Design Thinking for Innovative Healthcare Service (Text Version)

Slide Presentation from the AHRQ 2008 Annual Conference

On September 8, 2008, Shelly Evenson made this presentation at the 2008 Annual Conference. Select to access the PDF version (2.6 MB; Plugin Software Help)

Slide 1

Design Thinking for Innovative Healthcare Service

Shelley Evenson
School of Design
Carnegie Mellon University

Slide 2

Overview

• What is design thinking?
• Two case studies:
  • Intel research technology.
  • University of Pittsburgh Medical Center (UPMC) patient needs.
• Underlying methods.
• 3 Big needs.

Slide 3

What is design thinking?

"A discipline that uses the designer's sensibility and methods to match people's needs with what is technologically feasible and what a viable business strategy can convert into customer value and market opportunity."

Tim Brown, Harvard Business Review June 2008

Slide 4

Designing a Business from a Technology

Intel research+ Carnegie Mellon

Simon King, Casey Helfich, Anu Melville, Adil Wali
Mentors: David Westfall, Art Boni, Laurie Weingart, Shelley Evenson

Slide 5

The project began with giving the team a choice of open-source algorithms from intel research.

Slide includes a Ven diagram with three overlapping circles representing design (people), technology, and business.

Slide 6

They selected the Diamond algorithm for interactive search through non-indexed data.

Slide includes 2 cartoons showing a sad face related to the traditional search and a happy face related to a Diamond interactive search.

Traditional exhaustive search—the burden of discarding is on the person.
With Diamond—discarding happens in the background relieving the burden on the person.

Slide 7

They looked with fresh eyes at what the technology had to offer...

Slide includes an image showing the relationship of identifying medical issues to images, documents, video, and sound.

Slide 8

They looked with fresh eyes at what the technology had to offer... (continued)

Slide includes an image showing the relationship of managing personal media to images, documents, video, and sound.

Slide 9

They looked with fresh eyes at what the technology had to offer... (continued)

Slide includes an image showing the relationship of monitoring environmental changes to images, documents, video, and sound.

Slide 10

They looked with fresh eyes at what the technology had to offer... (continued)

Slide includes an image showing the relationship of analyzing sports plays to images, documents, video, and sound.

Slide 11

The team then looked at social, economic, and technical trends and applied other business analysis methods.

They saw Diamond-enabled medical imaging as having the greatest potential value—financially as well as socially.

Slide 12

They focused down even more, concentrating on melanoma because it is a leading cause of death, but early detection dramatically increases survival rates...

One person dies of melanoma every hour.
One in every 62 Americans will die of melanoma.
Incidence of melanoma has more than doubled since 1973.

Melanoma Statistics, 2006, CCMAC (http://www.ccmac.org/statistics.html)
Cancer Facts and Figures, 2006, American Cancer Society (http://www.cancer.org/downloads/STT/CAFF2006PWSecured.pdf), US Census Data 2000, chapter 20
Melanoma Basics, 2005, Melanoma Center (http://www.melanomacenter.org/basics/statistics.html)

Slide 13

The team then conducted interviews and observational research in dermapathology services. They discovered the current workflow often fails for difficult cases...

• View
• Search
• Compare
• Diagnose

Note: Above the words view, search, compare, and diagnosis are images to represent each concept.

Slide 14

They designed a new workflow and interface, "onPath."

Slide includes a screen shot of a Web page showing images from tissue slides under the microscope.

Slide 15

They evaluated it with real users.

"You can actually compare apples to apples and not just apples to oranges. This is really great!" —A Director of Dermatopathology, University of Pittsburgh Medical Center.

Slide includes a photo of a man working on a laptop computer.

Slide 16

The team then designed the business for building and delivering onPath (including designing the company's organization)

• Produced a marketing strategy.
• Developed a financial strategy.
• Crafted a business pitch to interest investors in making onPath a reality.

Slide 17

The result? 3 months, 3 students, and a viable new business that has the potential to transform practice and improve patient outcomes.

Slide 18

Designing more participatory solutions for healthcare services

UPMC + Carnegie Mellon

Slide 19

In a recent McKinsey survey of 2000+ patients with commercial insurance, 75% would consider switching hospitals to become better informed about treatments or if appointments were kept on time. If forced to choose between information and timeliness, 3 times as many patients said they valued information more...

Source: Grote, Newman, and Sutaria, A better hospital experience, McKinsey Quarterly November 2007

Slide 20

A collaborative project to improve experience while seeing as many patients as possible.

UPMC
Dr. Kassam
Neurosurgery clinic staff
Center for Quality Improvement and Innovation

Carnegie Mellon Students
Kip Lee, Kara Tennant, Leanne Libert, Jamin Hegerman, Melissa Cliver

Note: Above the two sets of names are photos of the project participants.

Slide 21

Exploratory: Observe with designer's eyes

What's being communicated here?

Slide includes a photo of a doctor's office receptionists desk. The receptionists are not facing the camera, and a large sign reads, "Payment is due at the time services are rendered."

Slide 22

Exploratory: Observe with designer's eyes (continued)

What's the patient experience?

Slide includes a photo of a busy patient waiting area. There are several people standing and looking toward the receptionists desk, and the space is so crowded that there is no way to easily move around for the 3 individuals in wheelchairs that are visible.

Slide 23

Is that your foot or mine?

Slide includes a photo of several people's legs sitting next to each other in a crowded patient waiting area.

Slide 24

Exploratory: Observe with designer's eyes (continued)

What's the staff experience?

Slide includes a photo of 3 clinical staff in a hallway. One is entering a room, another is walking quickly down the hall, the third is leaning against the wall. None of the staff are looking at each other.

Slide 25

Students combined observations and interview with quantitative research.

"My first visit took over four hours."

Slide 26

They created a model of the patient's journey.

Slide includes a timeline with points plotted for detection, primary care visit, diagnosis/first visit, Pre-op visit, surgery, post-op visit, and follow-up visit.

Slide 27

Generative: interactive experience research

Slide includes a photo of a person holding up 2 photos: 1 with a pianist playing in concert, the other of a child napping on a couch.

Slide 28

And produced a summary of needs

Slide 29

Opportunities for all Constituents

Slide 30

Evaluative: concept validation with patients

Slide includes a photo of a young person sitting cross-legged on a hospital table. She is reviewing what appears to be a report.

Slide 31

Dr. Kassam fact sheet to inform, engage, and comfort patients, and provide a model for their experience.

A welcome booklet that embodies the spirit of the physician, previews the experience for the patient of the Neurosurgery Clinic, and at the same time positions the staff to help with broader delivery role.

Slide includes an image of a brightly colored handout with a drawing of a smiling physician on the first page.

Slide 32

Embrace wait times with a clinic chat system to provide information updates even when the patient isn't being touched.

Slide includes several images, including a reproduction of an online chat room conversation and waiting room layouts showing where computers would be placed.

Slide 33

Our result?

Patients have the information to understand their journey and build communities, so they can become more active in codesigning their care.

Slide 34

Our projects lead to innovative results

Three things drive the way we work that we believe can continuously lead to innovation in healthcare services:

• Simultaneous interdisciplinarity.
• Modeling-based process.
• User-centered methods throughout.

Slide 35

Most innovation starts with a technology...

Slide includes a Ven diagram of three circles showing the overlap of design (people), technology, and business.

Slide 36

Better companies start from people...

Slide includes a Ven diagram showing three circles with the overlap of design (people), technology, and business.

Slide 37

We believe in simultaneous interdisciplinarity

Slide includes a Ven diagram showing three circles with the overlap of design (people), technology, and business.

Slide 38

We use a modeling based process

Slide includes an image of a square divided into 4 areas; under Researching is: the abstract model of "what is" (interpret) and the concrete "what is" (describe); under Prototyping is the abstract model of what "could be" (interpret) and what "could be" (describe).

Analysis-synthesis bridge model
Hugh Dubberly
Shelley Evenson
Rick Robinson

Interactions
March/April 2008

Slide 39

And we focus on user-centered methods throughout the design process

Slide includes a model of project research and design process.

Project research

• Exploratory
• Generative
• Evaluative

Design process

• Discover
• Form the framework and strategy
• Create/express (Refine)
• Socialize
• Implement

Slide 40

But there is more to design thinking...

Slide 41

Design thinking requires design and 6 types of thinking

• Understanding
• Integration
• Openness
• Attention
• Exploration
• Envisioning

Slide 42

Understanding (in the small and large)

A focus on deeply understanding people's expressed and latent needs viewed in the context of broader social, economic, and technical trends.

Slide 43

Integration

The ability to organize and integrate disparate information into something many stakeholders—with different viewpoints—believe is better.

Slide 44

Openness

Fearlessness with regard to listening to another person.

Or learning from another discipline or division's perspective.

Slide 45

Attention

Respect for emotion and its importance in driving rational choice and satisfaction.

Slide 46

Exploration

Letting creative extremes take you into ever-richer solution spaces.

Slide 47

Envisioning

Leaps of faith as to what might work and creating quick, tangible examples of it, while being unafraid to discard design options along the way.

Slide 48

Design thinking

Bringing design thinking to healthcare services will enable the creation of customer-centered innovations for healthcare and provide the skills needed to explore new organizations, business models, and healthcare service delivery.

Slide 49

3 Big Needs

New methods for modeling patient experience.

New models for skilling everyday people to become more active participants in their care.

Innovative prototyping for exploring new healthcare service delivery systems.

Slide 50

Thank you.