Innovation across System Levels: Human-Centred Services Peter Jones, PhD OCAD University, Toronto
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1 Innovation across System Levels: Human-Centred Services Peter Jones, PhD OCAD University, Toronto Healthcare Infrastructure Summit
2 designforcare.com Booksite Blogsite Associate Professor, OCADU Strategic Foresight & Innovation Managing partner, Redesign Design for Care: Innovating Healthcare Experience Helping designers transform healthcare services through design as care practice. 9 Chapters across health sectors Rethinking Consumers, Patients, Systems Innovation of Services, Practice, Info Technology Research, Methods, Cases Wrapped around a care story A Starting Point not final word
3 A Design Movement in Healthcare Information Technology & Digital Assets Devices & Medical Products Vendor innovation Patient Experience & Services Environments & Workplace Clinical innovation Can human-centred design (HCD) help us innovate Clinical care models Organizational culture / structure Distributed care systems Better policy, agencies, decisions?
4 Design cuts across & integrates complex domains.
5 So what s the problem? Patient-centricity. This is a huge change, not just another process. Social determinants & outcomes. Clinical design research, new mixed-qual approaches Absolute, strategic driver for integration. Expense, risk, & complexity of fragmentation. Peak Lean. We have maximized return on efficient workflows. Balance processes with HCD.
6 Lean is not a wicked problem solver. Optimizes current practices. Very well. Analysis, not synthesis. Impedes systems thinking. Reinforcing As Is Impedes innovation. Process fixation after analysis & retraining. Cannot address future unknowns Toussaint & Berry (2013). The promise of Lean in health care. In Mayo Clinic Proceedings. Elsevier.
7 We have Innovation Centres & Labs Necessary. Could be networked. Lab metaphor may not be productive. Must be positioned to achieve change. Divergence between innovation culture And evidence-based (workflow) culture.
8 Wicked Innovation Problems Unprecedented aging demographic People living with multi-chronic diseases Complexity of social determinants Medical innovation costs & churn of technology New business models Risks of change, & not Healthy Communities Care as a Service? Systemic problems, studying human needs & culture. Design of social, clinical & business services. Require all stakeholders, not isolated analysis.
9 Is Design the answer? Information & Online Services Where most designers are employed in healthcare today Necessary, but not sufficient.
10 Zero diabetes armband concept Mauro Amoroso Toshiba CT MRI scanner Devices & Medical Products Timesulin insulin pen - courtesy Marcel Botha
11 Services & Experiences Philips Design, from Coroflot magazine
12 Emerging Design Domains Complexity increases at each stage > Number of stakeholders > Need for collaboration Multi-skill, multi-design, multi-disciplinary Healthcare services require all 4 domains of skill & knowledge. System-level change crosses domains. D3.0 & D4.0 are stakeholder driven. Changes how we do process design.
13 Human-centred services in 4 domains Integrating clinical & community services Interventions for social determinants Community health promotion New business models Design & research for service innovation Clinical team coordination Patient experience of service EHR / information workflow Patient self-service Information seeking in care journeys Innovative & usable wayfinding Interior infection control
14 Need New Service Architectures. Top-Down, Macro (Ecosystems) Patient-Centred Care: Organizing care for the patient (as whole person) Balancing workflow with personalized care. Connected Care: Integrating care across separate facilities Expanding geographic reach, while providing better locality Enabled by shared EMRs / IT platforms Value-Based Care: Measuring costs & outcomes for each patient. Bundled prices for the full care cycle.
15 Adaptive organizations Models for service coordination Information inter-op, inter-connection Top-down & bottom-up services Smart routines (Serial & iterative)
16 Complex care is a design problem. Doctor as design thinker Here health is co-created value.
17 Case in point Atrial Fibrillation Care Chronic & complex illness are exceptions. Patients fall between the cracks & get fragmented care at many locations. By not adapting to the changing reality of chronics, costs rise as hospitals increase their exception cases. Morra, et al (2010). Reconnecting the pieces to optimize care in Atrial Fibrillation in Ontario.
18 Atrial Fibrillation System Goal is prevention of serious CVD Designed as an integrated practice across units. Connected care model at system & patient experience levels. Systemic, scalable to province.
19 Heart Rhythm Specialists Neurologists Internists Family Doctors Nurse Practitioners Pharmacists Researchers Designers and Engineers
20 Human-Centred Systems Bottom-up, Human-Centred, Micro Design for Patient Experience Care as experienced by the patient as person. (Can we do this systemically?) Community Prevention Working closely with communities to discover determinants Prevention & mitigation unique fit to context. Communicative Therapy: Communicating with people in their languages & media. Catalyzing new practices, such as coaching.
21 Today, services are moments of care Triggered by health-seeking, but not patient-centric
22 Human-Centred Service Design Bottom-up Systemic yet personal 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
23 OCADU Health & Wellness Centre Service Flow As-Is Service Blueprint
24 Promoting Resilience & Self-Management - A Student-Centred Perspective
25 New Learning, New Designers. MDes STRATEGIC FORESIGHT & INNOVATION Business & Design Thinking Human Factors Systemic Design / Systems Thinking Innovation Research Methods Strategic Foresight Innovation Strategy Business Model Innovation Strategic research with faculty & students + MDes DESIGN FOR HEALTH (2016)
26 Discussion Mayo Clinic is leading in service design. Norway leads in system-wide approaches. Why not Canadian institutions? Can we connect Policy > Systems > Services? What s really missing today? Are you ready to engage clinicians, patients, agencies in design decisions? What do you believe is best next?
27 Design for Care: Innovating Healthcare Experience designforcare.com Book images free download at Flicker from the book site Peter Jones, Ph.D.
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