Why I’m enrolled in this field. My experience with online publishing, CDSS, and clinical reference portals.Getting closer & closer to the clinician’s situation & seeing their utterly fragmented universe of systems.And most of them have no time or patience. And we are so rarely able to really design to the way they think …
See the connection? Mayeroff’s definition: Care is an exchange that helps others grow, and it grounds us ever more among the circle of others we care for. “There must be growth in the other”
Complexity, communicating, & collaborating across boundaries
Complexity, communicating, & collaborating across boundaries
Three spheres or activity systems – each a very different context for design methods and systemic design. Design for Care covers the spectrum of healthcare applications from individual to industry – but (I have found) no designer or even researcher that works effectively across all. Yet to become more effective we need to better understand the critical problem areas, trends, business and cost drivers, technologies, and human experiences in each of these sub-sectors. For any of us to design end-to-end, we have to know how to connect with the adjacent touchpoints.
Is there a conflict between a systems view and patient-centeredempathy? Empathic design has been a strong trend over the last 5 years, and it has influenced our approaches toward research, interviewing, app & service design. Its necessary but not sufficient – clinicians are often
These are three fundamental domains of healthcare that present the most significant design opportunities. All 3 complex systems, each with its own problems, methods, boundaries.
Let’s start with the individual human context. Why Health seekers? We’re not patients. A person’s health seeking is a continuous process of taking steps toward better health, before during and after any type of encounter with healthcare. Health seeking, as with other human motivations such as pleasure seeking or status seeking, represents an individual journey toward relatively better health. For a very healthy person, an ideal of perfect fitness may be an authentic health seeking journey. For a cancer sufferer, relative health may be a matter of surviving treatment and fighting for gains in remission. Being a patient is an exceptional situation, then, when we require treatment or professional care. But people don’t claim patiency as a role, except perhaps in the activist context of ePatient for example. Instead, the target of design for individual health
The health seeking journey shows layers of context and changes over time. As a “consumer” here, the health seeker deals with her personal sphere and seeks information, support and resources from her immediate circle of family and community toward meeting health goals. Design goals for the health seeker (in this journey view) might include:Connecting Elena to her immediate family to support her Caregiver role (through electronic media, printed artifacts such as notes and reminders, and multi-sensory media.Direct support for Elena to inform and manage her family’s health needs. Connecting her with any services for which she has regular touchpoints. Emotional support as a caregiver, for helping sustain her motivation and keep track of health progress.Easy update and tracking of her interaction with clinical services and healthcare systems.
Example by St Mike’s HDL, which produced a series of web-accessible design documentaries feat personal monologues by current patients dealing with cancer. They started with short films with hired actors, but as they learned discovered how much impact real people had on the helping people living with cancer in the community. Notice the themes linked to different life stages.
In one view, everything is “designed” by intention or not, by design teams or managers, clinicians and staff. Obviously not the function of design disciplines. Healthcare one of the last fields to be served by Multi-Disc design teams – for many reasons. The biggest one being that cost and risk drivers constrain how clinical and hospital service experiences have been provided. That existing system, mgt, process infrastructures are built to resist simple or experimental changes. A clinical version of scientific management and IndEgr have effectively designed current services. They work, and admins know how to manage them. Change would be disruptive and risky. But the value proposition for service and interaction design is not well defined or understood. Do we understand their work practice enough to make a compelling case to change?
Also includes sequential + followup and continuous care. Not really a spectrum – different designs for care practice for each.
CD levels are associated with complexity, as D1 – D4 are. In this view, of care services, Elena touches on each of the different modes of CD: CD1 with online communities (not complex), CD2 at Primary (lots of std procedures that could be better orchestrated), CD3 in the way multi-clinician treatments are designed, CD4 for the continuity across diagnoses and encounters.
