New ways to engage with patients
Learn how human-centered design innovations have helped OSF HealthCare and three other health care organizations improve services and outcomes.
Innovation based on the tenets of human-centered design
Human-centered design has been used by corporate America to tend to the needs of consumers, personalizing their shopping experiences and predicting their needs almost before they know they have any. For health care, the concept is just starting to be applied. Many health systems see human-centered design as having great potential to improve people’s experiences in all types of systems, processes and built environments.
Human-centered design starts with the assumption that all people using a system have basic needs and limitations and that it is the designer’s responsibility to understand, anticipate, and design by these needs and limitations, explains a 2010 article in Health Research Policy and Systems.
Health care has taken up human-centered design largely in response to reducing medical error, so the practice is found in places like medical engineering and design of electronic medical records. But proponents of the concept see its potential as going far beyond safety and being applied for the benefit of all users, whether they are patients, families, employees, clinicians or — most importantly — potential patients.
The Mayo Clinic was an early adopter; its Center on Innovation was established in 2008 and ideas around innovation and human-centered design are disseminated through its annual Transform conference, held every September.
OSF HealthCare creates culture of innovation
Matthew Warrens, vice president of innovation partnerships for Peoria, Ill.-based OSF HealthCare, was inspired by human-centered design presentations at the 2015 Transform conference and brought the ideas back to the office. “I talked to the chief strategy officer about how to start a program, where we would apply this new technique to get the best return on investment,” Warrens said. “We started with senior leader awareness and understanding of the discipline before we even had any staff hired.”
Human-centered design is a natural part of OSF Innovation, which also manages its simulation program for clinician continuing education and other forward-thinking initiatives. “I think of it as one more tool in our innovation toolkit,” says Warrens. OSF Innovation, launched in mid-2016, maintains multidisciplinary teams (including human-centered design, performance improvement specialists, industrial engineers, data analysts and others) working on all kinds of projects.
User journey experience
Example of a user journey map. This map shows that for a simple office appointment, a patient engages in extensive activity outside of actual contact with the medical office.
|The center works both internally — encouraging staff to generate ideas that can be turned into commercially viable products and services — and externally, partnering with external companies and investing in start-ups. It includes Jump Simulation, opened in 2013 to improve outcomes and lower costs through innovative training of medical professionals and trainees. It also pairs clinicians with engineers to develop new health care solutions.|
The human-centered design approach focuses on gathering data and information with a focus on the unique aspects of human behavior. Once compiled, this information has the possibility of reframing the challenge. As an example, other approaches may determine a gap in a common role, while human-centered design may surface the need for solutions in a different arena.
The initiative started out with research about how people access OSF HealthCare’s services, Warrens says. “We’ve been researching all the ways people are accessing our health care services and using it to better design our services to meet unmet needs.”
So, for instance, when the group sits down with an interviewee, who could be any patient or potential user of OSF services, the conversation is open-ended without a set list of questions, explains Shannon Ingles, a service designer who has been with the project from the beginning. The goal is to hear the person’s story and experience, without bias.
Taking a fresh look at big-picture issues
The human-centered design group, along with other members of the OSF Innovation team, look at big-picture issues facing any growing health system, and society at large, such as aging in place, access to care, and doing more for those with less. One project, for instance, looks at how to care for patients in communities within OSF’s service area where small hospitals have closed or will eventually. “How do we care for these patients in places where we can’t add capital infrastructure?” Warrens asks. OSF Innovation is working on an in-depth analysis of one such community, looking at the people who live there and a wide variety of trends and needs — e.g., transportation, diet, wellness, exercise.
For OSF, human-centered design and its Innovation Center are essential strategic pillars of the organization, not an optional “extra.” “If health care organizations don’t have an innovation agenda they won’t be able to compete not just against the hospital across the street, but against future competitors like the big four — Google, Amazon, Apple and Microsoft,” says Warrens.
The human-centered design initiative was embraced by OSF leadership after the initiative’s advocates invited senior leaders to a one-day “introduction to human-centered design” workshop. It won over top system leaders, and the workshop continues to be held once a month to share the ideas with people from all over OSF HealthCare, including marketing, IT, clinicians, nurses and physicians. The CEO of the system’s medical group took the workshop and liked it so well he sent his whole leadership team.
Case study 1: Teladoc's technology drives patient-focused care at Jefferson Health
Providing patients with access to comprehensive, high-quality, coordinated care when and where they need it is the principle behind JeffConnect, an initiative of Jefferson Health in Philadelphia which uses a telehealth technology platform and licensable solution provided by Teladoc that has earned the endorsement of the American Hospital Association.
What sets the Teladoc platform apart is its Software as a Service (SaaS) model, designed specifically for health systems, that integrates into the electronic health record. The enterprise-wide, cloud-based telehealth platform allows Jefferson physicians to conduct virtual visits with high-quality video 24 hours a day, 365 days a year.
The majority of Jefferson’s primary care doctors and specialists provide some form of virtual visits throughout four states. Many of those virtual visits are for emergencies that would otherwise involve a trip to the emergency department and a long wait; 80 percent of the virtual visits resolve the problem without the ED visit.
Case study 2: The Lennar Foundation Medical Center humanized spaces
Lennar Foundation Medical Center in Coral Gables, Fla., is a large ambulatory facility with 121 exam rooms and full diagnostic and procedural capabilities — with no beds. It was built about nine miles south of Miami to serve locals who didn’t want to travel downtown for care.
Designers took pains to design for users, both staff and patients. The light and open views provide a sense of well-being. Stainless steel modular operating rooms promote the best possible infection control. Care is delivered through service lines rather than specialties, so that the diabetes center provides coordinated care by an endocrinologist, nutritionist, social worker, ophthalmologist and cardiologist working together.
Patients can register online ahead of time; their record includes a photo so staff can walk up to greet them rather than calling their name. If an appointment is running late, the patient gets a call to let them know to arrive later or reschedule. Employees are screened for skill sets such as comfort with human interaction and an eagerness to help.
Case study 3: Balancing dignity and safety in design
When designing a children’s behavioral health facility, the most important questions are: What can the design do to make children feel comfortable? How can the design make parents feel confident they are making the right decision? What can design do to create the safest environment for effective treatment?
The remodeled child and adolescent behavioral health unit at the University of Minnesota Masonic Children’s Hospital provides design features in which patients have choice and control, offering greater perceptions of calm during their stay, according to a 2016 study of the remodel in Health Environments Research & Design Journal. In the unit, choice takes on many shapes. In patient rooms, light dimmers and color-changing accents allow patients to set the lighting and music levels they desire to help them feel calm and regulate their bodies. Different seating options including a window bench and a desk with a chair give the patient choices on where they find the most comfort. The individual desks allow patients to maintain a sense of dignity and personalization while the curved window bench provides an option for patients to curl up, creating feelings of individual comfort, security and safety.
At the entrance to rooms, floor patterns create “front porches” for patients who may want to leave their room but still don’t feel mentally healthy enough to socialize with other patients. This space marks a transition zone between patient room and community space, allowing patients to orient themselves to a more public atmosphere while transitioning in their treatment journey. Read more about the behavioral health unit’s design in Health Facilities Management.