Workshop 1 - Inspiring health movements in community networks: Community network innovations Dr. Rick Botelho, Family physician and U Rochester School of Medicine Challenge: How can we mobilize people within their local and extended social networks to socialize health learning and experience to improve population health in the community? Description: We address the problem of community health through the approach known as catalytic innovation, creating lightweight modes of peer learning appropriate for different types of social networks (online, neighborhood, community centres). To overcome the scarcity mindset in healthcare, patients become an integral solution to these complex problems. These peer-driven services complement professional services and build growing networks of peer learning and coaching for health improvement. The Health Coaching Buddies learning process developed by Dr. Botelho represents such a convenient, inexpensive and accessible peer learning system. These processes aim to improve health behaviors such as self-care of chronic diseases, improving health literacy, reducing social isolation and enhancing personal happiness and social well-being. These innovations can be made widely available, using social media, online programs and mobile phones. They are designed to create meaningful learning experiences that aim to accommodate people’s particular worldviews, needs, preferences and life circumstances, instead of making people fit into a particular program, theory, clinical approach or setting.

1. Copyright © 2015, Peter Jones
Designing Inspiration
for Community Health
Service Design for Health Movements
Peter Jones
OCAD University, Toronto
Service Design for Health
with Dr. Rick Botelho
April 21, 2015

2. Copyright © 2015, Peter Jones
Design’s emerging role in complex domains

3. Copyright © 2015, Peter Jones
Where is health located?
In the individual?
Where they live?

4. Copyright © 2015, Peter Jones
Care occurs in-place, in a community
we share with others.
Caring requires knowing, trust, patience, humility,
honesty, & the primacy of life’s rhythms.
“… there must also be developmental change on
the other as a result of what I do; I must actually
help the other grow.” M Mayerhoff

5. Copyright © 2015, Peter Jones
Design for “new value demand”
Less for failure demand
• From systems perspective,
disease focus is an intervention.
• Patient context is temporary
• How to motivate prevention,
adherence, & continuity?

6. Copyright © 2015, Peter Jones
WHAT IS HEALTH SEEKING ?

7. Copyright © 2015, Peter Jones
All people are health-seekers
A health-seeking journey occurs over a lifetime, a continuity
that proceeds through youth, adulthood, & older age.

8. Copyright © 2015, Peter Jones
3 ORDERS OF HEALTH FEEDBACK
Dubberly.com & Design for Care

9. Copyright © 2015, Peter Jones Dubberly.com & Design for Care
STAGES OF INTRA-PERSONAL
HEALTH SEEKING

10. Copyright © 2015, Peter Jones
Where does Health Live?
Dis-eases emerge from so many factors …
Can we design for:
• Home conditions
• Connectedness - Friends & family circles -
• Autonomy, mobility & communications
• Neighborhood, safety, food supply
• = community

11. Copyright © 2015, Peter Jones

12. Copyright © 2015, Peter Jones
How does identity change when a patient?
Are we disempowering self-care?

13. Copyright © 2015, Peter Jones

14. Copyright © 2015, Peter Jones
Today, services are discrete events

15. Copyright © 2015, Peter Jones
Functional unit of service provision
Can connect services across system levels

16. Copyright © 2015, Peter Jones
Functional unit of service
Connecting closer to the health-seeker
Coordinated services across systems

17. Copyright © 2015, Peter Jones
A Service Design process
Human Research
Design Research
Prototype Testing

18. Copyright © 2015, Peter Jones
Basic service concepts.

19. Copyright © 2015, Peter Jones
A simple service experience map.

20. Copyright © 2015, Peter Jones
Framing Coaching as a Service
• Service for “who in a community”
• Frames are reflective responses to a desired action.
There is always a “prior pattern”
• Our “initial appreciation” has huge leverage!
• Avoiding jargon & default ways of thinking
• What are the affordances in communities?
• How do movements (or contagions?) form?

21. Copyright © 2015, Peter Jones
“Frames not only simplify and create alternative views of a
problematic situation; they also evoke particular outcome spaces
that afford a range of responses.”
Paton & Dorst (2011). Briefing and reframing: A situated practice. Design Studies.
Language Co-Creation with your
stakeholders
Releasing fixation from prior frames
Considering “users” & their preferred
values, taste regimes

22. Copyright © 2015, Peter Jones
Framing exercise.
• Develop a framing concept for coaching in your
contexts, using handout.
• How might coaching / peer exchange take hold in
your network or situation?
• How would it be understood by others as a value to
be co-created?
• How would coaching be valued and understood?
Individually: Consider & enter responses in form
Pairs: Share concepts, identify similar / differing

23. Copyright © 2015, Peter Jones
Debrief
• What frames for coaching / movements / did you co-
create?
• What are the affordances in communities?
• How do movements (or contagions?) form?
• What’s the analogue today?

24. Copyright © 2015, Peter Jones
Today’s New Design Domains
Complexity increases at each .0
Number of stakeholders >
Need for collaboration >
Multi-tech, multi-design, multi-disciplinary
Future healthcare services will require all 4
levels of skill & knowledge.
But design skills do not transfer up.
Mixed teams always a necessity.

25. Copyright © 2015, Peter Jones
• Integrating clinical & community services
• Interventions for social determinants
• Community health promotion
• Redesigning services for new business models
• Design & research for care innovation
• Clinical teams communication & coordination
• Patient-health experience of service
• Redesign EHR / information as workflow
• Patient self-service in local clinics
• Patient information across care journeys
• Innovative & usable wayfinding
• Interior space infection control
Healthcare design across 4 domains

26. Copyright © 2015, Peter Jones
Demand Side Innovation (Bottom-up)
• Human experience – What are real concerns:
Student resilience in their first year of university
• Mapping out journey of “ups & downs”
• Identify key transition points
• Top of map - Campus service systems
Human-Centred Systems

27. Copyright © 2015, Peter Jones
A Service Design process
Human Research
Design Research
Prototype Testing

28. Copyright © 2015, Peter Jones
Demand Side Innovation (Bottom-up)
• Patient side - Human-centred concerns:
Mental wellness responsive to students.
• People don’t know what services are offered
• Fear or stigma associated with therapy
• Care complicated by other conditions, life situations
• Case study: OCADU Campus Mental Wellness
• Research modes: Ethnography, Dialogue, Public workshops
• Design methods: Service analysis, Blueprint, Journey, Mapping
Human-Centred Service Design

29. Copyright © 2015, Peter Jones
OCADU Health & Wellness Centre – Service Flow
Current Service Blueprint

30. Copyright © 2015, Peter Jones
As re-envisioned to enable early student self-care
Oikonen, Starkman, Jones, Yip. (2014).

31. Copyright © 2015, Peter Jones
Distributing health care resources
among different points of care:
• Person-Family
• Person-Community
• Patient-Patient
• Patient-Providers
• Providers-Community

32. Copyright © 2015, Peter Jones
Co-creating care in our communities

33. Copyright © 2015, Peter Jones
Extending our communities to larger
networks.

34. Copyright © 2015, Peter Jones