Applying design techniques to health care
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Adaptive Lab joined forces with Women’s College Hospital, Toronto to devise and test methods for designing health care services for people with complex needs – patients with multiple chronic or long-term conditions, often compounded with psychosocial challenges – using anthropological insights, principles from user-centred design and theories from behavioural psychology. The results of the project are detailed in a white paper, that looks at three problems and methods that could be applied to solve those problems: Problem 1: People are bad at connecting short term behaviour with long term gains. How can you help them form the right habits? Problem 2: How do you minimise the impact of unavoidable negative experiences on patients memory of their treatment? Problem 3: Patients are often asked to absorb complex information about their treatments at times of high cognitive load, possibly leading to lower levels of engagement. How could you redesign services to better take this into account On the paper Pritpal S Tamber, our health care advisor and founder of The Creating Health Collaborative, said: "We're losing the war against lifestyle-related, chronic conditions, especially in those dealing with challenging social circumstances. It's time we approached things differently. This paper is a brave and important start." To read the full finding download the paper at: http://enhancing-innovation-report.adaptivelab.com/ If you would like to find out how Adaptive Lab can help you innovate in health care then email: hey@adaptivelab.com
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Applying design techniques to health care
- 1. Enhancing Innovation in Health Care The Value of Deeper Problem Analysis If you would like to find out more about how Adaptive Lab can help you innovate in health care then email hey@adaptivelab.com.
- 2. Designing for Patients with Complex Needs
- 3. 3
- 4. 4 Who are “Patients with complex needs”? People with multiple chronic (or long-term) conditions, often compounded with psychosocial challenges.
- 5. 5 Why is this so important? 0 25 50 75 100 125 Patients Spend In Ontario, Canada, the top 5% of “high-users”, account for 66% of health care spending. high users everyone else
- 6. 8 Applying established approaches to health care challenges
- 7. 11 Reward card game Designing for the remembering self Assessing cognitive load
- 9. 13 Problem People are bad at connecting short term behaviour to long term gains.
- 11. 15 Nir Eyal’s Reward Types HUNT money stuff knowledge TRIBE acceptance inclusion attractiveness importance mastery consistency completion SELF
- 12. 16 Idea Look for ways to provide patients with short term rewards to encourage the formation of long term habits which improve health care outcomes.
- 13. 18 Designing for the remembering self
- 14. 19 Problem Health care can have unavoidable negative experiences such as pain, discomfort, embarrassment and confusion. For these types of experience, what can be done to improve the patients overall wellbeing?
- 15. 20 Experiencing self Remembering self
- 16. 21 Emotional impact Tie to positive emotion Reduce emotions Attention Ensure full attention Add distractions Repetition Repeat activity or reminder Reduce reminders Increase positive memories Reduce negative memories
- 17. 22 Idea Design methods to minimise the memory of negative experiences and maximise the memory of positive experiences, thereby increasing the likelihood of the patient remaining engaged with the health care service.
- 19. 26 Problem Seeking and receiving health care and self care requires patients to learn and integrate new ideas and activities into their lives. Patients are often introduced to these ideas and activities at non- optimal moments, decreasingly the likelihood of them being receptive to learning.
- 20. 27 intrinsic extraneous lots of options complexity novelty high emotional excitement mental fatigue environmental distractions Available cognitive resource multi-tasking
- 21. 28 Idea Introduce patients to new healthcare ideas and activities during moments of low cognitive load, when the are most receptive to new information.
- 23. 31 What did we discover and what’s next? The use of concepts from behavioural psychology to develop exercises to explore health care design problems has shown great promise. The success of applying these approaches to to design real world solutions will depend on identifying: • Appropriate design problem • Relevant user population We only looked at a few concepts - there are many more to explore…
- 24. 33 Leigh Hayden, Phd Medical Anthropologist, Women’s College Research Institute Toronto, CA Kat Matfield Service Designer, Adaptive Lab, London, UK
- 25. Enhancing Innovation in Health Care The Value of Deeper Problem Analysis If you would like to find out more about how Adaptive Lab can help you innovate in health care then email hey@adaptivelab.com.
Editor's Notes
- Collaborative project bringing together medical anthropological studies and ideas of drawn from service and product design Women’s College Research Institute, part of University of Toronto and Adaptive Lab, a product and service innovation agency Leigh Hayden - Medical Anthropologist Kat Matfield - Product and Service Designer at Adaptive Lab
- psychosocial = psychological development in, and interaction with, a social environment.
- In Ontario, Canada, the top 5% of “high-users”, typically patients with complex needs, account for 66% of health care spending. There’s a focus on improving the performance of health care services for high-users
- Resources: social, financial, cognitive When treatments are designed they rarely look at the entire experience for the patient. Each moment is considered independently With little thought given to the wider context in which the treatment is provided
- How do we take the things we’re doing in other sectors like financial, telco, media — design thinking, behavioural psychology — and apply them to the healthcare sector Design thinking - collaborative, user centred design, which places a value on making ideas tangible as soon as possible Behavioural design uses a deep understanding of the factors that help determine people’s behaviour — psychological, social, cognitive and emotional — to inform the design of new products and services. We’ve used these techniques to design everything from a better banking experience to methods of encouraging healthier shopping for a major UK retailer
- Views design as a process Design is collaborative User centred Explore many possible solutions will help you find the best solution The human rule – all design activity is ultimately social in nature The ambiguity rule – design thinkers must preserve ambiguity The re-design rule – all design is re-design The tangibility rule – making ideas tangible always facilitates communication
- Encourage the desired behaviour Used these to design 3 methods that could be used to help design better experiences for patients with complex needs
- Adapting methods to create three new design methods tailored for healthcare I’ve only got 10 mins so I’m not going to go into great detail on the methods used - they’re all in the whitepaper
- It is normally assumed that if patients understand what they are supposed to do they will act accordingly. Evidence suggests this is not the case. New practices can be difficult to integrate into existing routines. How can you help people form the routines and habits needed to promote positive health outcomes
- Commonly agreed on habit loop Charles Duhigg - author of Power of Habit (cue, routine, reward) Trigger: Walking past your favourite cake shop Action: Buying a cake Reward: Yummy cake Trigger: The opening frame of a video in your Facebook feed Action: Clicking on the video Reward: Seeing some dogs dance
- We looked at the types of reward that people respond to, as identified by Nir Eyal’s seminal book on designing habit forming products - Hooked acceptance: Mum’s shop at Iceland completion: LinkedIn’s profile completeness
- Process Introduce concepts Ask each participants to select a recent service experience Participants identify and discuss high and low points the experience Participants use the green and red cards to come up with ideas about how to improve or reduce the memory of each experience. Participants discuss their ideas and look for patterns/insights.
- There are also avoidable negative experiences such as inefficiency, ineffectiveness, lack of treatment and poor treatment.
- Daniel Kahnaman Being happy in your life vs about your life The experiencing self lives in the moment, one after another The remembering self is a story teller and the decision maker How can we enable people’s remembering selves to better stories about their experiences?
- Process Introduce concepts Ask each participants to select a recent service experience Participants identify and discuss high and low points the experience Participants use the green and red cards to come up with ideas about how to improve or reduce the memory of each experience. Participants discuss their ideas and look for patterns/insights.
- Cognitive resources are finite Willpower, memory, and any mental effort all deplete the same cognitive resources Cognitive load refers to the amount of information being processed by the working memory at any given time. Intrinsic cognitive load is inherent in the concepts being learned Extraneous is anything that consumes cognitive processing which is not concerned with the material at hand
- Intrinsic load: more difficult or complex content has a higher load Extraneous load: the sum of all other “noise” competing for attention
- Participants can quickly learn how to apply behavioural psychology concepts to assess a situation. Next steps Explore and build on these approaches in the community by partnering with health care organisations and patient groups.