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Sequence panel event: how design can influence the healthcare experience

Access to quality healthcare is a universal need. But thinking beyond access alone, what happens when we actually experience healthcare?

While the healthcare industry innovates constantly through the therapies, devices, techniques, and equipment needed to keep people healthy and alive, the human experiences we have with healthcare have received less attention, innovation, and investment.

This is likely due to a number of barriers to innovation found in the industry: stiff regulatory requirements, complex systems of treatment, value, coverage, and reimbursement, divergent incentives for different players in the ecosystem, and old-school practices for data sharing.

Pushing meaningful, human-centered innovation through this type of landscape is extremely difficult. If it were easy things might be solved already.

Meanwhile, we are living in a world of on-demand, personalized consumer experiences. Many of the companies that serve us offer unprecedented convenience. They’re eerily aware of our needs (sometimes before we are). And they enable us to transact anywhere at any time. As our personal access to data increases every day, we crave ways to make meaningful use of that data in nearly every aspect of our lives.

While these consumer experiences are resetting our expectations, how come our healthcare experiences lag so far behind?

Sequence held an event during San Francisco’s Design Week focused on this topic. I moderated an expert panel discussion that examined this expectation gap, and the role design can play in improving the healthcare experience of the future.

Our panelists included:
Susan Dybbs, Head of Design at Collective Health
Cheryn Flanagan, Customer Experience Practice Lead at Sequence
Chris McCarthy, Director of Kaiser Permanente’s Innovation Consultancy, and Executive Director of the Innovation Learning Network
Megan Moyer, Manager of Design and Innovation at Sutter Health
Lisa Zamosky, Journalist (Money, LA Times, Web MD), and recognized expert on the Affordable Care Act

The discussion covered a lot of territory. Here are some key takeaways from the discussion:

Designers’ mandate: bring human empathy to the table
It’s clear that the healthcare system in America today isn’t designed to make the people it serves more comfortable. Asymptomatic perhaps; but not necessarily comfortable.

Designers working on healthcare solutions have the opportunity to put people back in the center. By bringing human empathy to the process, designers can create systems and experiences that promote better outcomes and that take better care of people throughout their journeys.

“As designers we can empathize with people,” said Susan Dybbs. “We can design and imagine the future—and many different versions of the future. We’re really looking at some of the edge cases where the system fails people. I think that’s a huge impact that designers can have.”

Consumer expectations are rising, but don’t expect healthcare to keep pace until models change.
Sure, we can now summon a car from our phones; order takeout with a tap; and find a date with a swipe. But the things we’ve come to expect from the on-demand economy may not be reasonable to expect from our healthcare—at least not quite yet.

Even so, people are beginning to expect more from their healthcare. Sequence recently published a research report on the topic that highlights this expectation gap.

Our panelists underscored the fact that that buying and experiencing healthcare can’t be directly compared to other ‘consumer’ markets for a host of reasons:

1) The legacy systems, regulatory hurdles, and current financial incentives intertwined with today’s care and reimbursement models simply aren’t customer-centric enough to wow us anytime soon. There are notable exceptions (e.g. One Medical, Heal, Pager, etc.), but widespread availability and adoption of these consumer-centric healthcare experiences may be a ways off.

2) As patients we’re not that price sensitive (no one waits for brain surgery to go on sale before having a procedure they need). This changes the dynamic and what we’re willing to endure.

3) Healthcare is one of the only markets where consumers agree in advance to receive treatment, ignorant of the total cost until after all is said and done.

Our panelists agreed that most people bring their own deep seated baggage to the table when engaging the healthcare system. They almost expect it to be onerous and a bit painful. In fact, some people are distrustful of new kinds of healthcare experiences that don’t appear to fit their old mental models.

Cheryn Flanagan of Sequence, who helps healthcare clients reimagine experiences almost every day though her work in the Customer Experience practice, didn’t fully trust her recent experience with a mobile app she and her doctor used for telemedicine.

“I realized there was this lack of trust I had in this diagnosis that I was getting because it was a new way for it to be delivered,” said Flanagan, “even though I’m a designer and these are the kinds of experiences that I want to design.”

“It gave me a good dose of empathy for these new types of experiences that we’re designing,” she continued. “One of our biggest challenges may be how to get people to trust in them.”

One audience that’s totally open to a new way of engaging in healthcare? Younger people without as much baggage from past experiences. No surprise there.

The barriers for well-designed experiences in healthcare are numerous. Thank goodness designers are optimists.
Our discussion around the barriers that prevent great healthcare experiences from being realized bordered on depressing, until the Designer’s Optimism reentered the room. The barriers are so numerous and seemingly insurmountable, that nothing short of wholesale reinvention seems likely to have an impact on the status quo.

Lisa Zamosky highlighted the burden placed on patients and caregivers to do the legwork to connect disparate caregivers in a fragmented system where self-advocation may be the only option.

“Patients are like the free labor of the healthcare system,” Zamosky said.

She also blamed the current economic structures of the industry for getting us into this mess.

“The major redesign that needs to happen in this industry—and it is happening—is the design of the way that we pay providers; so that they are incentivized to provide coordination.”

Zamosky continued, “There comes a point where the layperson simply cannot manage these things for him or herself.”

Megan Moyer cited barriers to innovation within Sutter Health even more straightforward, like organizational silos, the need for shared terminology, and IT restrictions on basic collaborative tools like Google Docs. Ultimately, Moyer was optimistic in the face of these hurdles.

“As a newcomer to the space,” Moyer noted, “I have found that everyone within the system is very smart and very passionate. There is this really exciting desire for outside creative thinking. Designers have permission to be optimistic within this very conservative and risk-averse culture.”

Designers see opportunities in industry barriers, and bring optimism to the space
Despite the abundance of barriers, our panel was mostly optimistic about the opportunities for designers to make a difference in healthcare. This optimism emerged as one of the hallmarks of design in the field.

“If there’s one thing that can drive awesome design, it’s ‘mission’,” shared Chris McCarthy, referring to purpose-driven motivation.

“Many designers are craving the opportunity to have real impact,” McCarthy continued. “Yes dollars are beautiful, but a healthy baby or a somebody cured from cancer is even more beautiful. Mission is a resource that is almost unlimited in healthcare, which you probably can’t find in most industries.”

Design within a startup vs. a huge organization: each has its own challenges and opportunities
Our panel included design and innovation leaders from startups and large health networks alike.

McCarthy, who founded and grew the innovation team at Kaiser Permanente over 14 years, found successes in unexpected territory. By staying “on the fringe” and publicizing tangible successes, McCarthy and his team have been able to drive innovation forward without “triggering the immune system” of the larger organization that would otherwise squash this type of activity. But it turns out his group won’t be on the fringe for long.

“This year design has been invited to the table at Kaiser Permanente,” said McCarthy. “We’re embarking on this grand experiment of what does that mean when design is fully accepted at the table.”

Moyers shared, “the large healthcare system is really good at ‘sick care’ vs. ‘wellness’. And startup tech companies are really good at building digital tools to have ongoing relationships with people in their everyday lives. Is there a way for us to bring together the best of who we both are?”

At Collective Health, a health benefits startup, Dybbs started on the ground floor and has built a design organization on equal footing with engineering, marketing, and operations. She pointed to a common role designers play in organizations large and small.

“We’re all telling stories,” said Dybbs. “We can tell stories that actually humanize these experiences for the C-suite and for the boardroom. And that’s why it’s important for us to be at that table.”

Tectonic shifts in the healthcare ecosystem are already happening, making human-centered design ever more important.
Major shifts brought on by forces like the Affordable Care Act, the move toward value-based care, advancements in technology, and our own evolving expectations heighten the need for human-centered design in the healthcare arena.

As Zamosky put it, “We’re in another incredible phase of consolidation in healthcare. I would call it almost an arms race between health insurers and healthcare providers, all of which are merging or attempting to merge.”

In addition to this, tech giants like Apple and Google are bringing health-related utility to the deep relationships they already have with billions of people.

It raises the question: who might own the most direct relationship with patients in the future?

McCarthy believes it may be “some sort of government body that will take responsibility for the end-to-end data.”

“To get to perfection,” said McCarthy continued “it can’t be a business. We really need to have a societal view of what our data means, and what our care means, and get beyond ‘how is this making money.’”

Zamosky cited research that points to people having the most trust in their doctors, and believes that a collection of partnerships behind the scenes will stitch together technology and services, while our doctors remain or main interfaces with the system.

Flanagan predicted that patients may ultimately own the relationship.

“Each of us are creating personal archives with our smartphones,” she said. “If there’s a company that can bring that together with data and sensors, make it all make sense, and handle information responsibly—I think that is where it could go.”

“There’s a lot of opportunity to create more robust knowledge of ourselves and be empowered to make better decisions,” Flanagan continued.

Without a crystal ball, no one knows the true answers. But our panelists were generally hopeful about what the future holds.

Flanagan summed up up well when she shared, “we’re standing on the precipice of a huge opportunity to design this corner of our human experience.”

It’s clear we’re on the front of a wave of change that is moving through healthcare. It may not be moving quickly, but improvements are inevitable. Armed with optimism and creative problem solving skills, designers will be instrumental in improving the healthcare experiences of tomorrow.

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