is
a good way to save time for doctors. The doctors can give a
feedback in a short time, also creating a positive quick
feedback for patients.
47
KEEP HEALTHY
In future, delivery medicine is a obvious trend. But
people is afraid of delivery medicine. 4/5 people think
they hope their doctor can make sure the medicine is
correct through the delivery system. This point will create
a new business model in future. Who can be in charge of
the medicine to delivery.. This system should be very
flexible for different customers.
48
testing
c o l l e c t
d a t a
o k
o kc o l l e c t
d a t a
b l o o d p r e s s u r e
h e a r t r a t e
000mmHg / 000mmHg
000/min
130mmHg
85mmHg
10/24
2015
10/24
2015
10/24
2015
10/24
2015
10/24
2015
10/24
2015
10/24
2015
10/24
2015
60/min
100/min
10/24
2015
10/24
2015
10/24
2015
10/24
2015
10/24
2015
10/24
2015
10/24
2015
10/24
2015
h e a l c a r d i o
PM
TREATMENT
USER’S JOURNEY
There are already a lot of APPs tracking the body
data. For simplifying the healcardio. healcardio can
get the data directly from other APPs like ihealth,
during the clickable prototype test, 4/5 people felt
confused and difficult to use it, if they can use
healcardio to collect data directly.
49
Comparing the APPs on
the market, most of the
Apps are green. To
create a uniqle brand, I
choose to use single
main color red with a
soft style. The basic
principle of the Apps is
simplicity. I will follow it.
h e a l c a r d i o
sign in
sign up
An angel for your heart.
Gill Sans
Adobe Caslon
Avenir Next
Color Font
Soft
Sharp
Multiple
Color
Single
Color
BRANDING
50
IDENTITY OF DESCRIPTION
New Journey
for
you
01/10/1015 to 01/11/1015
Dear Lily,
As I said through healcardio, your situation is quite nice.Continue to take Aspirin & Metoprolol to
keep health.
ASPIRIN
This is an element for prevent heart attacks, strokes, and chest pain.
Take 1 tablet everyday at the beginning of happy days before breakfast.
Scan Code
Put on your Aspirin Package
METOPROLOL
This is an element for prevent high blood pressure and chest pain.
Take 1 tablet at the morning and 1 tablet at evening before diet everyday.
Scan Code
Put on your Metoprolol Package
Your GP
THIS IS FOR PHARMACY OR SHOPPING ONLINE
CODE:
DFBFSDA89DDA
Scan Code
Nitroglycerin
01/10/1015 to 05/10/1015
Dear Lily,
is Nitroglycerin is for a 5 days treatment, you should take it very carefully before
next week examination.
How
Take 1 tablet at 7:00am&9:00pm everyday.
Do NOT swallow, chew, or crush this tablet. Dissolve the tablet
under the tongue or between the cheek and gum.To treat an
angina attack, use nitroglycerin tablets at the first sign of chest
pain. Sit quietly while the tablet is dissolving.
WHAT
Preventing or relieving a sudden attack of chest pain caused by heart disease. Nitroglycerin is a nitrate. It works by
dilating (widening) blood vessels. Chest pain occurs when the heart needs more oxygen than it can get. Dilating
blood vessels allows blood to flow more easily. This reduces the heart's workload and the amount of oxygen needed
by the heart.
NOTICE
Do NOT use nitroglycerin tablets if:
you are allergic to any ingredient in nitroglycerin tablets
you have increased pressure in the head
you have severe anemia
Your Doctor
!"#$%&'()*$"+ !"#$%&'()*$"+
,'%%-./*00*'0
!"#$%&'()*$"+
,%+&-*
an easy way
to
keep you
from
cardiovascular disease
Dear Lily,
Depending on your current situation ( see your document ), I think you are at a high risk of
cardiovascular disease, but don't worry about it, it is not serious, if you follow these steps.
STEP ONE
Suitable Exercise and a Balance Diet as possible as you can, this is not just for prevention but
also a good daily life.
STEP TWO
Most important things for diet are salt and fat. I recommended the max daily amount of salt is
6.00g and the max daily amount of fat is 6.00g.
STEP THREE
Download this lovely APP - healcaedio. This is a important bridge between us.
1. It can help you to track fat and salt.
2. You can use it to manage your body data.
3. You can use it to communicate with me, and share the data you like to share. I can give you
feedback as soon as possible and make a future plan.
Sign up
Enter this code: 463284325324
Remember that we use healcardio together. Don't feel alone.
Your GP
I asked users to make sequences
based on professional. 1=not
professional, 3=professional
A:2 1 3/ B:1 2 3/C:2 1 3/D:2 1 3/E:
1 2 3
Use color for different stages.
Keeping Health and Prevention
stages have the same color.
Treatment is use another color to
show the process should be paid
more attention.
The illustration is very necessary.
4/5 users think it is useful.
51
5/5 users think they can use healcardio through doctors. They don't
think they can use an APP through the APPs store directly.
I asked users to make sequences based on professional. 1=not
professional, 3=professional
A:2 1 3/ B:1 2 3/C:2 1 3/D:2 1 3/E:1 2 3
Use color for different stages.
Keeping Health and Prevention stages have the same color.
Treatment is use another color to show the process should be paid
more attention.
The illustration is very necessary. 4/5 users think it is useful.
52
Two Action One Action
YESorNO
IDENTITY OF DESCRIPTION
Two Action
53
Test with clickable prototype
9 54
IDENTITY OF DESCRIPTION
accurate
joyful
Joyful
Accurate
Use professional way to address the importance on diet. People use this
way to communicate with doctors and get encourage.Use the joyful
interaction way to change the identity of long-term medicine and make this
activity more relaxed.Checklist is the most familiar way for users. This way
can provide professional and accurate interaction way.Test for accurate and
joyful. This quality is low. Due to the test group are 5 people.
55
Salt
0.50g 0.50g 0.50g 0.50g 0.50g
IDENTITY OF FOOD
I sent my idea to my interviewees before
through the e-mail. Surprisedly, they think this
is a problem for them not just for salt and fat.
Sometimes their doctors to ask them to have
fix amount of food, but they don't have ability
to measure them.
56
New Journey
for
you
01/10/1015 to 01/11/1015
Dear Lily,
As I said through healcardio, your situation is quite nice.Continue to take Aspirin & Metoprolol to
keep health.
ASPIRIN
This is an element for prevent heart attacks, strokes, and chest pain.
Take 1 tablet everyday at the beginning of happy days before breakfast.
Scan Code
Put on your Aspirin Package
METOPROLOL
This is an element for prevent high blood pressure and chest pain.
Take 1 tablet at the morning and 1 tablet at evening before diet everyday.
Scan Code
Put on your Metoprolol Package
Your GP
THIS IS FOR PHARMACY OR SHOPPING ONLINE
CODE:
DFBFSDA89DDA
SHOPPING ONLINE
STICKERS
When people prefer to believe the professions, feedback becomes
important. It doesn't mean doctor should do anything for their
customers. We don't have enough medical staff to provide an
extremely good user experience. Thus, the way of people to take the
medicine, I choose empowering the individual to make a small change
for future change. People use the sticks to manage the medicine by
themselves.
IDENTITY OF MEDICINE
57
New Journey
for
you
01/10/1015 to 01/11/1015
Dear Lily,
As I said through healcardio, your situation is quite nice.Continue to take Aspirin & Metoprolol to
keep health.
ASPIRIN
This is an element for prevent heart attacks, strokes, and chest pain.
Take 1 tablet everyday at the beginning of happy days before breakfast.
Scan Code
Put on your Aspirin Package
METOPROLOL
This is an element for prevent high blood pressure and chest pain.
Take 1 tablet at the morning and 1 tablet at evening before diet everyday.
Scan Code
Put on your Metoprolol Package
Your GP
THIS IS FOR PHARMACY OR SHOPPING ONLINE
CODE:
DFBFSDA89DDA
Scan Code
Nitroglycerin
01/10/1015 to 05/10/1015
Dear Lily,
is Nitroglycerin is for a 5 days treatment, you should take it very carefully before
next week examination.
How
Take 1 tablet at 7:00am&9:00pm everyday.
Do NOT swallow, chew, or crush this tablet. Dissolve the tablet
under the tongue or between the cheek and gum.To treat an
angina attack, use nitroglycerin tablets at the first sign of chest
pain. Sit quietly while the tablet is dissolving.
WHAT
Preventing or relieving a sudden attack of chest pain caused by heart disease. Nitroglycerin is a nitrate. It works by
dilating (widening) blood vessels. Chest pain occurs when the heart needs more oxygen than it can get. Dilating
blood vessels allows blood to flow more easily. This reduces the heart's workload and the amount of oxygen needed
by the heart.
NOTICE
Do NOT use nitroglycerin tablets if:
you are allergic to any ingredient in nitroglycerin tablets
you have increased pressure in the head
you have severe anemia
Your Doctor
!"#$%&'()*$"+ !"#$%&'()*$"+
,'%%-./*00*'0
!"#$%&'()*$"+
,%+&-*
I sent a email to ask
two interviewees
before. Both of them
think they feel the
physical paper is
much safer than the
digitalization. They
will print it by
themselves if they
just have digital
edition.
4/5 users told that
they can use the
paper to check the
information on app.
This can set a safer
scenario.
SAFETY CULTURE
58
PROFESSIONAL COMMUNICATION
5/5 people during the test, they are happy to use healcardio to
communicate with doctors especially during the treatment stage. 2/2
doctors think this is a good way to communicate with patients. The doctors
doesn't want to make a link through their private APPs like imassage, eve
though a lot of patients want to add them.
Communication part is difficult to test in a short time. The problem here is
that should doctor can know anything. I just design one image for users to
communicate with others, some people doubt that they don't want show
some data to the doctors. If I make this apps just for cardiovascular
patients. Users (5/5) can accept the data to share (salt fat blood pressure
and heart rate)
Share the image with others through other SNS apps is better than
creating a fountain that they can use this apps with other family members
and other same people. This can make the apps more complex agains the
strategy simplicity. Through other platform can also make a better
integration.
59
FUTURE SYSTEM
This is new system in future. I hope use this project to show the holistic
process can not live without t system thinking. I found that it is difficult to do a
holistic experience now in Norway because the institution under government
is independent like helfo and public health center. There should be a
innovation center in future. Obviously with DNV GL basic research on
healthcare. more and more design industry will go into this system.
60
MAP
I W O R K W I T H
N E W I D E N T I T Y F O R F O O D A N D
M E D I C I N E I N S Y S T E M T H I N K I N G
H O L I S T I C P R O C E S S
F O R T H E
C A R D I O V A S C U L A R
A P R O F E S S I O N A L P I P E
B E T W E E N C U S T O M E R S
A N D D O C T O R S .
I W O R K F O R
SAFETY CULTURE
VALUE SAFETY
BELIEFS
ATTITUDES
PERCEPTIONS
Communications founded on
mutual trust
Confidence in the efficacy of
preventive measures.
Shared perceptions of the
importance of safety
PATIENT CENTERED CARE
SYSTEM
PATIENTS
GOOD CASES
using risk based approach to redesign service
empower individuals
organize care for needs not diseases
payments on results not activity
integrating care across doctors and patients
long investment for system
invest in climate adaptation
standard
develop safety cases
creating cultures and midgets
manage risk locally
PHYSICAL/PSYCHOLOGICAL/SOCIAL NEED
decision making
incorporating their abilities
preferences
lifestyle
own treatment
patient engagement
sustainable hospital
mobile health
health alliance
digital appointment
measuring true value
knowledge sharing
professional
patients
researchers
policy makers
STATEHOLDERS INFLUENCE FACTORS
equality
sustainability
EVALUATION
environment
timeliness
cost
efficiency
person
centered
safety
debt crsis/coherent
aging population/equal
expanding
government leading
urban and rural
high cost/serious pressure
gap between
the rich and poor
MAIN MARKET
conservative culture
patient habits and preference
sector fragmentation
GENERAL PROBLEM
aging population
emerging disease pattern
climate change
rising costs
inequitable access
poor safety record
no holistic care
SPECIFIC PROBLEMS
1/10 patients harmed in hospital
dementia/chronic increase
ICT is slow
poor coordinated effort
CARDIOVASCULAR
STATE/NATIONAL BUDGET
CITIZENS / EMPLOYERS/PATIENTS
REGIONAL HEALTH AUTHORITIES
LOCAL GOVERNMENT (MUNICIPALITIES / COUNTIES)
HELFO
PUBLIC HOSPITALS
PRIVATE SPECIALISTS
PRIVATE HOSPITALS
GP
NURSING HOMES AND LONG-TERM CARE
DENTAL CARE FOR CHILDREN AND OTHER DEFINED GROUPS
NATIONAL TAXES
LOCAL TAXES
FINANCIAL SYSTEM
maritime
sustainable organisation
(environmental/social/economic-longterm)
FOOD&WATER/OIL&GAS/ELECTRICITY&RENEWABLE/SHIPPING
SAFER
SMARTER
GREENER
SAFE AND
SUSTAINABLE
FUTURE
oil and gas
energy
business insurance
software
AREABRANDING
MANAGE RISK
BUILD TRUST
HEALTHCARE INNOVATION
global impact
aligning split incentives
managing system risks
empowering stakeholders
accounting for value
transforming mindset
an easy way
to
keep you
from
cardiovascular disease
Dear Lily,
Depending on your current situation ( see your document ), I think you are at a high risk of
cardiovascular disease, but don't worry about it, it is not serious, if you follow these steps.
STEP ONE
Suitable Exercise and a Balance Diet as possible as you can, this is not just for prevention but
also a good daily life.
STEP THREE
Most important things for diet are salt and fat. I recommended the max daily amount of salt is
6.00g and the max daily amount of fat is 6.00g.
STEP FOUR
Download this lovely APP - healcaedio. This is a important bridge between us.
1. It can help you to track fat and salt.
2. You can use it to manage your body data.
3. You can use it to communicate with me, and share the data you like to share. I can give you
feedback as soon as possible and make a future plan.
Sign up
Enter this code: 463284325324
Remember that we use healcardio together. Don't feel alone.
Your GP
New Journey
for
you
01/10/1015 to 01/11/1015
Dear Lily,
As I said through healcardio, your situation is quite nice.Continue to take Aspirin & Metoprolol to
keep health.
ASPIRIN
This is an element for prevent heart attacks, strokes, and chest pain.
Take 1 tablet everyday at the beginning of happy days before breakfast.
Scan Code
Put on your Aspirin Package
METOPROLOL
This is an element for prevent high blood pressure and chest pain.
Take 1 tablet at the morning and 1 tablet at evening before diet everyday.
Scan Code
Put on your Metoprolol Package
Your GP
THIS IS FOR PHARMACY OR SHOPPING ONLINE
CODE:
DFBFSDA89DDA
Scan Code
Nitroglycerin
01/10/1015 to 05/10/1015
Dear Lily,
is Nitroglycerin is for a 5 days treatment, you should take it very carefully before
next week examination.
How
Take 1 tablet at 7:00am&9:00pm everyday.
Do NOT swallow, chew, or crush this tablet. Dissolve the tablet
under the tongue or between the cheek and gum.To treat an
angina attack, use nitroglycerin tablets a f chest
pain. Sit quietly while the tablet is dissolving.
WHAT
Preventing or relieving a sudden attack of chest pain caused by heart disease. Nitroglycerin is a nitrate. It works by
dilating (widening) blood vessels. Chest pain occurs when the heart needs more oxygen than it can get. Dilating
re easily. This reduces the heart's workload and the amount of oxygen needed
by the heart.
NOTICE
Do NOT use nitroglycerin tablets if:
you are allergic to any ingredient in nitroglycerin tablets
you have increased pressure in the head
you have severe anemia
Your Doctor
!"#$%&'()*$"+ !"#$%&'()*$"+
,'%%-./*00*'0
!"#$%&'()*$"+
,%+&-*
MANAGEMENT SYSTEM
NATIONAL INSURANCE SCHEME
MINISTRY OF LABOUR
HOSPITALS
HOSPITAL TRUSTS
REGIONAL HEALTH AUTHORITIES
MINISTRY OF HEALTH AND CARE SERVICES
GOVERNMENT
PARLIAMENT DENTAL PRIMARY CARE CARE PROVIDERS
PRIMARY CARE CARE PROVIDERS PROVIDERS
MUNICIPALITIES
COUNTIES
DIRECTORATE OF HEALTH (INCL. HELFO)
BOARD OF HEALTH SUPERVISION
INSTITUTE OF PUBLIC HEALTH
MEDICINES AGENCY
RADIATION PROTECTION AGENCY
BIOTECHNOLOGY ADVISORY BOARD
SYSTEM OF PATIENT INJURY COMPENSATION
SAK
NOKC
POBO
61
USER RESEARCH
CARDIOVASCULAR
PATIENTS
DIAGNOSE
EMERGENCY
RESCUE
EMERGENCY
RESCUE
EMERGENCY
RESCUE
REGULAR
INSPECTION
REGULAR
INSPECTION
STANDARD INFORMATION SYSTEM
ENOUGH DOCTOR AND NURSE
MONEY SEGMENT
EASY COMMUNICATION PIPE
BETWEEN DOCTORS
GOOD UNDERSTANDING
BETWEEN PATIENTS AND DOCTORS
RESCUE SYSTEM
BAD REHABILITATION QUALITY
FAMILY SUPPORT
YES
NO
PERSPECTIVE
PERSPECTIVEPATIENT A
PATIENT B PERSPECTIVE
an easy way
to
keep you
from
cardiovascular disease
Dear Lily,
Depending on your current situation ( see your document ), I think you are at a high risk of
cardiovascular disease, but don't worry about it, it is not serious, if you follow these steps.
STEP ONE
Suitable Exercise and a Balance Diet as possible as you can, this is not just for prevention but
also a good daily life.
STEP THREE
Most important things for diet are salt and fat. I recommended the max daily amount of salt is
6.00g and the max daily amount of fat is 6.00g.
STEP FOUR
Download this lovely APP - healcaedio. This is a important bridge between us.
1. It can help you to track fat and salt.
2. You can use it to manage your body data.
3. You can use it to communicate with me, and share the data you like to share. I can give you
feedback as soon as possible and make a future plan.
Sign up
Enter this code: 463284325324
Remember that we use healcardio together. Don't feel alone.
Your GP
New Journey
for
you
01/10/1015 to 01/11/1015
Dear Lily,
As I said through healcardio, your situation is quite nice.Continue to take Aspirin & Metoprolol to
keep health.
ASPIRIN
This is an element for prevent heart attacks, strokes, and chest pain.
Take 1 tablet everyday at the beginning of happy days before breakfast.
Scan Code
Put on your Aspirin Package
METOPROLOL
This is an element for prevent high blood pressure and chest pain.
Take 1 tablet at the morning and 1 tablet at evening before diet everyday.
Scan Code
Put on your Metoprolol Package
Your GP
THIS IS FOR PHARMACY OR SHOPPING ONLINE
CODE:
DFBFSDA89DDA
Scan Code
Nitroglycerin
01/10/1015 to 05/10/1015
Dear Lily,
is Nitroglycerin is for a 5 days treatment, you should take it very carefully before
next week examination.
How
Take 1 tablet at 7:00am&9:00pm everyday.
Do NOT swallow, chew, or crush this tablet. Dissolve the tablet
under the tongue or between the cheek and gum.To treat an
angina attack, use nitroglycerin tablets a f chest
pain. Sit quietly while the tablet is dissolving.
WHAT
Preventing or relieving a sudden attack of chest pain caused by heart disease. Nitroglycerin is a nitrate. It works by
dilating (widening) blood vessels. Chest pain occurs when the heart needs more oxygen than it can get. Dilating
re easily. This reduces the heart's workload and the amount of oxygen needed
by the heart.
NOTICE
Do NOT use nitroglycerin tablets if:
you are allergic to any ingredient in nitroglycerin tablets
you have increased pressure in the head
you have severe anemia
Your Doctor
!"#$%&'()*$"+ !"#$%&'()*$"+
,'%%-./*00*'0
!"#$%&'()*$"+
,%+&-*
an easy way
to
keep you
from
cardiovascular disease
Dear Lily,
Depending on your current situation ( see your document ), I think you are at a high risk of
cardiovascular disease, but don't worry about it, it is not serious, if you follow these steps.
STEP ONE
Suitable Exercise and a Balance Diet as possible as you can, this is not just for prevention but
also a good daily life.
STEP THREE
Most important things for diet are salt and fat. I recommended the max daily amount of salt is
6.00g and the max daily amount of fat is 6.00g.
STEP FOUR
Download this lovely APP - healcaedio. This is a important bridge between us.
1. It can help you to track fat and salt.
2. You can use it to manage your body data.
3. You can use it to communicate with me, and share the data you like to share. I can give you
feedback as soon as possible and make a future plan.
Sign up
Enter this code: 463284325324
Remember that we use healcardio together. Don't feel alone.
Your GP
85-130
mmHg
60-100
/min
Salt:6g
Fat:66g
k e e p
h e a l t h
blood
pressure
heart
rate
62
Report yue
reference
44
44
Giga-mapping: Visualisation for Complexity and
Systems Thinking in Design.
Birger Sevaldson
Dancing With Systems
Donella Meadows
Types of Systemic Relations
Birger Sevaldson
The Design Way
Intentional Change in an Unpredictable World
Harold G. Nelson
7 Reasons Why Our Social Services Keep Failing: An
Argument for Grounded Change
Dr. Sarah Schulman
Design For Care
Peter Jones
Prototype Evaluation in Service Design
A Case Study at an Emergency Ward
Johan Blomkvist
Radical Redesign
The Australian Center for Social Innovation
Healthcare 2050
DNV GL
Patient Centered Care
DNV GL
Transitions to Sustainable Development: New Directions
in the Study of Long Term Transformative Change
Grin J, Rotmans J
reflections
44
44
This is a meaningful semester to know something new.
In the studio, I learnt system oriented design systematically. I know how to
use the system to set up a design project from research to systematic impact
step by step. I can use giga-mapping in different ways. At the beginning,
using the giga-mapping to find a start point-ZIP. This is most important thing
for the complex problems which is difficult to find a correct stone to carry on.
After that, gaga-mapping can also be used as a tool to find the relationships
between problems especially combined with iceberg model. Giga-mapping
can also be used in design process which can make me figure out a holistic
solution easily and know the relationships between different touch points.
Giga-mapping is a great process crossing the whole design process.
Cooperation with DNV GL is a super happy process. They have done a lot of
project about healthcare and are a global company. In this way, I can get a
big picture of healthcare system all around world, and this is a great way to
understand the different culture between Norway, China and other countries
after the deep user researches this semester. I’m luck to visit Mayo Clinic
which provide me a deep understanding of healthcare system.
I think the result of this semester is good, even through the design seems to
be unclear and not very interesting. The meaningful part is that this result is
from system thinking not just from a good idea. Seeing the whole system
map, I think my design is effective and really can benefit people in a holistic
perspective. This project is not addressing single design. I think my design
can make the whole touchpoint work together for a systematic impact.
It is not enough time to understand the system oriented design just for one
semester. It is obvious that I need a long time to practice the system thinking.
I’m not familiar with the all the context of create a positive systematic impact
for my design. There are so many method to create leverage points. In a real
system, there are many methods which can be used together at the same
time. When I consider the system impact, I often forgot to use multiple ways
to create systematic impact on my own system. Using one design which can
address different methods is quite difficult.
44
I’m struggling with the balance between system and design. Sometimes I will
face a conflict between a good idea from creativity and a normal idea from
system thinking. I don't know how to adapt them to each other and put the a
good idea from creativity in system thinking. This process is quite difficult.
Some good ideas are not very relevant with each other, but normal ideas can
be seen as a group power. System oriented design is quite difficult to
evaluate in real world for a student. It is difficult for me to say which is better.
Foreigner is difficult to do user research sometimes. Native language is
important for interviews. This can make the interviewees into a familiar
scenario. I met another interesting problem. This happened during my
random access interview with 10 people. I ask them if they think Norway has
a good healthcare system. 9/10 told me they think Norway has a great
healthcare system. For me, my Norwegian friends complained a lot about
healthcare service in Norway, but it is difficult for me to ask something bad in
Norway’s healthcare system. I guess the reason is national pride.
Time management is urgent issue for me this semester. Everybody has the
same deadline which gave me a lot of pressure. Everyone has different
projects, in this situation I think the amount of work is different at different
stages. The same deadline sometimes make me super busy and sometimes
have little thing to do. I have no balance speed this semester. I used the
textbook time to balance my time, but I will forgot the knowledge, if I didn't
do any practice.
I hope I can practice system oriented design method more to understand
this complex world.
44

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Report yue

  • 1. h e a l c a r d i o SYSTEM ORIENTED DESIGN A holistic solution for the cardiovascular Yue Zou
  • 3. SYSTEM ORIENTED DESIGN A holistic solution for the cardiovascular h e a l c a r d i o This project submitted to the Oslo School of Architecture and Design for System Oriented Design Studio cooperated with DNV GL Yue Zou, author Linda Blaasvær, Manuela Aguirre, advisor
  • 5. ABSTRACT What is the future healthcare in future? Design itself is a important power to make the healthcare system change a lot. This project is aimed at exploring the future healthcare service in system thinking to make a holistic process and assumption of future system. Cardiovascular patients is a biggest group in the world. I hope working with this group can bring a lot of inspiration for other healthcare issue. In this project, I use strategy design, service design and interaction design method to create a hotlist service for cardiovascular patients out of the hospital. Nowadays a lot of people are suffering from longterm diseases and having high risk of cardiovascular. The food is a good way to address this problem. The meaning of the food and medicine are changing. The longterm medicine cause a mental problem at the beginning. The industry of medicine are struggling with their development, The goal of this project is to discuss the touchpoint food and medicine to address all the problems here, using system design methodology.
  • 7. KNOWLEDGEMENTS Thank you to my advisor Linda and Manuela for their support and guidance on this project. Thanks also for Mosse and Natalia for their tutoring of interaction design and service design. Thanks a lot for my partners, Marius, Stephen and other people from DNV GL healthcare innovation center. We had great workshops during this project.
  • 8. CONTENTS • research 1 • leverage points 23 • prototyping 44
  • 12. WHY CARDIOVASCULAR One in four deaths (12.9 million) was from heart disease or strike in 2010. Two in three deaths worldwide were from chronic diseases in 2010 Most cardiovascular diseases can be prevented by addressing lifestyle - related risk factors. It’s obvious that cardiovascular is the biggest groups which means most important..There are two things for me. Firstly, I hope other disease can also get some insight from my project. Secondly,it’s easily to contact the patients easily. 3
  • 14. MY PARTNER My partner DNV GL is quite a world leading group which is famous for give certification to organizations including hospitals. I’m working with healthcare innovation in DNV GL. Safer, smarter and greener is a process for the society to transformative. Sustainability needs transformative. This three words is a good evaluation for my project. Digitalization, localization are the good strategy for the branding.The main target group is China, USA, European(Norway).The evolution part is valuable as a starting point. Holistic care is necessarily. 5
  • 15. DNV GL healthcare innovation center has done a lot of projects. They are focusing on human centered care. These general principle of patient centered care from DNV GL can give me a lot of inspiration to imply in my project. The principle has many different levels perspectives from individual level to system level.what is safety culture? It’s a big question. I use giga-mapping to figure out the DNA of safety culture. I found three words to support the DNA-SHARED EFFICIENCY TRUST. 6
  • 16. CO-CREATION WORKSHOP This is first workshop in DNV GL. Because healthcare is a big image and my client did not give me any limitation in direction at beginning. I think I should find a start point to work with. This co-creation workshop’s main goal is to find some general problem of the cardiovascular in professional’s perspective. 7
  • 17. Using timeline is a good way to find different problems in a holistic perspective. I want to discovery which is more important in healthcare system between in hospital or out of hospital. Iceberg model is a good way to find a same solution to relevant problems. The process aims at find ing the basic problem. 8
  • 18. CO-CREATION WORKSHOP We had 8 steps in the the workshop, but we just finished 2 steps in the workshop. It is still meaningful. After the workshop, I collected the problems and continued the iceberg model. This process is to find the potential problems and from specific problem to new problem. Stand on the system to form a system solution for the new general problem.I use the iceberg model to find the basic and general problem. This is a good way narrow my user research. Standard information system/ Suitable Diet/Money segment/Easy communication pipe/between doctors7Good understanding between patients and doctors/Rescue system/Bad rehabilitation quality/Family support 9
  • 19. I interviewed with two patients deeply and a short random access interview with Ten People. One was at his home for 3 hours. Another was in a cafe near his working place for an hour. It is difficult for me to contact with patients in Norway due to the protection policy. USER RESEARCH 10
  • 20. INTERVIEW A I design an interview based on problems from the first workshops, talking about overview,Things,Lifesty le&Drug,Relationships( community),family support and rescue. 11
  • 21. ‘I believe my doctors.I don't need my children to support me. My children visit me a lot, but I don't think they can support me for my troubles. They just gave me some regular suggestions.’ ‘I put this fitness equipment very close to my bed. It makes me feel safe, when I do some excises.’ ‘Healthy diet and nutrients work good for my trouble. 3 year ago, I followed a healthy diet routine. The doctor told me my heart trouble was better after that routine. I gave up, because it was a burden-money and a lot of steps, and doctors gave me some new medicine.’ ‘I use computer a lot. Mobile phone is important for me, because it means communication.’ 12
  • 22. INTERVIEW B ‘I am afraid to take medicine and it make me feel like a patient. Expect hypertension, I'm quite healthy. Sometimes I forgot to take the medicine.’ 13
  • 23. Based on the deep interview, I choose what I am interested in to do a short random interview. Two people is a small group for user research, but it is difficult to go on deep interview many times. 9/10 people believe Norway’s healthcare system. They believe doctors more than family members.Not like China, the healthcare are not very good. The people are more relied on family 7/10 people believe good diet can treat disease and keep healthy, but it is difficult to insist on a special diet.People can not insist on it because the diet is expensive and with more steps to follow. People not address a lot on diet. 9/10 people will forget to take medicine more than 4 times per month, especially longterm medicine. The longterm medicine cause social problem when they have medicine other people always ask their situation. RANDOM ACCESS INTERVIEW 14
  • 24. PROBLEM COMPARING MAP Use this map to discover the problems. Eg; the communications between doctors Patient A agreed: he think it is not necessary, he can be a bridge between doctors.Patient B disagree: he told me they just share information not discuss my condition 15
  • 25. I interviewed the leader of communication from LHL.LHL is special organization, because they are not only an organization but also owner of a hospital. They call this is a perfect healthcare model. We had a 2 hour talk. Kristin told me some cases about LHL- a social innovation for lung disease all around Norway which is an activity for healing mental problem and the balance between top-down structure and bottom up structure. They have a project to develop an APP for cardiovascular patients. I only know one doctor is my doctor in Oslo kommune, Legevakten. She is always busy,but she sent me some paper materials about healthcare system in Norway. INTERVIEW WITH DOCTORS 16
  • 26. GIGA-MAPPING HEALTHCARE SYSTEM IN NORWAY General Process Management System Economic Process After the interview, I used the insights and paper materials to giga-mapping the healthcare system in Norway. 17
  • 27. RESEARCH MAP After finishing the research map, I put the potential problems in the whole map and see their relationships in different levels, and think some preliminary ideas. 18
  • 28. DESIGN TREND Based on structure in School of Design, CMU Nowadays, design researcher divide the design area into three area. Based on this structure, I work out three different preliminary ideas. 19
  • 29. Good Understanding between Patients and Doctors Good understanding between patients and doctors is potential area. Opposite opinions and some same views make this area active. It can evolve in a long journey for patients in existing system. ARE SYSTEM PATIENTS GOOD CASES using risk based approach to redesign service empower individuals organize care for needs not diseases payments on results not activity integrating care across doctors and patients long investment for system invest in climate adaptation standard develop safety cases creating cultures and midgets manage risk locally ED decision making incorporating their abilities preferences lifestyle own treatment patient engagement sustainable hospital mobile health health alliance digital appointment measuring true value knowledge sharing Patients’ Journey & Existing System moderate change Medical Case Paper Visual Communication& Interaction Design PRELIMINARY IDEA ONE 20
  • 30. Culture Driven/ Professional Power Service Design/ Interaction Design ED CARE SYSTEM PATIENTS GOOD CASES using risk based approach to redesign service empower individuals organize care for needs not diseases payments on results not activity integrating care across doctors and patients long investment for system invest in climate adaptation standard develop safety cases creating cultures and midgets manage risk locally OCIAL NEED decision making incorporating their abilities preferences lifestyle own treatment patient engagement sustainable hospital mobile health health alliance digital appointment measuring true value knowledge sharing z TY CULTURE VALUE SAFETY BELIEFS ATTITUDES PERCEPTIONS Communications founded on mutual trust Confidence in the efficacy of preventive measures. Shared perceptions of the importance of safety z Patients’ Journey & Emerging System significant change Rehabilitation Based on Community PRELIMINARY IDEA TWO 21
  • 31. Change Medicine Industry Deign for Radical Change There are lot of research about cardiovascular patient to map the new system based on trend study. Create new scenario to interact with people under patient centered care to promote the new system.I hope to use design method to promote the hospital or medicine industry can change their role in the system. PRELIMINARY IDEA THREE 22
  • 34. People Resource Interactions Mechanisms of Change Direction/ Idea IDEA ONE IDEA TWO IDEA THREE preliminary idea Use PRISM to Improve Ideas 1 2 LEVERAGE POINTS3 Improve Ideas PRISM METHOD from InWithForward PROCESS 25
  • 35. 26
  • 36. Specialist Nurse Object/Display in hospital Patients Interaction APPiPhone iWatch Website at home Object GP collect data Visualization Information Mechanisms of Change Contributing & Reciprocating to increase meaning & purpose Good touched visualization can increasing the meaning for experience and increase purpose frothier health. Scale Daily life/Hospital The young/Middle-aged Object/Environment Interaction/Product IDEA ONE 27
  • 37. DAILY LIFE Interaction Design Product Design IN HOSPITAL Interaction Design Product Design it is a good Kickstarter project. It is a real digital object or some object combined with iwatch or iPhone. In hospital maybe is a screen connected to customer’s app and doctor’s system. This is a holistic design involve in different scenarios. IDEA ONE 28
  • 38. Change the structure of information flows IDEA ONE 29
  • 39. Frida is a middle age guy. He is crazy about apple products. He has a great job in a band which means he is super busy everyday. One day he felt bad, and go to see doctor. He was diagnosed with high blood pressure. a was sad. He though he was too busy to notice his health condition, Although he had some apps for his health. One day, he found a fabulous flower. He brought it to home. That’s a magic flower. The feel bad, The flower will also be in super bad condition.That’s great visualization to make him realize his health condition. HEALTH TIME HEALTH TIME IDEA ONE 30
  • 40. Resources DNV GL Research Resources (Standard of Health) LHL (consultant) People Cardiovascular Patients General Doctors Specialist Nurse Interactions CHECKLIST LIFESTYLE GUIDE CHECKLIST REHEBITATION GUIDE CHECKLIST NOTICE MEDICINE STORY BOOK OPERATION PROCESS his pack gift is a holistic interaction between customers and professionals. Scale Daily life-Hospital Male-Female Service-Management Mechanisms of Change Feedback to increase validation & motivation The goal is to use feedback to change and promote the experience during the process. IDEA TWO 31
  • 41. For the design part compare form and function like app or paper is important. The movie should be cartoon which not creates new mental problem. Medicine management can applied in the gift pack system. CHECKLIST LIFESTYLE GUIDE CHECKLIST REHEBITATION GUIDE CHECKLIST NOTICE MEDICINE STORY BOOK OPERATION PROCESS APP Paper Paper Cartoon PaperDigital Explore best form/materials/techniques/ ideas for gift pack Daily Medicine IDEA TWO 32
  • 42. The gain around driving positive feedback loops. IDEA TWO 33
  • 43. Laura is 50 years ago. She usually go to visit GP. At that time, she got a gift pack. Yes, a gift pack for her current situation. A checklist to manage her diet and CHECKLIST LIFESTYLE GUIDE When her condition got worse and worse, she went to see her GP. The GP referred a special examination. At this time, she got a gift pack. This gift pack has some CHECKLIST NOTICE MEDICINE after the special examination, She need a surgery. Before the surgery, she got a gift pack. This gift pack have a story book to soft her emotion and a movie of the operation process. STORY BOOK OPERATION PROCESS After the surgery, she also got a gift pack. In this gift pack, there is a check list and rehebitation guide book CHECKLIST REHEBITATION GUIDE IDEA TWO 34
  • 44. Diversity and deep understanding of food and medicine change the role of food and medicine.Food can be a treatment.Medicine is for keeping health, not for treatment.More and more medicine companies evolve in food industry. Resources DNV GL Research Resources (Standard of Health/ Patient Centered Care) Designers (consultant) IDEA THREE Mechanisms of Change Taster Experiences to shape preferences & goals Barrier Busting to manage stressors & increase future orientation This direction is aim at shaping the preferences and goals also increasing future orientation. Trend People Cardiovascular Patients General Doctors Specialist Nurse Hospital Medicine Industry DNV GL Research Group Government http://www.kenko.com/product/ item/itm_6924185772.html 35
  • 45. Food and medicine in future not just the object. It will will be with a lot of information on itself and its package or people’s APP. Regard this, use the food and medicine as a new touchpoint between the customers and professors.This also change the role of supermarket and Pharmacy in Future.Government should involve in it. DNV GL can be a certification provider in new area Scale IDEA THREE Trend 36
  • 46. Change the rules of system IDEA THREE 37
  • 47. Co-design is a very interesting process based on the background of DNV GL. We can figure the form, function , techniques and ideas for different stage. It also will create other relevant design evolve in this process, product and APP and service. This is a good outcome to cause discussion of the unclear Border between the food and medicine. IDEA THREE 38
  • 49. We use the one way to identify the patients. We ignore the identity for health for people.In the workshop we used card sorting to do co- design workshop. Touchpoint: Medicine and Food Card sorting for form/function/techniques/ idea in holistic process. Based on human centered design. SEVERAL MONTHS PREVENTION VISIT GP MAKE A TENTATIVE DIAGNOSIS RECEIVING S EXAMINATION REFERS TO AN S DEPARTMENT GP/( PUBLIC HOSPITAL) EXAMINATION OPERATION NECESSARY MEDICATION SURGERY PUBLIC HOSPITAL PRIVATE HOSPITAL REHABILITATION AT HOSPITAL SHORT TIME HELFO GP VISIT GP A B C D CO-DESIGN WORKSHOP 40
  • 50. T�ea���n� K��� He�l�� Fish Oil Collagen Te� Ve�et���� Fi�� F��i� J�i�� Nu����nt� Nu����nt�G���i� Me�i���� f�� L�n�-���� ACEI Captopril/Enalapril//Perindopril/Benaz- epril/Iimidapril/Fosinopril/Ramipril Me�i���� f�� L�n�-���� ARB Losartan/Valsartan/Olmesartan/Telmisartan/- Candesartan/Iirbesartan Me�i���� f�� L�n�-���� B blockers Metoprolol/Bisoprolol/Atenolol/Esmo- lol/Propranolol Me�i���� f�� L�n�-���� Calcium channel blockers Nifedipine/Felodipine/Amlodipine/Dilti- azem/Verapamil Me�i���� f�� L�n�-���� Diuretics Furosemide/Hydrochlorothia- zide/Indapamide/Spironolactone Me�i���� f�� L�n�-���� Antiplatelet and anticoagulants Aspirin/Clopidogrel/Tirofiban Hydrochloride/Heparin/Warfarin Me�i���� f�� ���p���n� Coenzyme Q10 Me�i���� f�� ���p���n� Cyclic Adenosine Monophosphate Me�i���� f�� �h��-���� A blocker Prazosin/Terazosin Me�i���� f�� �h��-���� Anti-ischemic Nitroglycerine/Isosorbide Dinitrate Me�i���� f�� �h��-���� Thrombolytic Urokinase/Streptokinase/rt-PA Me�i���� f�� �h��-���� Lipid regulating Atorvastatin Calcium/Rosuvastatin Calcium Me�i���� f�� �h��-���� Anti-arrhythmic Quinidine/Propranolol/Amiodarone /Verapamil Me�i���� f�� �h��-���� Inotropic agents Digoxin/Cedilanid/Milrinone Me�i���� f�� �h��-���� Anti-shock Dopamine/Adrenaline/Atropine Treatment Keep Health NEW CLARIFICATION 41
  • 51. IDEA FROM WORKSHOP IT’S TIME TO HAVE A IT’S TIME TO HAVE B IT’S For keeping health. For keeping health. For treatment. (even through the chronic disease people have same image with normal people) Treatment Keep Health One day package X days package After x days, people will have a examination Interaction identity Package identity IT’S IT’S IT’S Health Map good bad Visual Report 42
  • 52. DESIGN DEFINITION A TOOL TO COMMUNICATE WITH DOCTORS REDESIGN THE IDENTITY OF MEDICINE AND DIET IN SMART NOT JUST APPEARANCE ➤ Redesign the identity for medicine and food ➤ Design a professional way for people to communicate with doctors outside of hospital. Norway has a good healthcare system. People believe the professionals than other pipes. The professional communication tools are necessary for people even through they are just at high risk of cardiovascular patients. It difficult to change the identity of medicine and food trough directly way package or appearance, but digitalization still provides some opportunities to change the identity of the medicine and food. All the things require me to regard App as a touchpoint to connect the different touch points to make a holistic service for customers. HELFO is making the patients information standard which play an important role on the App which can be easily set up in future. Design is increasingly important in healthcare system. App is also a good factor to change the whole system, 43
  • 55. MAKE APP WITH MODULAR FUNCTION 46
  • 56. an easy way to keep you from cardiovascular disease Dear Lily, Depending on your current situation ( see your document ), I think you are at a high risk of cardiovascular disease, but don't worry about it, it is not serious, if you follow these steps. STEP ONE Suitable Exercise and a Balance Diet as possible as you can, this is not just for prevention but also a good daily life. STEP TWO Most important things for diet are salt and fat. I recommended the max daily amount of salt is 6.00g and the max daily amount of fat is 6.00g. STEP THREE Download this lovely APP - healcaedio. This is a important bridge between us. 1. It can help you to track fat and salt. 2. You can use it to manage your body data. 3. You can use it to communicate with me, and share the data you like to share. I can give you feedback as soon as possible and make a future plan. Sign up Enter this code: 463284325324 Remember that we use healcardio together. Don't feel alone. Your GP PREVENTION USER’S JOURNEY Actually people can not have a talk about suggestion for their future healthy life. Depending on the user research, people prefer to listen to professional people suggestions. Due to this reason, creating a very professional scenario is necessary for people. This is easy way to make the people follow the suggestion for prevention. They will begin their prevention from GP., regarding the prevention process as a professional treatment. Visual report is a strategy for engaging doctors. Doctors is very busy. Making a simple and meaningful image based on data is a good way to save time for doctors. The doctors can give a feedback in a short time, also creating a positive quick feedback for patients. 47
  • 57. KEEP HEALTHY In future, delivery medicine is a obvious trend. But people is afraid of delivery medicine. 4/5 people think they hope their doctor can make sure the medicine is correct through the delivery system. This point will create a new business model in future. Who can be in charge of the medicine to delivery.. This system should be very flexible for different customers. 48
  • 58. testing c o l l e c t d a t a o k o kc o l l e c t d a t a b l o o d p r e s s u r e h e a r t r a t e 000mmHg / 000mmHg 000/min 130mmHg 85mmHg 10/24 2015 10/24 2015 10/24 2015 10/24 2015 10/24 2015 10/24 2015 10/24 2015 10/24 2015 60/min 100/min 10/24 2015 10/24 2015 10/24 2015 10/24 2015 10/24 2015 10/24 2015 10/24 2015 10/24 2015 h e a l c a r d i o PM TREATMENT USER’S JOURNEY There are already a lot of APPs tracking the body data. For simplifying the healcardio. healcardio can get the data directly from other APPs like ihealth, during the clickable prototype test, 4/5 people felt confused and difficult to use it, if they can use healcardio to collect data directly. 49
  • 59. Comparing the APPs on the market, most of the Apps are green. To create a uniqle brand, I choose to use single main color red with a soft style. The basic principle of the Apps is simplicity. I will follow it. h e a l c a r d i o sign in sign up An angel for your heart. Gill Sans Adobe Caslon Avenir Next Color Font Soft Sharp Multiple Color Single Color BRANDING 50
  • 60. IDENTITY OF DESCRIPTION New Journey for you 01/10/1015 to 01/11/1015 Dear Lily, As I said through healcardio, your situation is quite nice.Continue to take Aspirin & Metoprolol to keep health. ASPIRIN This is an element for prevent heart attacks, strokes, and chest pain. Take 1 tablet everyday at the beginning of happy days before breakfast. Scan Code Put on your Aspirin Package METOPROLOL This is an element for prevent high blood pressure and chest pain. Take 1 tablet at the morning and 1 tablet at evening before diet everyday. Scan Code Put on your Metoprolol Package Your GP THIS IS FOR PHARMACY OR SHOPPING ONLINE CODE: DFBFSDA89DDA Scan Code Nitroglycerin 01/10/1015 to 05/10/1015 Dear Lily, is Nitroglycerin is for a 5 days treatment, you should take it very carefully before next week examination. How Take 1 tablet at 7:00am&9:00pm everyday. Do NOT swallow, chew, or crush this tablet. Dissolve the tablet under the tongue or between the cheek and gum.To treat an angina attack, use nitroglycerin tablets at the first sign of chest pain. Sit quietly while the tablet is dissolving. WHAT Preventing or relieving a sudden attack of chest pain caused by heart disease. Nitroglycerin is a nitrate. It works by dilating (widening) blood vessels. Chest pain occurs when the heart needs more oxygen than it can get. Dilating blood vessels allows blood to flow more easily. This reduces the heart's workload and the amount of oxygen needed by the heart. NOTICE Do NOT use nitroglycerin tablets if: you are allergic to any ingredient in nitroglycerin tablets you have increased pressure in the head you have severe anemia Your Doctor !"#$%&'()*$"+ !"#$%&'()*$"+ ,'%%-./*00*'0 !"#$%&'()*$"+ ,%+&-* an easy way to keep you from cardiovascular disease Dear Lily, Depending on your current situation ( see your document ), I think you are at a high risk of cardiovascular disease, but don't worry about it, it is not serious, if you follow these steps. STEP ONE Suitable Exercise and a Balance Diet as possible as you can, this is not just for prevention but also a good daily life. STEP TWO Most important things for diet are salt and fat. I recommended the max daily amount of salt is 6.00g and the max daily amount of fat is 6.00g. STEP THREE Download this lovely APP - healcaedio. This is a important bridge between us. 1. It can help you to track fat and salt. 2. You can use it to manage your body data. 3. You can use it to communicate with me, and share the data you like to share. I can give you feedback as soon as possible and make a future plan. Sign up Enter this code: 463284325324 Remember that we use healcardio together. Don't feel alone. Your GP I asked users to make sequences based on professional. 1=not professional, 3=professional A:2 1 3/ B:1 2 3/C:2 1 3/D:2 1 3/E: 1 2 3 Use color for different stages. Keeping Health and Prevention stages have the same color. Treatment is use another color to show the process should be paid more attention. The illustration is very necessary. 4/5 users think it is useful. 51
  • 61. 5/5 users think they can use healcardio through doctors. They don't think they can use an APP through the APPs store directly. I asked users to make sequences based on professional. 1=not professional, 3=professional A:2 1 3/ B:1 2 3/C:2 1 3/D:2 1 3/E:1 2 3 Use color for different stages. Keeping Health and Prevention stages have the same color. Treatment is use another color to show the process should be paid more attention. The illustration is very necessary. 4/5 users think it is useful. 52
  • 62. Two Action One Action YESorNO IDENTITY OF DESCRIPTION Two Action 53
  • 63. Test with clickable prototype 9 54
  • 64. IDENTITY OF DESCRIPTION accurate joyful Joyful Accurate Use professional way to address the importance on diet. People use this way to communicate with doctors and get encourage.Use the joyful interaction way to change the identity of long-term medicine and make this activity more relaxed.Checklist is the most familiar way for users. This way can provide professional and accurate interaction way.Test for accurate and joyful. This quality is low. Due to the test group are 5 people. 55
  • 65. Salt 0.50g 0.50g 0.50g 0.50g 0.50g IDENTITY OF FOOD I sent my idea to my interviewees before through the e-mail. Surprisedly, they think this is a problem for them not just for salt and fat. Sometimes their doctors to ask them to have fix amount of food, but they don't have ability to measure them. 56
  • 66. New Journey for you 01/10/1015 to 01/11/1015 Dear Lily, As I said through healcardio, your situation is quite nice.Continue to take Aspirin & Metoprolol to keep health. ASPIRIN This is an element for prevent heart attacks, strokes, and chest pain. Take 1 tablet everyday at the beginning of happy days before breakfast. Scan Code Put on your Aspirin Package METOPROLOL This is an element for prevent high blood pressure and chest pain. Take 1 tablet at the morning and 1 tablet at evening before diet everyday. Scan Code Put on your Metoprolol Package Your GP THIS IS FOR PHARMACY OR SHOPPING ONLINE CODE: DFBFSDA89DDA SHOPPING ONLINE STICKERS When people prefer to believe the professions, feedback becomes important. It doesn't mean doctor should do anything for their customers. We don't have enough medical staff to provide an extremely good user experience. Thus, the way of people to take the medicine, I choose empowering the individual to make a small change for future change. People use the sticks to manage the medicine by themselves. IDENTITY OF MEDICINE 57
  • 67. New Journey for you 01/10/1015 to 01/11/1015 Dear Lily, As I said through healcardio, your situation is quite nice.Continue to take Aspirin & Metoprolol to keep health. ASPIRIN This is an element for prevent heart attacks, strokes, and chest pain. Take 1 tablet everyday at the beginning of happy days before breakfast. Scan Code Put on your Aspirin Package METOPROLOL This is an element for prevent high blood pressure and chest pain. Take 1 tablet at the morning and 1 tablet at evening before diet everyday. Scan Code Put on your Metoprolol Package Your GP THIS IS FOR PHARMACY OR SHOPPING ONLINE CODE: DFBFSDA89DDA Scan Code Nitroglycerin 01/10/1015 to 05/10/1015 Dear Lily, is Nitroglycerin is for a 5 days treatment, you should take it very carefully before next week examination. How Take 1 tablet at 7:00am&9:00pm everyday. Do NOT swallow, chew, or crush this tablet. Dissolve the tablet under the tongue or between the cheek and gum.To treat an angina attack, use nitroglycerin tablets at the first sign of chest pain. Sit quietly while the tablet is dissolving. WHAT Preventing or relieving a sudden attack of chest pain caused by heart disease. Nitroglycerin is a nitrate. It works by dilating (widening) blood vessels. Chest pain occurs when the heart needs more oxygen than it can get. Dilating blood vessels allows blood to flow more easily. This reduces the heart's workload and the amount of oxygen needed by the heart. NOTICE Do NOT use nitroglycerin tablets if: you are allergic to any ingredient in nitroglycerin tablets you have increased pressure in the head you have severe anemia Your Doctor !"#$%&'()*$"+ !"#$%&'()*$"+ ,'%%-./*00*'0 !"#$%&'()*$"+ ,%+&-* I sent a email to ask two interviewees before. Both of them think they feel the physical paper is much safer than the digitalization. They will print it by themselves if they just have digital edition. 4/5 users told that they can use the paper to check the information on app. This can set a safer scenario. SAFETY CULTURE 58
  • 68. PROFESSIONAL COMMUNICATION 5/5 people during the test, they are happy to use healcardio to communicate with doctors especially during the treatment stage. 2/2 doctors think this is a good way to communicate with patients. The doctors doesn't want to make a link through their private APPs like imassage, eve though a lot of patients want to add them. Communication part is difficult to test in a short time. The problem here is that should doctor can know anything. I just design one image for users to communicate with others, some people doubt that they don't want show some data to the doctors. If I make this apps just for cardiovascular patients. Users (5/5) can accept the data to share (salt fat blood pressure and heart rate) Share the image with others through other SNS apps is better than creating a fountain that they can use this apps with other family members and other same people. This can make the apps more complex agains the strategy simplicity. Through other platform can also make a better integration. 59
  • 69. FUTURE SYSTEM This is new system in future. I hope use this project to show the holistic process can not live without t system thinking. I found that it is difficult to do a holistic experience now in Norway because the institution under government is independent like helfo and public health center. There should be a innovation center in future. Obviously with DNV GL basic research on healthcare. more and more design industry will go into this system. 60
  • 70. MAP I W O R K W I T H N E W I D E N T I T Y F O R F O O D A N D M E D I C I N E I N S Y S T E M T H I N K I N G H O L I S T I C P R O C E S S F O R T H E C A R D I O V A S C U L A R A P R O F E S S I O N A L P I P E B E T W E E N C U S T O M E R S A N D D O C T O R S . I W O R K F O R SAFETY CULTURE VALUE SAFETY BELIEFS ATTITUDES PERCEPTIONS Communications founded on mutual trust Confidence in the efficacy of preventive measures. Shared perceptions of the importance of safety PATIENT CENTERED CARE SYSTEM PATIENTS GOOD CASES using risk based approach to redesign service empower individuals organize care for needs not diseases payments on results not activity integrating care across doctors and patients long investment for system invest in climate adaptation standard develop safety cases creating cultures and midgets manage risk locally PHYSICAL/PSYCHOLOGICAL/SOCIAL NEED decision making incorporating their abilities preferences lifestyle own treatment patient engagement sustainable hospital mobile health health alliance digital appointment measuring true value knowledge sharing professional patients researchers policy makers STATEHOLDERS INFLUENCE FACTORS equality sustainability EVALUATION environment timeliness cost efficiency person centered safety debt crsis/coherent aging population/equal expanding government leading urban and rural high cost/serious pressure gap between the rich and poor MAIN MARKET conservative culture patient habits and preference sector fragmentation GENERAL PROBLEM aging population emerging disease pattern climate change rising costs inequitable access poor safety record no holistic care SPECIFIC PROBLEMS 1/10 patients harmed in hospital dementia/chronic increase ICT is slow poor coordinated effort CARDIOVASCULAR STATE/NATIONAL BUDGET CITIZENS / EMPLOYERS/PATIENTS REGIONAL HEALTH AUTHORITIES LOCAL GOVERNMENT (MUNICIPALITIES / COUNTIES) HELFO PUBLIC HOSPITALS PRIVATE SPECIALISTS PRIVATE HOSPITALS GP NURSING HOMES AND LONG-TERM CARE DENTAL CARE FOR CHILDREN AND OTHER DEFINED GROUPS NATIONAL TAXES LOCAL TAXES FINANCIAL SYSTEM maritime sustainable organisation (environmental/social/economic-longterm) FOOD&WATER/OIL&GAS/ELECTRICITY&RENEWABLE/SHIPPING SAFER SMARTER GREENER SAFE AND SUSTAINABLE FUTURE oil and gas energy business insurance software AREABRANDING MANAGE RISK BUILD TRUST HEALTHCARE INNOVATION global impact aligning split incentives managing system risks empowering stakeholders accounting for value transforming mindset an easy way to keep you from cardiovascular disease Dear Lily, Depending on your current situation ( see your document ), I think you are at a high risk of cardiovascular disease, but don't worry about it, it is not serious, if you follow these steps. STEP ONE Suitable Exercise and a Balance Diet as possible as you can, this is not just for prevention but also a good daily life. STEP THREE Most important things for diet are salt and fat. I recommended the max daily amount of salt is 6.00g and the max daily amount of fat is 6.00g. STEP FOUR Download this lovely APP - healcaedio. This is a important bridge between us. 1. It can help you to track fat and salt. 2. You can use it to manage your body data. 3. You can use it to communicate with me, and share the data you like to share. I can give you feedback as soon as possible and make a future plan. Sign up Enter this code: 463284325324 Remember that we use healcardio together. Don't feel alone. Your GP New Journey for you 01/10/1015 to 01/11/1015 Dear Lily, As I said through healcardio, your situation is quite nice.Continue to take Aspirin & Metoprolol to keep health. ASPIRIN This is an element for prevent heart attacks, strokes, and chest pain. Take 1 tablet everyday at the beginning of happy days before breakfast. Scan Code Put on your Aspirin Package METOPROLOL This is an element for prevent high blood pressure and chest pain. Take 1 tablet at the morning and 1 tablet at evening before diet everyday. Scan Code Put on your Metoprolol Package Your GP THIS IS FOR PHARMACY OR SHOPPING ONLINE CODE: DFBFSDA89DDA Scan Code Nitroglycerin 01/10/1015 to 05/10/1015 Dear Lily, is Nitroglycerin is for a 5 days treatment, you should take it very carefully before next week examination. How Take 1 tablet at 7:00am&9:00pm everyday. Do NOT swallow, chew, or crush this tablet. Dissolve the tablet under the tongue or between the cheek and gum.To treat an angina attack, use nitroglycerin tablets a f chest pain. Sit quietly while the tablet is dissolving. WHAT Preventing or relieving a sudden attack of chest pain caused by heart disease. Nitroglycerin is a nitrate. It works by dilating (widening) blood vessels. Chest pain occurs when the heart needs more oxygen than it can get. Dilating re easily. This reduces the heart's workload and the amount of oxygen needed by the heart. NOTICE Do NOT use nitroglycerin tablets if: you are allergic to any ingredient in nitroglycerin tablets you have increased pressure in the head you have severe anemia Your Doctor !"#$%&'()*$"+ !"#$%&'()*$"+ ,'%%-./*00*'0 !"#$%&'()*$"+ ,%+&-* MANAGEMENT SYSTEM NATIONAL INSURANCE SCHEME MINISTRY OF LABOUR HOSPITALS HOSPITAL TRUSTS REGIONAL HEALTH AUTHORITIES MINISTRY OF HEALTH AND CARE SERVICES GOVERNMENT PARLIAMENT DENTAL PRIMARY CARE CARE PROVIDERS PRIMARY CARE CARE PROVIDERS PROVIDERS MUNICIPALITIES COUNTIES DIRECTORATE OF HEALTH (INCL. HELFO) BOARD OF HEALTH SUPERVISION INSTITUTE OF PUBLIC HEALTH MEDICINES AGENCY RADIATION PROTECTION AGENCY BIOTECHNOLOGY ADVISORY BOARD SYSTEM OF PATIENT INJURY COMPENSATION SAK NOKC POBO 61
  • 71. USER RESEARCH CARDIOVASCULAR PATIENTS DIAGNOSE EMERGENCY RESCUE EMERGENCY RESCUE EMERGENCY RESCUE REGULAR INSPECTION REGULAR INSPECTION STANDARD INFORMATION SYSTEM ENOUGH DOCTOR AND NURSE MONEY SEGMENT EASY COMMUNICATION PIPE BETWEEN DOCTORS GOOD UNDERSTANDING BETWEEN PATIENTS AND DOCTORS RESCUE SYSTEM BAD REHABILITATION QUALITY FAMILY SUPPORT YES NO PERSPECTIVE PERSPECTIVEPATIENT A PATIENT B PERSPECTIVE an easy way to keep you from cardiovascular disease Dear Lily, Depending on your current situation ( see your document ), I think you are at a high risk of cardiovascular disease, but don't worry about it, it is not serious, if you follow these steps. STEP ONE Suitable Exercise and a Balance Diet as possible as you can, this is not just for prevention but also a good daily life. STEP THREE Most important things for diet are salt and fat. I recommended the max daily amount of salt is 6.00g and the max daily amount of fat is 6.00g. STEP FOUR Download this lovely APP - healcaedio. This is a important bridge between us. 1. It can help you to track fat and salt. 2. You can use it to manage your body data. 3. You can use it to communicate with me, and share the data you like to share. I can give you feedback as soon as possible and make a future plan. Sign up Enter this code: 463284325324 Remember that we use healcardio together. Don't feel alone. Your GP New Journey for you 01/10/1015 to 01/11/1015 Dear Lily, As I said through healcardio, your situation is quite nice.Continue to take Aspirin & Metoprolol to keep health. ASPIRIN This is an element for prevent heart attacks, strokes, and chest pain. Take 1 tablet everyday at the beginning of happy days before breakfast. Scan Code Put on your Aspirin Package METOPROLOL This is an element for prevent high blood pressure and chest pain. Take 1 tablet at the morning and 1 tablet at evening before diet everyday. Scan Code Put on your Metoprolol Package Your GP THIS IS FOR PHARMACY OR SHOPPING ONLINE CODE: DFBFSDA89DDA Scan Code Nitroglycerin 01/10/1015 to 05/10/1015 Dear Lily, is Nitroglycerin is for a 5 days treatment, you should take it very carefully before next week examination. How Take 1 tablet at 7:00am&9:00pm everyday. Do NOT swallow, chew, or crush this tablet. Dissolve the tablet under the tongue or between the cheek and gum.To treat an angina attack, use nitroglycerin tablets a f chest pain. Sit quietly while the tablet is dissolving. WHAT Preventing or relieving a sudden attack of chest pain caused by heart disease. Nitroglycerin is a nitrate. It works by dilating (widening) blood vessels. Chest pain occurs when the heart needs more oxygen than it can get. Dilating re easily. This reduces the heart's workload and the amount of oxygen needed by the heart. NOTICE Do NOT use nitroglycerin tablets if: you are allergic to any ingredient in nitroglycerin tablets you have increased pressure in the head you have severe anemia Your Doctor !"#$%&'()*$"+ !"#$%&'()*$"+ ,'%%-./*00*'0 !"#$%&'()*$"+ ,%+&-* an easy way to keep you from cardiovascular disease Dear Lily, Depending on your current situation ( see your document ), I think you are at a high risk of cardiovascular disease, but don't worry about it, it is not serious, if you follow these steps. STEP ONE Suitable Exercise and a Balance Diet as possible as you can, this is not just for prevention but also a good daily life. STEP THREE Most important things for diet are salt and fat. I recommended the max daily amount of salt is 6.00g and the max daily amount of fat is 6.00g. STEP FOUR Download this lovely APP - healcaedio. This is a important bridge between us. 1. It can help you to track fat and salt. 2. You can use it to manage your body data. 3. You can use it to communicate with me, and share the data you like to share. I can give you feedback as soon as possible and make a future plan. Sign up Enter this code: 463284325324 Remember that we use healcardio together. Don't feel alone. Your GP 85-130 mmHg 60-100 /min Salt:6g Fat:66g k e e p h e a l t h blood pressure heart rate 62
  • 74. 44 Giga-mapping: Visualisation for Complexity and Systems Thinking in Design. Birger Sevaldson Dancing With Systems Donella Meadows Types of Systemic Relations Birger Sevaldson The Design Way Intentional Change in an Unpredictable World Harold G. Nelson 7 Reasons Why Our Social Services Keep Failing: An Argument for Grounded Change Dr. Sarah Schulman Design For Care Peter Jones Prototype Evaluation in Service Design A Case Study at an Emergency Ward Johan Blomkvist Radical Redesign The Australian Center for Social Innovation Healthcare 2050 DNV GL Patient Centered Care DNV GL Transitions to Sustainable Development: New Directions in the Study of Long Term Transformative Change Grin J, Rotmans J
  • 76. 44 This is a meaningful semester to know something new. In the studio, I learnt system oriented design systematically. I know how to use the system to set up a design project from research to systematic impact step by step. I can use giga-mapping in different ways. At the beginning, using the giga-mapping to find a start point-ZIP. This is most important thing for the complex problems which is difficult to find a correct stone to carry on. After that, gaga-mapping can also be used as a tool to find the relationships between problems especially combined with iceberg model. Giga-mapping can also be used in design process which can make me figure out a holistic solution easily and know the relationships between different touch points. Giga-mapping is a great process crossing the whole design process. Cooperation with DNV GL is a super happy process. They have done a lot of project about healthcare and are a global company. In this way, I can get a big picture of healthcare system all around world, and this is a great way to understand the different culture between Norway, China and other countries after the deep user researches this semester. I’m luck to visit Mayo Clinic which provide me a deep understanding of healthcare system. I think the result of this semester is good, even through the design seems to be unclear and not very interesting. The meaningful part is that this result is from system thinking not just from a good idea. Seeing the whole system map, I think my design is effective and really can benefit people in a holistic perspective. This project is not addressing single design. I think my design can make the whole touchpoint work together for a systematic impact. It is not enough time to understand the system oriented design just for one semester. It is obvious that I need a long time to practice the system thinking. I’m not familiar with the all the context of create a positive systematic impact for my design. There are so many method to create leverage points. In a real system, there are many methods which can be used together at the same time. When I consider the system impact, I often forgot to use multiple ways to create systematic impact on my own system. Using one design which can address different methods is quite difficult.
  • 77. 44 I’m struggling with the balance between system and design. Sometimes I will face a conflict between a good idea from creativity and a normal idea from system thinking. I don't know how to adapt them to each other and put the a good idea from creativity in system thinking. This process is quite difficult. Some good ideas are not very relevant with each other, but normal ideas can be seen as a group power. System oriented design is quite difficult to evaluate in real world for a student. It is difficult for me to say which is better. Foreigner is difficult to do user research sometimes. Native language is important for interviews. This can make the interviewees into a familiar scenario. I met another interesting problem. This happened during my random access interview with 10 people. I ask them if they think Norway has a good healthcare system. 9/10 told me they think Norway has a great healthcare system. For me, my Norwegian friends complained a lot about healthcare service in Norway, but it is difficult for me to ask something bad in Norway’s healthcare system. I guess the reason is national pride. Time management is urgent issue for me this semester. Everybody has the same deadline which gave me a lot of pressure. Everyone has different projects, in this situation I think the amount of work is different at different stages. The same deadline sometimes make me super busy and sometimes have little thing to do. I have no balance speed this semester. I used the textbook time to balance my time, but I will forgot the knowledge, if I didn't do any practice. I hope I can practice system oriented design method more to understand this complex world.
  • 78. 44