Designing for Patient-Centred Innovation

Designing for Patient-centred InnovationSusan Bartlett & Chris FergusonCooler Solutions Inc.AMI 2012 Annual Meeting

Cooler Solutions Inc.

Overview

Patient-Centred Care

Our Approach to Innovation

Some Case Studies

Take-Aways

• What is design?

• What is patient centred care?

• How is it relevant to medical illustrators?

Cooler Solutions Inc. 4

Innovation is creativity with a job to do.

—John Emmerling

Innovation Consultant

“”

innovation ≠ invention

innovation ≠ improvement

TechnologyResearch & Development

BusinessManagement

Consulting

HumanValues

Design

Citation: Stanford D School. http://dschool.stanford.edu/our-point-of-view/#innovators

BusinessManagement

Consulting

HumanValues

Design

BusinessManagement

Consulting

HumanValues

Design

BusinessManagement

Consulting

HumanValues

Design

BusinessManagement

Consulting

HumanValues

Design

Design Innovation

Healthcare Technology Innovation

AntibioticsVaccines

MRIs Robot-assistedSurgeries

Nano-technology

Transplants

Healthcare Business Innovation

ElectronicHealth Records

Pharmaceuticals with Value-add Services

Multi-disciplinaryFamily Health Teams

If a physician from the 1950s were magically brought back to life today, he would recognize none of the technology that a contemporary doctor uses, but he would feel quite at home in the settings in which the technology is used.

—David Cutler

Professor of Economics, Harvard

Patient-centredCare

Cooler Solutions Inc. 13Bechtel, C., & Ness, D. L. (2010). If you build it, will they come? Designing truly patient-centered health care. Health affairs (Project Hope), 29(5), 914-20. doi:10.1377/hlthaff.2010.0305

Whole Person Care

Bechtel, C., & Ness, D. L. (2010). If you build it, will they come? Designing truly patient-centered health care. Health affairs (Project Hope), 29(5), 914-20. doi:10.1377/hlthaff.2010.0305

Whole Person Care

Collaborative, Coordinated

Whole Person Care

Supportive, Empowering

Ready Access

Whole Person Care

Supportive, Empowering

Banking

Retail

Telecom

Journey Through Healthcare

Cartoon Removed due to Licensing Restrictions

Patient-centred Model Fee-for-service Model

Information Silos Poor Collaboration Tools

Healthcare IT

Patient and Clinician

Healthcare Business Models

Healthcare IT

Patient-Centred Care

Healthcare IT

Design Innovation

Innovation requires

POSSIBILITYOF FAILURE = RISK

POSSIBILITYOF FAILURE

If you're not failing every now and again, it's a sign you're not doing anything very innovative.

— Woody AllenFilmmaker

The way to succeed is to double your failure rate.

— Thomas J. Watson, Sr.IBM founder

“”

Healthcare decision makers want evidence

that innovation will work.

Innovative=

No evidence of its working elsewhere

Healthcare decision makers want

quantified promises about return on

investment

Innovation:No good ways to

quantify for something that

hasn’t been done

Healthcare decision makers aren’t

comfortable with failure

Innovationsoften require lots of small failures before

they get to success

Cooler Solutions Inc. 31Organisation for Economic Cooperation and Development (2010), “OECD Health Data”, OECD Health Statistics (database). doi: 10.1787/data-00350-en (Accessed on 14 February 2011).

1970 2005

$1,000

$2,000

$3,000

$4,000

$5,000

$6,000

$7,000

$8,000P

Growth in Total Health Expenditure Per Capita, US, 1970-2008

Cooler Solutions Inc. 32Source: Harvard Business Review

Elderly patients discharged with Adverse Drug Events:

4%Before Program

After Program

Healthcare organizations are the most complex form of human organization.

—Peter Drucker

Our Approach to Innovation

RESEARCH + DESIGN

DESIGN_____________________________________

Biomedical CommunicatorsIndustrial DesignersService DesignersGraphic Designers

RESEARCH_____________________________________

Social ScientistsStrategists

Biomedical ScientistsDocumentary Film-makers

Audience Participation Game

One-Word Letter• Pair Up

• Choose person A and B

• Write a letter with each person using only one word at a time

... ...

One-Word Letter• Convince your aunt that

you should be added back to the will even though you ran over her cat.

... ...

One-Word Letter• Convince your aunt that

you should be added back to the will even though you ran over her cat.

On purpose.

... ...

Ground Rules

• Listen to what the other person has to say

• Build off your partner’s ideas

• Allow the letter to go places you did not expect

If it feels weird, then it’s working.

• I wanted to take it in a certain direction

• I found it hard to listen because I was thinking about what I wanted to say

• I found it hard to work together to build a coherent story

KNOW DO

KNOW-DOGAPKNOW DO

The chasm between what is known through the research and the solution that needs to be created and implemented.

KNOW DO

“Bridging the know–do gap is one of the most important challenges for public health in this century. It also poses the greatest opportunity for strengthening health systems”- Departments of Knowledge Management and Sharing & Research Policy and Cooperation, World Health Organization 2006

KNOW DO

“Bridging the know–do gap is one of the most important challenges for public health in this century. It also poses the greatest opportunity for strengthening health systems”- Departments of Knowledge Management and Sharing & Research Policy and Cooperation, World Health Organization 2006

KNOW DO

KNOW DOBRIDGEOur leading-edge social science and medical research identifies where innovation lies.

KNOW DOBRIDGE

Principles for enabling design solutions focused on optimizing the human experience.

KNOW DOBRIDGEPrototyping, testing and evolving designs to arrive at a highly valued solution.

Case Studies

Bariatric Seating ProjectThe experience of living with obesity

M I S F I T

KNOW DOBRIDGE

Principle: Use subtle cues that inform people with obesity that they have been

considered without alienating them.

KNOW DOBRIDGE

Design Phase

• Photo slideshow

• video clip from misfit video

Early Sketches

Design Phase

• Photo slideshow

• video clip from misfit video

Early Prototypes

Models and Final Renderings

KNOW DO

Artery of EducationAn immersive, interactive experience

KNOW DOBRIDGE

An immersive interactive experience

KNOW DOBRIDGE

Artery tunnel photo

Artery Wall

Communicating Risk to Oncology Patients

Cooler Solutions Inc. 80http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2829758/

I was able to continue working at my job

I felt tired all the time...

Percentage of patients with breast cancer that rate keeping their breast a top priority:

DOCTORS PATIENT REPORTED

Source: Lee et al. 2010

71% 7%

Percentage of patients with breast cancer considering chemotherapy that rate living as long as possible a top priority:

96% 59%

Cooler Solutions Inc.Neuner-Jehle, S. et al. 2011. 84

Percentage of physicians that communicate to patients using:

VERBAL QUALIFIERSEXCLUSIVELY

VISUALS

73% 16%

Patients tend to hear from their clinicians more about the pros than about the cons and potential side effects

—Mike Barry,

President, Foundation for Informed Decision Making

Professor, Harvard Medical School

“The hospital doesn’t have resources to support decisions…90% of patients are left without treatment support.”

–Clinical Oncologist

“The nurse told me, and she used a big long word I couldn’t even pronounce. She said, ‘you’re taking this really well,’ and I said ‘that’s because I don’t know what you just said.’” –Cancer patient

KNOW DOBRIDGE

Principle: Allow users to expand and collapse content so they control the

amount of information displayed.

KNOW DOBRIDGE

Principle: Use relatable narratives and help individuals understand implications by providing context of their daily lives.

KNOW DOBRIDGE

Take-Aways• Design is a discipline that starts from an understanding

of unmet needs to develop new products, services,

• Patient-centred care is transforming our healthcare system by innovating from the perspective of technology, business models, and human values

• Medical illustrators can use their skills to elevate and differentiate patient-centred innovation projects.

KNOW DO

BusinessManagement

Consulting

HumanValues

Design

Design Innovation

BusinessManagement

Consulting

HumanValues

Design

Medical IllustratorsBiomedical Communications

BusinessManagement

Consulting

Thank you for listening!

FOLLOW US ON TWITTER:

@coolerSusan@chrisFerg

Designing for Patient-Centred Innovation

Business

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