Guest speaker - Dr. Zayna Khayat Design in Health - COVID Edition: Your Silver linings Playbook Design Thinking Process Homework

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4. Why are you
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I’m curious
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This course was
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colleague/friend
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5. Special Guest
#VDS2020
@Design4AHS
Where are we on the
landscape of healthcare, and
how do we make sure we
don’t get left behind?!
Zayna Khayat
The Future of Healthcare and Design
Zayna is a Future Strategist with SE Health in Ontario, Canada.

6. Design in health – COVID edition:
your Silver Linings PlaybookZayna Khayat, PhD
Future Strategist at SE Health
April 7 2020
@ZaynaKhayat @SEHC_SEHealth @SEFutures

8. WHY we exist To spread hope and happiness
WHAT we do
VALUES We are collaborators
We see possibility everywhere
We believe in the power of people, families and communities
Hospital Care at Home
&
Transitions
Seniors’ Living
Specialized Home
Health Care Education
Elizz Caregiver
Solutions
112Years of forward thinking
~9,000
Leaders of Impact
~20,000
Care exchanges a day

9. Co-creating a Future where
Canadians Age with Agency,
Dignity, Health and Vitality

10. Black Plague
[14th c. Europe]
9/11
Source: Sailor - Victor Jorgensen, United States Navy/Associated Press; Ballet - Vincent Yu/AP @ZaynaKhayat
World War II 2003 SARS
outbreak
[China]

11. Future: Person
Proactive, preventative, predictive
Personalized, intelligent
Decentralized, omnichannel, digi-cal
Continuous | team
People-powered
Value, outcomes, fee-for-health
Reactive, sick care
1 size fits all, crude, analog
Institution-centred
Episodic, intermittent, silo’d
Healthcare provider
Volume, inputs, costs, fee-for-service
Today: System
The Future of Health
TIMING
PRECISION
MODALITY
DURATION
POWER
CURRENCY
= Innovation
@ZaynaKhayat

12. Central paradigm:
The system
New paradigm:
The Person
Drivers
$
@ZaynaKhayat

13. CELLULAR
THERAPY
3D
Printing
SENSORS / IOT
NEURO-TECHf
Health exponentials
https://gnhic.com/
AI -
Predictalytics
Voice
Recognition
Virtual
Reality
Blockchain
Sensors –
IoT
‘Omics
Robotics
‘bots
Autonomous
Transport
Neuro
Tech
Nano
biology
Cellular
Therapy

14. @ZaynaKhayat

15. Digitized Deceptive
Dematerialize
Democratize
Adapted from Peter Diamandiis’ 6 D’s of Exponential Development
Disruptive
Demonetize
6 D’s of Exponential
Development
@ZaynaKhayat

16. Source: Mobihealth News (2019)
Started 2015: “AI-assisted medical system”
Subscription: $40-$100 Cdn / year
June 2019 the network:
• 300M registered, 57M active monthly
• 1,200 in-house docs; 5,200 outside docs
• 3K hospitals
• 15K pharmacies
• 47K virtual clinics
• 1.3K GP clinics
• 1.2K dental offices
• 1.9K other institutions
• 1 hr drug delivery service in >70 cities
@ZaynaKhayat

17. Source: Kaiser Permanente; CIHI and Ontario Telemedicine Network
<1%
Kaiser Permanente: 62% virtual [2019]
@ZaynaKhayat

18. Today:
System
2. Entrenched producer interests
6. Outdated regulations /policies
1. Mindsets
4. Governance/structures
10. Capacity for innovation
7. Financing & incentives
5. Silos at many levels
3. Politics
9. Adoption pathways [or lack thereof]
Future:
Citizen
8. Data flow, infostructure
Barriers to
health
innovation
@ZaynaKhayat

19. Vala Afshar; Citi Digital Strategy Team; Michael Felton, The New York Times (in HBR.org)
Time to reach 50 M users
17 yrs
Average time
from evidence to
practice in
medicine
@ZaynaKhayat

20. Digitized Deceptive
Dematerialize
Democratize
Adapted from Peter Diamandiis’ 6 D’s of Exponential Development
Healthcare is
largely here
Disruptive
Demonetize
6 D’s
@ZaynaKhayat

21. @ZaynaKhayat

22. Central paradigm:
The system
New paradigm:
The Person
Drivers – COVID edition
$
@ZaynaKhayat
 Shift in behaviours due to risk
of personal contact
 Shifts & spikes in demand curves
(vents, PPE, staff, policies)
 Demand for [digital] alternatives – how we work AND deliver care
 Existing data, tools, equipment, tests, therapies insufficient

23. Source: Kaiser Permanente
April 7 Kaiser Permanente COVID brief
@ZaynaKhayat
90% primary care
75% specialty care
“Here to stay”
4000% spike in
video visits
(some regions)
Saw signals early:
5000 new calls – led
to local gov policy
changes re: shelter
in place

24. •
Comus - John Milton (1634)

25. Where have we seen this before?
Black Plague.
[14th c. Europe]
• ~25M killed (1/3 of
Europeans)
• Credited with ending
feudalism & serfdom
• Power shift to scarce
labor resources
9/11
• Reshaped transportation
and security policies
worldwide
• Shift in attitudes re:
trade-off between
personal privacy &
security
Source: BCG and web research; Images: Sailor - Victor Jorgensen, United States Navy/Associated Press; Ballet - Vincent Yu/AP @ZaynaKhayat
World War II
• Women’s participation in
workforce
• Jet engine, pressurized
aircraft cabins, helicopters,
atomic technology,
computers, synthetic rubber,
rocketry, radar, penicillin,
internet
2003 SARS
outbreak
[China]
• Changed attitudes toward
shopping/ consumption
• e-commerce channels
opened and stayed –
paved the way way for the
rise of Alibaba & other
digital giants

27. A snapshot
@ZaynaKhayat
1.Digital: reimbursement & fee codes [or free access] over night – primary /MH / home care
2.Clinicians: Cross licensing, call up from retirement, med students, upskilling, sharing staff
3.Data: transparency, liquidity, generation eg apps in Taipei, Singapore, Korea, Bahrain, France
4.Hospital capacity: new builds in days; makeshift hospitals in conference centres & hotels
5.Testing: drive through testing, kiosks; from days to hours and minutes; data in real time
6.Coverage: non-insured, non-documented, out of system
7. Fast track regulation: FDA, Health Canada, health systems – PPE, vaccine trials, ventilators,
etc.
8. Policy: Public health policy innovation in hours; economic innovations in hours
Product and service pivots in non healthcare industries
• Explosive, grassroots social innovation: libraries become food banks, volunteer drives, relief funds ….
• Dyson, Elon Musk, Ford Motor Co., etc: ventilators
• 3D printers + apparel brands H&M, Haynes, Bauer, Gap, Canada Goose - masks, gowns
• Brewers & distilleries Labbatt, microbrews, boutiques, etc: Hand Sanitizer
• Financial services: ATM that disinfects cash; lower interest on cards; bridge loans for small biz
• Grocers, banks, Walmart raising front line wages; “hazard pay” premiums; Telcos waving charges
• Essential workers, elderly: Starbucks and Timmies free coffee; early open times

28. @ZaynaKhayat
INSIDE
TRACKS TO
OUTSIDE
MORE HAPPENS IN 10 DAYS THAN IN 10 YEARS

29. Future: Person
Proactive, preventative, predictive
Personalized, intelligent
Decentralized, omnichannel, digi-cal
Continuous | team
People-powered
Value, outcomes, fee-for-health
Reactive, sick care
1 size fits all, crude, analog
Institution-centred
Episodic, intermittent, silo’d
Healthcare provider
Volume, inputs, costs, fee-for-service
Today: System
Barriers to innovation are SMASHED
TIMING
PRECISION
MODALITY
DURATION
POWER
CURRENCY
@ZaynaKhayat
“Healthcare
innovations are the
most high demand
business concept in
the world right now”Dr. Ismail Sayeed, VIOS

30. CONFIDENTIAL – DO NOT DISTRIBUTE WITHOUT FACULTY PERMISSION
1. Doing the right things
2. Doing things right
3. Doing things better
4. Doing away with things
5. Doing things other people are doing
– In health and care
– In other industries
6. Doing things no one else is doing
7. Doing things that cannot be done
Adapted from Plsek, 2014
Improvement
Innovation
@ZaynaKhayat
Innovation vs. improvement

31. Practices/
Capabilities
Developed
Source: Adapted from McKinsey & Co, 3
Horizons & Ralph Christian Orr Dual
nnovation management System
NewtoSE
Newto
theworld
Business Model
New
Horizon 3:
Create New
Markets
Existing
Horizon 2:
Reshape the
Core
Horizon 1:
Optimize Core
Evolved
Requires different:
- methods
- ways of working
- timelines
- metrics
Innovation @ SE =
A future offering, practice or business model that significantly*
impacts hope&happiness, our people, health system & society
@ZaynaKhayat

32. Can we CREATE value?
Problem-solution fit?
Addresses the user’s job to be done?
Alleviates pain points?
Creates gains?
Can they use it seamlessly?
D.Kelley, IDEO; Business Innovation Factory; SE Futures
Can we DELIVER value?
Operationally feasible (capabilities)?
Can technology be leveraged?
Legally feasible?
Can we CAPTURE value?
Solution-market fit?
Sustainable business model?
Finance-able?
@ZaynaKhayat
VIABILITY
(org)
FEASIBILITY
(tech/ops)
Innovation
DESIRABILITY
(human)

33. Human
Centered
Design
@ZaynaKhayat
VIABILITY
(org)
FEASIBILITY
(tech/ops)
DESIRABILITY
(human)
D.Kelley, IDEO
Innovation

34. Topology of
problems
[in the health
sector]
L
LH Certainty / Predictability of Answer
H
StakeholderAgreement
“Wicked”
“Chaotic”
“Complex”
“Complicated”
“Simple”
“Tame”
“Political”
“Crisis”
Source: Adapted from the Stacey Matrix; MaRS Solutions Lab
Human
Centered
Design
@ZaynaKhayat

35. (Backup) Topology of problems
“Complex”“Complicated” “Wicked”“Simple”
• Known knowns
• Cause-effect
predictable, obvious
• Solve based on truth
(binary logic)
• Best practices
Source: Adapted from the Stacey Matrix; MaRS Solutions Lab
• Known unknowns
• Cause-effect exists, but
not obvious, so requires
analysis and expert
knowledge
• Solve with facts + some
context
• Good practices /
benchmarking
• Unknown unknowns
• Cause-effect only
obvious in hindsight
• Solve based on context
• Probe – sense –
experiment – iterate
• Emergent solution
Health sector often treats complex/wicked problems as if they are simple or complicated
• Unknowable unknowns
• No cause-effect
relationship
• Solve in real-time
• Solve based on
values/principles
• Novel practice emerges
@ZaynaKhayat

36. Complexity

37. Source: Professor David Dunne
@ZaynaKhayat

38. In Summary:
Future of Health – 6 shifts
6 D’s of exponential development
Massive opportunity to lead &
accelerate in creating the future
Good design is vital now more than
ever
Your mission: do not waste this crisis
Zayna Khayat, Ph.D.
ZaynaKhayat@SEHC.com
@ZaynaKhayat | @SEFutures | @SEHealth_SEHC

39. KEEP CALM & KEEP DESIGNING
Zayna Khayat, Ph.D.
Futures at SE Health
ZaynaKhayat@SEHC.com
@ZaynaKhayat | @SEFutures | @SEHealth_SEHC
https://futureofaging.sehc.com/

40. From the Chat Box
#VDS2020
@Design4AHS
Tweet us your burning
questions and tag us
@Design4AHS
#VDS2020
Question for Zayna?
Throw it in the chat
box or tag her in a
tweet @ZaynaKhayat
#VDS2020

41. What’s your current knowledge of design thinking?
#VDS2020
@Design4AHS
I’m a master
of design
I’m starting to
dabble in design
I’ve heard about it and
I want to know more
Nope, not
a clue
5%
42%44%
9%

42. Design Thinking Process
Mindset + Culture
Discover
Map
Ideate Decide
Build
Test
#VDS2020
@Design4AHS

43. Week Two
#VDS2020
@Design4AHS
This session is all about how
to frame – and reframe –
problems to generate the
most possibilities.
Margriet Buseman
From Your Problem to Your User’s Problem
Margriet is the founder of Orange Minds, from Amsterdam.

44. Week Three
#VDS2020
@Design4AHS
Putting yourself in the role of
the user is a powerful way to
find opportunities for
impactful change.
Andrew Siu
Mapping the Human Experience
Andrew works for the Patient Safety + Quality Council in British Columbia, Canada.

45. Week Four
#VDS2020
@Design4AHS
Brainstorming is a lot more
than shouting at a
whiteboard. Learn practical
tools and insider tips on how
designers ideate.
Josina Vink
Building Creative Confidence
Josina is an Associate Professor in Service Design at
Oslo School of Architecture and Design in Norway.

46. Week Five
#VDS2020
@Design4AHS
If you’re explaining your
prototype, you’re doing it
wrong. Find out the many right
ways to prototype during this
session.
Tai Huynh
Prototyping - Show, Don’t Tell
Tai is Creative Director at UHN OpenLab in Toronto, Canada.

47. Week Six
#VDS2020
@Design4AHS
The world-renowned healthcare
rebel joins us for a candid
conversation on the role of
design in change agency.
Helen Beven
Design + Change Agency
Helen is a Leader of Change within the NHS in England, UK.

48. What can you commit to?
No time, just joining
when I can find the time
I can commit to almost every
webinar and 1 hour of homework
I can commit to every webinar and
go the distance with homework
This course will consume my self-
isolation. I’ve got nothing but time.

49. #VDS2020
@Design4AHS
Places to find
problems
Try to solve
your friend’s
problem
A problem that
has been
plaguing you at
work
Listen to a story
about a bad
experience
Something that
has been irking
you for a while
You have an
idea but don’t
know if it’ll fly
A change you’d
like to see but
don’t know how
to make
You’ve come into
power and want
to try
something new
You’ve tried to
solve this
problem before
but never like
this
You know there’s
a problem to fix
but you don’t
know where to
start
Consider a
situation you
wish had gone
better

50. Homework
#VDS2020
@Design4AHS
My elderly, frail grandmother needs
to attend a cancer check-up in winter
My grandmother and myself Parking at the hospital is limited
and its -20 degrees celcius outside
My grandmother can’t walk from where I can park and she’s anxious to be alone by the front door.

51. Be rooted with a mindset
Curiosity is key
Trust the process
You are all designers now
Key Takeaways
#VDS2020
@Design4AHS

52. Next Week!
#VDS2020
@Design4AHS
This session is all about how
to frame – and reframe –
problems to generate the
most possibilities.
Margriet Buseman
From Your Problem to Your User’s Problem
Margriet is the founder of Orange Minds, from Amsterdam.

53. Let's chat: Design.Lab@AHS.ca
@Design4AHS
@Design4AHS
#VDS2020
D4AHS.com
Get in touch