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h e a l c a r d i oSYSTEM ORIENTED DESIGN A holistic solution for the cardiovascular
Yue Zou
SYSTEM ORIENTED DESIGN A holistic solution for the cardiovascular
h e a l c a r d i o
This project submitted to the Oslo School of Architecture and Design for System Oriented Design Studio cooperated with DNV GL
Yue Zou, author Linda Blaasvær, Manuela Aguirre, advisor
ABSTRACT
What is the future healthcare in future? Design itself is a important power to make the healthcare system change a lot. This project is aimed at exploring the future healthcare service in system thinking to make a holistic process and assumption of future system. Cardiovascular patients is a biggest group in the world. I hope working with this group can bring a lot of inspiration for other healthcare issue. In this project, I use strategy design, service design and interaction design method to create a hotlist service for cardiovascular patients out of the hospital. Nowadays a lot of people are suffering from longterm diseases and having high risk of cardiovascular. The food is a good way to address this problem. The meaning of the food and medicine are changing. The longterm medicine cause a mental problem at the beginning. The industry of medicine are struggling with their development, The goal of this project is to discuss the touchpoint food and medicine to address all the problems here, using system design methodology.
KNOWLEDGEMENTS
Thank you to my advisor Linda and Manuela for their support and guidance on this project. Thanks also for Mosse and Natalia for their tutoring of interaction design and service design.
Thanks a lot for my partners, Marius, Stephen and other people from DNV GL healthcare innovation center. We had great workshops during this project.
CONTENTS
• research 1
• leverage points 23
• prototyping 44
First Giga-mapping
research leverage point prototype
research
1
First Co-creation Workshop 2
WHY CARDIOVASCULAR
One in four deaths (12.9 million) was from heart disease or strike in 2010.
Two in three deaths worldwide were from chronic diseases in 2010
Most cardiovascular diseases can be prevented by addressing lifestyle - related risk factors.
It’s obvious that cardiovascular is the biggest groups which means most important..There are two things for me. Firstly, I hope other disease can also get some insight from my project. Secondly,it’s easily to contact the patients easily.
3
RESEARCH PROCESS
4
MY PARTNER
My partner DNV GL is quite a world leading group which is famous for give certification to organizations including hospitals. I’m working with healthcare innovation in DNV GL. Safer, smarter and greener is a process for the society to transformative. Sustainability needs transformative. This three words is a good evaluation for my project. Digitalization, localization are the good strategy for the branding.The main target group is China, USA, European(Norway).The evolution part is valuable as a starting point. Holistic care is necessarily.
5
DNV GL healthcare innovation center has done a lot of projects. They are focusing on human centered care. These general principle of patient centered care from DNV GL can give me a lot of inspiration to imply in my project. The principle has many different levels perspectives from individual level to system level.what is safety culture? It’s a big question. I use giga-mapping to figure out the DNA of safety culture. I found three words to support the DNA-SHARED EFFICIENCY TRUST.
6
CO-CREATION WORKSHOP
This is first workshop in DNV GL. Because healthcare is a big image and my client did not give me any limitation in direction at beginning. I think I should find a start point to work with. This co-creation workshop’s main goal is to find some general problem of the cardiovascular in professional’s perspective.
7
Using timeline is a good way to find different problems in a holistic perspective. I want to discovery which is more important in healthcare system between in hospital or out of hospital. Iceberg model is a good way to find a same solution to relevant problems. The process aims at find ing the basic problem.
8
CO-CREATION WORKSHOP
We had 8 steps in the the workshop, but we just finished 2 steps in the workshop. It is still meaningful. After the workshop, I collected the problems and continued the iceberg model. This process is to find the potential problems and from specific problem to new problem. Stand on the system to form a system solution for the new general problem.I use the iceberg model to find the basic and general problem. This is a good way narrow my user research. Standard information system/Suitable Diet/Money segment/Easy communication pipe/between doctors7Good understanding between patients and doctors/Rescue system/Bad rehabilitation quality/Family support
9
I interviewed with two patients deeply and a short random access interview with Ten People. One was at his home for 3 hours. Another was in a cafe near his working place for an hour. It is difficult for me to contact with patients in Norway due to the protection policy.
USER RESEARCH
10
INTERVIEW A
I design an interview based on problems from the first workshops, talking about overview,Things,Lifestyle&Drug,Relationships(community),family support and rescue.
11
‘I believe my doctors.I don't need my children to support me. My children visit me a lot, but I don't think they can support me for my troubles. They just gave me some regular suggestions.’
‘I put this fitness equipment very close to my bed. It makes me feel safe, when I do some excises.’
‘Healthy diet and nutrients work good for my trouble. 3 year ago, I followed a healthy diet routine. The doctor told me my heart trouble was better after that routine. I gave up, because it was a burden-money and a lot of steps, and doctors gave me some new medicine.’ ‘I use computer a lot. Mobile phone is important for me, because it means communication.’
12
INTERVIEW B
‘I am afraid to take medicine and it make me feel like a patient. Expect hypertension, I'm quite healthy. Sometimes I forgot to take the medicine.’
13
Based on the deep interview, I choose what I am interested in to do a short random interview. Two people is a small group for user research, but it is difficult to go on deep interview many times.
9/10 people believe Norway’s healthcare system. They believe doctors more than family members.Not like China, the healthcare are not very good. The people are more relied on family
7/10 people believe good diet can treat disease and keep healthy, but it is difficult to insist on a special diet.People can not insist on it because the diet is expensive and with more steps to follow. People not address a lot on diet.
9/10 people will forget to take medicine more than 4 times per month, especially longterm medicine. The longterm medicine cause social problem when they have medicine other people always ask their situation.
RANDOM ACCESS INTERVIEW
14
PROBLEM COMPARING MAP
Use this map to discover the problems. Eg; the communications between doctors Patient A agreed: he think it is not necessary, he can be a bridge between doctors.Patient B disagree: he told me they just share information not discuss my condition
15
I interviewed the leader of communication from LHL.LHL is special organization, because they are not only an organization but also owner of a hospital. They call this is a perfect healthcare model. We had a 2 hour talk. Kristin told me some cases about LHL- a social innovation for lung disease all around Norway which is an activity for healing mental problem and the balance between top-down structure and bottom up structure. They have a project to develop an APP for cardiovascular patients.
I only know one doctor is my doctor in Oslo kommune, Legevakten. She is always busy,but she sent me some paper materials about healthcare system in Norway.
INTERVIEW WITH DOCTORS
16
GIGA-MAPPING HEALTHCARE SYSTEM IN NORWAY
General Process
Management System
Economic Process
After the interview, I used the insights and paper materials to giga-mapping the healthcare system in Norway.
17
RESEARCH MAP
After finishing the research map, I put the potential problems in the whole map and see their relationships in different levels, and think some preliminary ideas.
18
DESIGN TREND
Based on structure in School of Design, CMU
Nowadays, design researcher divide the design area into three area. Based on this structure, I work out three different preliminary ideas.
19
Good Understanding between Patients and Doctors
Good understanding between patients and doctors is potential area. Opposite opinions and some same views make this area active. It can evolve in a long journey for patients in existing system.
PATIENT CENTERED CARE
SYSTEM
PATIENTS
GOOD CASES
using risk based approach to redesign service
empower individuals
organize care for needs not diseases
payments on results not activity
integrating care across doctors and patients
long investment for system
invest in climate adaptation
standard
develop safety cases
creating cultures and midgets
manage risk locally
PHYSICAL/PSYCHOLOGICAL/SOCIAL NEED
decision making
incorporating their abilities
preferences
lifestyle
own treatment
patient engagement
sustainable hospital
mobile health
health alliance
digital appointment
measuring true value
knowledge sharing
Patients’ Journey & Existing System
moderate change
Medical Case Paper
Visual Communication& Interaction Design
PRELIMINARY IDEA ONE
20
Culture Driven/Professional Power Service Design/Interaction Design
PATIENT CENTERED CARE
SYSTEM
PATIENTS
GOOD CASES
using risk based approach to redesign service
empower individuals
organize care for needs not diseases
payments on results not activity
integrating care across doctors and patients
long investment for system
invest in climate adaptation
standard
develop safety cases
creating cultures and midgets
manage risk locally
PHYSICAL/PSYCHOLOGICAL/SOCIAL NEED
decision making
incorporating their abilities
preferences
lifestyle
own treatment
patient engagement
sustainable hospital
mobile health
health alliance
digital appointment
measuring true value
knowledge sharing
z
SAFETY CULTURE VALUE SAFETY
BELIEFS
ATTITUDES
PERCEPTIONS
Communications founded on mutual trust
Confidence in the efficacy of preventive measures.
Shared perceptions of the importance of safety
z
Patients’ Journey & Emerging System
significant change
Rehabilitation Based on Community
PRELIMINARY IDEA TWO
21
Change Medicine Industry Deign for Radical Change
There are lot of research about cardiovascular patient to map the new system based on trend study. Create new scenario to interact with people under patient centered care to promote the new system.I hope to use design method to promote the hospital or medicine industry can change their role in the system.
PRELIMINARY IDEA THREE
22
leverage points
23
First Co-creation Workshop 24
People
Resource
Interactions
Mechanisms of Change
Direction/Idea
IDEA ONE IDEA TWO IDEA THREE
preliminary idea
Use PRISM to Improve Ideas
1
2
LEVERAGE POINTS3Improve Ideas
PRISM METHOD from InWithForward
PROCESS
25
26
SpecialistNurse
Object/Display
in hospital
Patients
Interaction
APPiPhoneiWatch
Website
at home
Object
GP
collectdata
Visualization
Information
Mechanisms of Change
Contributing & Reciprocating to increase meaning & purpose Good touched visualization can increasing the meaning for experience and increase purpose frothier health.
Scale
Daily life/Hospital The young/Middle-aged Object/Environment Interaction/Product
IDEA ONE
27
DAILY LIFE Interaction Design Product Design
IN HOSPITAL Interaction Design Product Design
it is a good Kickstarter project. It is a real digital object or some object combined with iwatch or iPhone. In hospital maybe is a screen connected to customer’s app and doctor’s system. This is a holistic design involve in different scenarios.
IDEA ONE
28
Change the structure of information flows
IDEA ONE
29
Frida is a middle age guy. He is crazy about apple products. He has a great job in a band which means he is super busy everyday.
One day he felt bad, and go to see doctor. He was diagnosed with high blood pressure.
a was sad. He though he was too busy to notice his health condition, Although he had some apps for his health.
One day, he found a fabulous flower. He brought it to home.
That’s a magic flower. The feel bad, The flower will also be in super bad condition.That’s great visualization to make him realize his health condition.
HEALTH
TIME
HEALTH
TIME
IDEA ONE
30
Resources
DNV GL Research Resources (Standard of Health)
LHL (consultant)
People
Cardiovascular Patients
General Doctors
Specialist
Nurse
Interactions
CHECKLIST
LIFESTYLEGUIDE CHECKLIST
REHEBITATIONGUIDE
CHECKLIST NOTICE MEDICINE STORY BOOKOPERATIONPROCESS
his pack gift is a holistic interaction between customers and professionals.
Scale
Daily life-Hospital Male-Female Service-Management
Mechanisms of Change
Feedback to increase validation & motivation The goal is to use feedback to change and promote the experience during the process.
IDEA TWO
31
For the design part compare form and function like app or paper is important. The movie should be cartoon which not creates new mental problem. Medicine management can applied in the gift pack system.
CHECKLIST
LIFESTYLEGUIDE CHECKLIST
REHEBITATIONGUIDE
CHECKLIST NOTICE MEDICINE STORY BOOKOPERATIONPROCESS
APP Paper
Paper Cartoon
PaperDigital
Explore best form/materials/techniques/ideas for gift pack
Daily Medicine
IDEA TWO
32
The gain around driving positive feedback loops.
IDEA TWO
33
Laura is 50 years ago. She usually go to visit GP. At that time, she got a gift pack.
Yes, a gift pack for her current situation. A checklist to manage her diet and
CHECKLIST
LIFESTYLE
GUIDE
When her condition got worse and worse, she went to see her GP. The GP referred a special examination. At this time, she got a gift pack.
This gift pack has some CHECKLIST
NOTICE
MEDICINE
after the special examination, She need a surgery. Before the surgery, she got a gift pack. This gift pack have a story book to soft her emotion and a movie of the operation process.
STORY BOOK
OPERATION
PROCESS
After the surgery, she also got a gift pack.
In this gift pack, there is a check list and rehebitation guide book
CHECKLIST
REHEBITATIONGUIDE
IDEA TWO
34
Diversity and deep understanding of food and medicine change the role of food and medicine.Food can be a treatment.Medicine is for keeping health, not for treatment.More and more medicine companies evolve in food industry.
Resources
DNV GL Research Resources (Standard of Health/Patient Centered Care)
Designers (consultant)
IDEA THREE
Mechanisms of Change
Taster Experiences to shape preferences & goals
Barrier Busting to manage stressors & increase future orientation
This direction is aim at shaping the preferences and goals also increasing future orientation.
Trend
People
Cardiovascular Patients
General Doctors Specialist
Nurse
Hospital
Medicine Industry
DNV GL Research Group
Government
http://www.kenko.com/product/item/itm_6924185772.html
35
Food and medicine in future not just the object. It will will be with a lot of information on itself and its package or people’s APP. Regard this, use the food and medicine as a new touchpoint between the customers and professors.This also change the role of supermarket and Pharmacy in Future.Government should involve in it. DNV GL can be a certification provider in new area
Scale
IDEA THREE
Trend
36
Change the rules of system
IDEA THREE
37
Co-design is a very interesting process based on the background of DNV GL.
We can figure the form, function , techniques and ideas for different stage.
It also will create other relevant design evolve in this process, product and APP and service.
This is a good outcome to cause discussion of the unclear Border between the food and medicine.
IDEA THREE
38
CO-DESIGN WORKSHOP
39
We use the one way to identify the patients. We ignore the identity for health for people.In the workshop we used card sorting to do co-design workshop.
Touchpoint: Medicine and Food
Card sorting for form/function/techniques/idea in holistic process. Based on human centered design.
SEVERAL MONTHS
PREVENTION VISIT GP MAKE A TENTATIVE DIAGNOSIS RECEIVING S EXAMINATIONREFERS TO AN S DEPARTMENT GP/( PUBLIC HOSPITAL)
EXAMINATION
OPERATION
NECESSARY MEDICATION SURGERY
PUBLIC HOSPITAL
PRIVATE HOSPITAL
REHABILITATION AT HOSPITAL
SHORT TIME
HELFO
GP
VISIT GP
A
B
C
D
CO-DESIGN WORKSHOP
40
T�ea���n� K��� He�l��
Fish Oil
Collagen
Te�
Ve�et����
Fi��
F��i�
J�i�� Nu����nt�
Nu����nt�G���i�
Me�i���� f�� L�n�-����
ACEICaptopril/Enalapril//Perindopril/Benaz-epril/Iimidapril/Fosinopril/Ramipril
Me�i���� f�� L�n�-����
ARBLosartan/Valsartan/Olmesartan/Telmisartan/-Candesartan/Iirbesartan
Me�i���� f�� L�n�-����
B blockersMetoprolol/Bisoprolol/Atenolol/Esmo-lol/Propranolol
Me�i���� f�� L�n�-����
Calcium channel blockersNifedipine/Felodipine/Amlodipine/Dilti-azem/Verapamil
Me�i���� f�� L�n�-����
DiureticsFurosemide/Hydrochlorothia-zide/Indapamide/Spironolactone
Me�i���� f�� L�n�-����
Antiplatelet and anticoagulantsAspirin/Clopidogrel/Tirofiban Hydrochloride/Heparin/Warfarin
Me�i���� f�� ���p���n�
Coenzyme Q10
Me�i���� f�� ���p���n�
Cyclic Adenosine Monophosphate
Me�i���� f�� �h��-����
A blockerPrazosin/Terazosin
Me�i���� f�� �h��-����
Anti-ischemicNitroglycerine/Isosorbide Dinitrate
Me�i���� f�� �h��-����
ThrombolyticUrokinase/Streptokinase/rt-PA
Me�i���� f�� �h��-����
Lipid regulatingAtorvastatin Calcium/Rosuvastatin Calcium
Me�i���� f�� �h��-����
Anti-arrhythmicQuinidine/Propranolol/Amiodarone/Verapamil
Me�i���� f�� �h��-����
Inotropic agentsDigoxin/Cedilanid/Milrinone
Me�i���� f�� �h��-����
Anti-shockDopamine/Adrenaline/Atropine
Treatment
Keep Health
NEW CLARIFICATION
41
IDEA FROM WORKSHOP
IT’S TIME TO HAVE A
IT’S TIME TO HAVE B
IT’S
For keeping health.
For keeping health.
For treatment.
(even through the chronic disease people have same image with normal people)
Treatment Keep Health
One day package
X days package After x days, people will have a examination
Interaction identity Package identity
IT’S IT’S IT’S
Health Map
good bad
Visual Report
42
DESIGN DEFINITION
A TOOL TO COMMUNICATE WITH DOCTORS
REDESIGN THE IDENTITY OF MEDICINE AND DIET IN SMART NOT JUST APPEARANCE
➤ Redesign the identity for medicine and food
➤ Design a professional way for people to communicate with doctors outside of hospital.
Norway has a good healthcare system. People believe the professionals than other pipes. The professional communication tools are necessary for people even through they are just at high risk of cardiovascular patients. It difficult to change the identity of medicine and food trough directly way package or appearance, but digitalization still provides some opportunities to change the identity of the medicine and food. All the things require me to regard App as a touchpoint to connect the different touch points to make a holistic service for customers. HELFO is making the patients information standard which play an important role on the App which can be easily set up in future. Design is increasingly important in healthcare system. App is also a good factor to change the whole system,
43
prototype
44
TREATMENTKEEP HEALTHYPREVENTION
HOLISTIC PROCESS
45
MAKE APP WITH MODULAR FUNCTION
46
an easy way to keep you from cardiovascular disease
Dear Lily,
Depending on your current situation ( see your document ), I think you are at a high risk of cardiovascular disease, but don't worry about it, it is not serious, if you follow these steps.
STEP ONE Suitable Exercise and a Balance Diet as possible as you can, this is not just for prevention but also a good daily life.
STEP TWO Most important things for diet are salt and fat. I recommended the max daily amount of salt is 6.00g and the max daily amount of fat is 6.00g.
STEP THREE
Download this lovely APP - healcaedio. This is a important bridge between us. 1. It can help you to track fat and salt. 2. You can use it to manage your body data. 3. You can use it to communicate with me, and share the data you like to share. I can give you
feedback as soon as possible and make a future plan.
Sign up Enter this code: 463284325324
Remember that we use healcardio together. Don't feel alone.
Your GP
PREVENTION
USER’S JOURNEY
Actually people can not have a talk about suggestion for their future healthy life. Depending on the user research, people prefer to listen to professional people suggestions. Due to this reason, creating a very professional scenario is necessary for people. This is easy way to make the people follow the suggestion for prevention. They will begin their prevention from GP., regarding the prevention process as a professional treatment.
Visual report is a strategy for engaging doctors. Doctors is very busy. Making a simple and meaningful image based on data is a good way to save time for doctors. The doctors can give a feedback in a short time, also creating a positive quick feedback for patients.
47
KEEP HEALTHY
In future, delivery medicine is a obvious trend. But people is afraid of delivery medicine. 4/5 people think they hope their doctor can make sure the medicine is correct through the delivery system. This point will create a new business model in future. Who can be in charge of the medicine to delivery.. This system should be very flexible for different customers.
48
tes t ing
c o l l e c td a t a
o k
o kc o l l e c td a t a
b l o o d p r e s s u r e
h e a r t r a t e
000mmHg / 000mmHg
000 /min
130mmHg
85mmHg
10/24
2015
10/24
2015
10/24
2015
10/24
2015
10/24
2015
10/24
2015
10/24
2015
10/24
2015
60/min
100/min
10/24
2015
10/24
2015
10/24
2015
10/24
2015
10/24
2015
10/24
2015
10/24
2015
10/24
2015
h e a l c a r d i oPM
TREATMENT
USER’S JOURNEY
There are already a lot of APPs tracking the body data. For simplifying the healcardio. healcardio can get the data directly from other APPs like ihealth, during the clickable prototype test, 4/5 people felt confused and difficult to use it, if they can use healcardio to collect data directly.
49
Comparing the APPs on the market, most of the Apps are green. To create a uniqle brand, I choose to use single main color red with a soft style. The basic principle of the Apps is simplicity. I will follow it.
h e a l c a r d i o
sign in
sign up
An angel for your heart.Gill Sans
Adobe Caslon
Avenir Next
Color Font
Soft
Sharp
Multiple Color
Single Color
BRANDING
50
IDENTITY OF DESCRIPTION
New Journeyforyou
01/10/1015 to 01/11/1015
Dear Lily,
As I said through healcardio, your situation is quite nice.Continue to take Aspirin & Metoprolol to keep health.
ASPIRIN
This is an element for prevent heart attacks, strokes, and chest pain. Take 1 tablet everyday at the beginning of happy days before breakfast.
Scan Code Put on your Aspirin Package
METOPROLOL
This is an element for prevent high blood pressure and chest pain. Take 1 tablet at the morning and 1 tablet at evening before diet everyday.
Scan Code Put on your Metoprolol Package
Your GP
THIS IS FOR PHARMACY OR SHOPPING ONLINE
CODE: DFBFSDA89DDA
Scan Code
Nitroglycerin
01/10/1015 to 05/10/1015
Dear Lily,
is Nitroglycerin is for a 5 days treatment, you should take it very carefully before next week examination. How
Take 1 tablet at 7:00am&9:00pm everyday.
Do NOT swallow, chew, or crush this tablet. Dissolve the tablet under the tongue or between the cheek and gum.To treat an angina attack, use nitroglycerin tablets at the first sign of chest pain. Sit quietly while the tablet is dissolving.
WHAT Preventing or relieving a sudden attack of chest pain caused by heart disease. Nitroglycerin is a nitrate. It works by dilating (widening) blood vessels. Chest pain occurs when the heart needs more oxygen than it can get. Dilating blood vessels allows blood to flow more easily. This reduces the heart's workload and the amount of oxygen needed by the heart.
NOTICE Do NOT use nitroglycerin tablets if: you are allergic to any ingredient in nitroglycerin tablets you have increased pressure in the head you have severe anemia
Your Doctor
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an easy way to keep you from cardiovascular disease
Dear Lily,
Depending on your current situation ( see your document ), I think you are at a high risk of cardiovascular disease, but don't worry about it, it is not serious, if you follow these steps.
STEP ONE Suitable Exercise and a Balance Diet as possible as you can, this is not just for prevention but also a good daily life.
STEP TWO Most important things for diet are salt and fat. I recommended the max daily amount of salt is 6.00g and the max daily amount of fat is 6.00g.
STEP THREE
Download this lovely APP - healcaedio. This is a important bridge between us. 1. It can help you to track fat and salt. 2. You can use it to manage your body data. 3. You can use it to communicate with me, and share the data you like to share. I can give you
feedback as soon as possible and make a future plan.
Sign up Enter this code: 463284325324
Remember that we use healcardio together. Don't feel alone.
Your GP
I asked users to make sequences based on professional. 1=not professional, 3=professional A:2 1 3/ B:1 2 3/C:2 1 3/D:2 1 3/E:1 2 3
Use color for different stages. Keeping Health and Prevention stages have the same color. Treatment is use another color to show the process should be paid more attention.
The illustration is very necessary. 4/5 users think it is useful.
51
5/5 users think they can use healcardio through doctors. They don't think they can use an APP through the APPs store directly.
I asked users to make sequences based on professional. 1=not professional, 3=professional A:2 1 3/ B:1 2 3/C:2 1 3/D:2 1 3/E:1 2 3
Use color for different stages. Keeping Health and Prevention stages have the same color. Treatment is use another color to show the process should be paid more attention.
The illustration is very necessary. 4/5 users think it is useful.
52
Two Action One Action
YES or NO
IDENTITY OF DESCRIPTION
Two Action
53
Test with clickable prototype 9 54
IDENTITY OF DESCRIPTION
accuratejoyful
Joyful
Accurate
Use professional way to address the importance on diet. People use this way to communicate with doctors and get encourage.Use the joyful interaction way to change the identity of long-term medicine and make this activity more relaxed.Checklist is the most familiar way for users. This way can provide professional and accurate interaction way.Test for accurate and joyful. This quality is low. Due to the test group are 5 people.
55
Salt
0.50g 0.50g 0.50g 0.50g 0.50g
IDENTITY OF FOOD
I sent my idea to my interviewees before through the e-mail. Surprisedly, they think this is a problem for them not just for salt and fat. Sometimes their doctors to ask them to have fix amount of food, but they don't have ability to measure them.
56
New Journeyforyou
01/10/1015 to 01/11/1015
Dear Lily,
As I said through healcardio, your situation is quite nice.Continue to take Aspirin & Metoprolol to keep health.
ASPIRIN
This is an element for prevent heart attacks, strokes, and chest pain. Take 1 tablet everyday at the beginning of happy days before breakfast.
Scan Code Put on your Aspirin Package
METOPROLOL
This is an element for prevent high blood pressure and chest pain. Take 1 tablet at the morning and 1 tablet at evening before diet everyday.
Scan Code Put on your Metoprolol Package
Your GP
THIS IS FOR PHARMACY OR SHOPPING ONLINE
CODE: DFBFSDA89DDA
SHOPPING ONLINE
STICKERS
When people prefer to believe the professions, feedback becomes important. It doesn't mean doctor should do anything for their customers. We don't have enough medical staff to provide an extremely good user experience. Thus, the way of people to take the medicine, I choose empowering the individual to make a small change for future change. People use the sticks to manage the medicine by themselves.
IDENTITY OF MEDICINE
57
New Journeyforyou
01/10/1015 to 01/11/1015
Dear Lily,
As I said through healcardio, your situation is quite nice.Continue to take Aspirin & Metoprolol to keep health.
ASPIRIN
This is an element for prevent heart attacks, strokes, and chest pain. Take 1 tablet everyday at the beginning of happy days before breakfast.
Scan Code Put on your Aspirin Package
METOPROLOL
This is an element for prevent high blood pressure and chest pain. Take 1 tablet at the morning and 1 tablet at evening before diet everyday.
Scan Code Put on your Metoprolol Package
Your GP
THIS IS FOR PHARMACY OR SHOPPING ONLINE
CODE: DFBFSDA89DDA
Scan Code
Nitroglycerin
01/10/1015 to 05/10/1015
Dear Lily,
is Nitroglycerin is for a 5 days treatment, you should take it very carefully before next week examination. How
Take 1 tablet at 7:00am&9:00pm everyday.
Do NOT swallow, chew, or crush this tablet. Dissolve the tablet under the tongue or between the cheek and gum.To treat an angina attack, use nitroglycerin tablets at the first sign of chest pain. Sit quietly while the tablet is dissolving.
WHAT Preventing or relieving a sudden attack of chest pain caused by heart disease. Nitroglycerin is a nitrate. It works by dilating (widening) blood vessels. Chest pain occurs when the heart needs more oxygen than it can get. Dilating blood vessels allows blood to flow more easily. This reduces the heart's workload and the amount of oxygen needed by the heart.
NOTICE Do NOT use nitroglycerin tablets if: you are allergic to any ingredient in nitroglycerin tablets you have increased pressure in the head you have severe anemia
Your Doctor
!"#$%&'()*$"+ !"#$%&'()*$"+
,'%%-./*00*'0
!"#$%&'()*$"+
,%+&-*
I sent a email to ask two interviewees before. Both of them think they feel the physical paper is much safer than the digitalization. They will print it by themselves if they just have digital edition. 4/5 users told that they can use the paper to check the information on app. This can set a safer scenario.
SAFETY CULTURE
58
PROFESSIONAL COMMUNICATION
5/5 people during the test, they are happy to use healcardio to communicate with doctors especially during the treatment stage. 2/2 doctors think this is a good way to communicate with patients. The doctors doesn't want to make a link through their private APPs like imassage, eve though a lot of patients want to add them. Communication part is difficult to test in a short time. The problem here is that should doctor can know anything. I just design one image for users to communicate with others, some people doubt that they don't want show some data to the doctors. If I make this apps just for cardiovascular patients. Users (5/5) can accept the data to share (salt fat blood pressure and heart rate) Share the image with others through other SNS apps is better than creating a fountain that they can use this apps with other family members and other same people. This can make the apps more complex agains the strategy simplicity. Through other platform can also make a better integration.
59
FUTURE SYSTEM
This is new system in future. I hope use this project to show the holistic process can not live without t system thinking. I found that it is difficult to do a holistic experience now in Norway because the institution under government is independent like helfo and public health center. There should be a innovation center in future. Obviously with DNV GL basic research on healthcare. more and more design industry will go into this system.
60
MAP
I W O R K W I T H
N E W I D E N T I T Y F O R F O O D A N D M E D I C I N E I N S Y S T E M T H I N K I N G
H O L I S T I C P R O C E S S F O R T H E C A R D I O V A S C U L A R
A P R O F E S S I O N A L P I P EB E T W E E N C U S T O M E R SA N D D O C T O R S .
I W O R K F O R
SAFETY CULTURE
VALUE SAFETY
BELIEFS
ATTITUDES
PERCEPTIONS
Communications founded on mutual trust
Confidence in the efficacy of preventive measures.
Shared perceptions of the importance of safety
PATIENT CENTERED CARE
SYSTEM
PATIENTS
GOOD CASES
using risk based approach to redesign serviceempower individualsorganize care for needs not diseasespayments on results not activityintegrating care across doctors and patientslong investment for systeminvest in climate adaptationstandarddevelop safety casescreating cultures and midgetsmanage risk locally
PHYSICAL/PSYCHOLOGICAL/SOCIAL NEED
decision makingincorporating their abilitiespreferenceslifestyleown treatment
patient engagementsustainable hospitalmobile healthhealth alliancedigital appointmentmeasuring true valueknowledge sharing
professional
patients
researchers
policy makers
STATEHOLDERS INFLUENCE FACTORS
equality
sustainability
EVALUATION
environment
timeliness
costefficiency
person centered
safety
debt crsis/coherentaging population/equal
expandinggovernment leadingurban and rural
high cost/serious pressuregap between the rich and poor
MAIN MARKET
conservative culturepatient habits and preferencesector fragmentation
GENERAL PROBLEM
aging populationemerging disease patternclimate changerising costsinequitable accesspoor safety recordno holistic care
SPECIFIC PROBLEMS
1/10 patients harmed in hospitaldementia/chronic increaseICT is slowpoor coordinated effort
CARDIOVASCULAR
STATE/NATIONAL BUDGET
CITIZENS / EMPLOYERS/PATIENTS
REGIONAL HEALTH AUTHORITIES
LOCAL GOVERNMENT (MUNICIPALITIES / COUNTIES)
HELFO
PUBLIC HOSPITALS
PRIVATE SPECIALISTS
PRIVATE HOSPITALS
GP
NURSING HOMES AND LONG-TERM CARE
DENTAL CARE FOR CHILDREN AND OTHER DEFINED GROUPS
NATIONAL TAXES LOCAL TAXES
FINANCIAL SYSTEM
maritime
sustainable organisation(environmental/social/economic-longterm)
FOOD&WATER/OIL&GAS/ELECTRICITY&RENEWABLE/SHIPPING
SAFER
SMARTER
GREENER
SAFE AND SUSTAINABLE
FUTURE
oil and gas
energy
business insurance
software
AREABRANDING
MANAGE RISK
BUILD TRUST
HEALTHCARE INNOVATION
global impact
aligning split incentivesmanaging system risksempowering stakeholdersaccounting for valuetransforming mindset
an easy way to keep you from cardiovascular disease
Dear Lily,
Depending on your current situation ( see your document ), I think you are at a high risk of cardiovascular disease, but don't worry about it, it is not serious, if you follow these steps.
STEP ONE Suitable Exercise and a Balance Diet as possible as you can, this is not just for prevention but also a good daily life.
STEP THREE Most important things for diet are salt and fat. I recommended the max daily amount of salt is 6.00g and the max daily amount of fat is 6.00g.
STEP FOUR
Download this lovely APP - healcaedio. This is a important bridge between us. 1. It can help you to track fat and salt. 2. You can use it to manage your body data. 3. You can use it to communicate with me, and share the data you like to share. I can give you
feedback as soon as possible and make a future plan.
Sign up Enter this code: 463284325324
Remember that we use healcardio together. Don't feel alone.
Your GP
New Journeyforyou
01/10/1015 to 01/11/1015
Dear Lily,
As I said through healcardio, your situation is quite nice.Continue to take Aspirin & Metoprolol to keep health.
ASPIRIN
This is an element for prevent heart attacks, strokes, and chest pain. Take 1 tablet everyday at the beginning of happy days before breakfast.
Scan Code Put on your Aspirin Package
METOPROLOL
This is an element for prevent high blood pressure and chest pain. Take 1 tablet at the morning and 1 tablet at evening before diet everyday.
Scan Code Put on your Metoprolol Package
Your GP
THIS IS FOR PHARMACY OR SHOPPING ONLINE
CODE: DFBFSDA89DDA
Scan Code
Nitroglycerin
01/10/1015 to 05/10/1015
Dear Lily,
is Nitroglycerin is for a 5 days treatment, you should take it very carefully before next week examination. How
Take 1 tablet at 7:00am&9:00pm everyday.
Do NOT swallow, chew, or crush this tablet. Dissolve the tablet under the tongue or between the cheek and gum.To treat an angina attack, use nitroglycerin tablets aW�WKH�ƓUVW�VLJQ�Rf chest pain. Sit quietly while the tablet is dissolving.
WHAT Preventing or relieving a sudden attack of chest pain caused by heart disease. Nitroglycerin is a nitrate. It works by dilating (widening) blood vessels. Chest pain occurs when the heart needs more oxygen than it can get. Dilating EORRG�YHVVHOV�DOORZV�EORRG�WR�ŴRZ�PRre easily. This reduces the heart's workload and the amount of oxygen needed by the heart.
NOTICE Do NOT use nitroglycerin tablets if: you are allergic to any ingredient in nitroglycerin tablets you have increased pressure in the head you have severe anemia
Your Doctor
!"#$%&'()*$"+ !"#$%&'()*$"+
,'%%-./*00*'0
!"#$%&'()*$"+
,%+&-*
MANAGEMENT SYSTEM
NATIONAL INSURANCE SCHEME
MINISTRY OF LABOUR
HOSPITALS
HOSPITAL TRUSTS
REGIONAL HEALTH AUTHORITIES
MINISTRY OF HEALTH AND CARE SERVICES
GOVERNMENT
PARLIAMENT DENTAL PRIMARY CARE CARE PROVIDERS
PRIMARY CARE CARE PROVIDERS PROVIDERS
MUNICIPALITIES
COUNTIES
DIRECTORATE OF HEALTH (INCL. HELFO)
BOARD OF HEALTH SUPERVISION
INSTITUTE OF PUBLIC HEALTH
MEDICINES AGENCY
RADIATION PROTECTION AGENCY
BIOTECHNOLOGY ADVISORY BOARD
SYSTEM OF PATIENT INJURY COMPENSATION
SAK
NOKC
POBO
61
USER RESEARCH
CARDIOVASCULAR
PATIENTS
DIAGNOSE
EMERGENCY
RESCUE
EMERGENCY
RESCUE
EMERGENCY
RESCUE
REGULAR
INSPECTION
REGULAR
INSPECTION
STANDARD INFORMATION SYSTEM
ENOUGH DOCTOR AND NURSE
MONEY SEGMENT
EASY COMMUNICATION PIPE BETWEEN DOCTORS
GOOD UNDERSTANDING BETWEEN PATIENTS AND DOCTORS
RESCUE SYSTEM
BAD REHABILITATION QUALITY
FAMILY SUPPORT
YES
NO
PERSPECTIVE
PERSPECTIVEPATIENT A
PATIENT B PERSPECTIVE
an easy way to keep you from cardiovascular disease
Dear Lily,
Depending on your current situation ( see your document ), I think you are at a high risk of cardiovascular disease, but don't worry about it, it is not serious, if you follow these steps.
STEP ONE Suitable Exercise and a Balance Diet as possible as you can, this is not just for prevention but also a good daily life.
STEP THREE Most important things for diet are salt and fat. I recommended the max daily amount of salt is 6.00g and the max daily amount of fat is 6.00g.
STEP FOUR
Download this lovely APP - healcaedio. This is a important bridge between us. 1. It can help you to track fat and salt. 2. You can use it to manage your body data. 3. You can use it to communicate with me, and share the data you like to share. I can give you
feedback as soon as possible and make a future plan.
Sign up Enter this code: 463284325324
Remember that we use healcardio together. Don't feel alone.
Your GP
New Journeyforyou
01/10/1015 to 01/11/1015
Dear Lily,
As I said through healcardio, your situation is quite nice.Continue to take Aspirin & Metoprolol to keep health.
ASPIRIN
This is an element for prevent heart attacks, strokes, and chest pain. Take 1 tablet everyday at the beginning of happy days before breakfast.
Scan Code Put on your Aspirin Package
METOPROLOL
This is an element for prevent high blood pressure and chest pain. Take 1 tablet at the morning and 1 tablet at evening before diet everyday.
Scan Code Put on your Metoprolol Package
Your GP
THIS IS FOR PHARMACY OR SHOPPING ONLINE
CODE: DFBFSDA89DDA
Scan Code
Nitroglycerin
01/10/1015 to 05/10/1015
Dear Lily,
is Nitroglycerin is for a 5 days treatment, you should take it very carefully before next week examination. How
Take 1 tablet at 7:00am&9:00pm everyday.
Do NOT swallow, chew, or crush this tablet. Dissolve the tablet under the tongue or between the cheek and gum.To treat an angina attack, use nitroglycerin tablets aW�WKH�ƓUVW�VLJQ�Rf chest pain. Sit quietly while the tablet is dissolving.
WHAT Preventing or relieving a sudden attack of chest pain caused by heart disease. Nitroglycerin is a nitrate. It works by dilating (widening) blood vessels. Chest pain occurs when the heart needs more oxygen than it can get. Dilating EORRG�YHVVHOV�DOORZV�EORRG�WR�ŴRZ�PRre easily. This reduces the heart's workload and the amount of oxygen needed by the heart.
NOTICE Do NOT use nitroglycerin tablets if: you are allergic to any ingredient in nitroglycerin tablets you have increased pressure in the head you have severe anemia
Your Doctor
!"#$%&'()*$"+ !"#$%&'()*$"+
,'%%-./*00*'0
!"#$%&'()*$"+
,%+&-*
an easy way to keep you from cardiovascular disease
Dear Lily,
Depending on your current situation ( see your document ), I think you are at a high risk of cardiovascular disease, but don't worry about it, it is not serious, if you follow these steps.
STEP ONE Suitable Exercise and a Balance Diet as possible as you can, this is not just for prevention but also a good daily life.
STEP THREE Most important things for diet are salt and fat. I recommended the max daily amount of salt is 6.00g and the max daily amount of fat is 6.00g.
STEP FOUR
Download this lovely APP - healcaedio. This is a important bridge between us. 1. It can help you to track fat and salt. 2. You can use it to manage your body data. 3. You can use it to communicate with me, and share the data you like to share. I can give you
feedback as soon as possible and make a future plan.
Sign up Enter this code: 463284325324
Remember that we use healcardio together. Don't feel alone.
Your GP
85-130
mmHg
60-100
/min
Salt:6g
Fat:66g
k e e p h e a l t h
blood
pressure
hear t
rate
62
reference
44
44
Giga-mapping: Visualisation for Complexity and Systems Thinking in Design. Birger Sevaldson
Dancing With Systems Donella Meadows
Types of Systemic Relations Birger Sevaldson
The Design Way Intentional Change in an Unpredictable World Harold G. Nelson
7 Reasons Why Our Social Services Keep Failing: An Argument for Grounded Change Dr. Sarah Schulman
Design For Care Peter Jones
Prototype Evaluation in Service Design A Case Study at an Emergency Ward Johan Blomkvist
Radical Redesign The Australian Center for Social Innovation
Healthcare 2050 DNV GL
Patient Centered Care DNV GL
Transitions to Sustainable Development: New Directions in the Study of Long Term Transformative Change Grin J, Rotmans J
reflections
44
44
This is a meaningful semester to know something new.
In the studio, I learnt system oriented design systematically. I know how to use the system to set up a design project from research to systematic impact step by step. I can use giga-mapping in different ways. At the beginning, using the giga-mapping to find a start point-ZIP. This is most important thing for the complex problems which is difficult to find a correct stone to carry on. After that, gaga-mapping can also be used as a tool to find the relationships between problems especially combined with iceberg model. Giga-mapping can also be used in design process which can make me figure out a holistic solution easily and know the relationships between different touch points. Giga-mapping is a great process crossing the whole design process.
Cooperation with DNV GL is a super happy process. They have done a lot of project about healthcare and are a global company. In this way, I can get a big picture of healthcare system all around world, and this is a great way to understand the different culture between Norway, China and other countries after the deep user researches this semester. I’m luck to visit Mayo Clinic which provide me a deep understanding of healthcare system.
I think the result of this semester is good, even through the design seems to be unclear and not very interesting. The meaningful part is that this result is from system thinking not just from a good idea. Seeing the whole system map, I think my design is effective and really can benefit people in a holistic perspective. This project is not addressing single design. I think my design can make the whole touchpoint work together for a systematic impact.
It is not enough time to understand the system oriented design just for one semester. It is obvious that I need a long time to practice the system thinking. I’m not familiar with the all the context of create a positive systematic impact for my design. There are so many method to create leverage points. In a real system, there are many methods which can be used together at the same time. When I consider the system impact, I often forgot to use multiple ways to create systematic impact on my own system. Using one design which can address different methods is quite difficult.
44
I’m struggling with the balance between system and design. Sometimes I will face a conflict between a good idea from creativity and a normal idea from system thinking. I don't know how to adapt them to each other and put the a good idea from creativity in system thinking. This process is quite difficult. Some good ideas are not very relevant with each other, but normal ideas can be seen as a group power. System oriented design is quite difficult to evaluate in real world for a student. It is difficult for me to say which is better.
Foreigner is difficult to do user research sometimes. Native language is important for interviews. This can make the interviewees into a familiar scenario. I met another interesting problem. This happened during my random access interview with 10 people. I ask them if they think Norway has a good healthcare system. 9/10 told me they think Norway has a great healthcare system. For me, my Norwegian friends complained a lot about healthcare service in Norway, but it is difficult for me to ask something bad in Norway’s healthcare system. I guess the reason is national pride.
Time management is urgent issue for me this semester. Everybody has the same deadline which gave me a lot of pressure. Everyone has different projects, in this situation I think the amount of work is different at different stages. The same deadline sometimes make me super busy and sometimes have little thing to do. I have no balance speed this semester. I used the textbook time to balance my time, but I will forgot the knowledge, if I didn't do any practice.
I hope I can practice system oriented design method more to understand this complex world.
44