How Can You Improve Design in Healthcare? (Tim Peck, IDEO)

Great design comes together when the designer takes into account viability, feasibility and desirability.

“When we think about human-centered design and what we call design thinking, we have three pillars that we weigh. We weigh that desirability piece, the piece that most people associate with design, but we also weigh the viability piece, making sure whatever is being made is profitable or funded and definitely sustainable over time,” says Tim Peck, Executive Portfolio Director of Health at IDEO - probably the most prominent global design company.

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Tim Peck is an entrepreneur and a Harvard-trained Emergency Medicine physician, who has been practicing human-centered design for over a decade. He spent 3 months in a nursing home to grasp the reality and problems of the elderly care environment before he built Call9 - a health technology company that provided medical equipment and a platform to video chat with a doctor for nursing home residents, so instead of calling 911 they received care in place (The company sunsetted its operations in 2019). 

How can one design UX for healthcare? 

Healthcare is an extremely complex industry. On top of that, work in healthcare is filled with emotions, the work environment is stressful. The number one quality designers need to possess is empathy, says Peck. The tool they can use in the ideation phase is design research. This includes qualitative research with patients and end-users to help the designer understand the gaps in healthcare processes.

“Nurses are amazing designers.”

Discussions with the end-users are essential in the design process. Research should go beyond asking users about functionalities of the solution one wants to build or feedback on updates. Research needs to outline a broader understanding of the user's life, constraints, and more. Sometimes users are also able to best tell what they need and help with the design of solutions. “Nurses are amazing designers. We find this all the time because they are constantly hacking the system, working around the systems that they have. Our job isn't necessarily to tell them, Hey stop hacking, stop doing that. It's to look at those hacks and say, how could we change the software, the systems, the organizations to be more to have a better flow in their lives?”

Enlightened leaders.

Apart from products such as breast pumps or insulin pens, IDEO designs companies or works with companies, non-profit organizations, and services to help re-organize them. “We look for what we call enlighten leaders - people who are leading these companies and who know that healthcare is typically built much more for the viability and feasibility of the system and much less for the desirability of the people using the healthcare system. We look for people who know that and are willing to change that.”

Getting to good solutions requires a lot of observation of the users and gathering their feedback. 

How to talk to the end-users? How might we… 

It’s easy to say one needs user feedback in product development, but how to ask questions that avoid confirmation bias and bring the innovator relevant insights, is a skill one needs to learn. 

Tim Peck: “An interview with a patient should be 45 minutes or an hour long. It could be two hours. We're talking about long interviews to not only understand this one problem that you're trying to fix, but talking about their life, understanding how their life intersects with whatever healthcare problem you're trying to figure out. We use a tool called “how might we…”. How might we solve this problem? If you ask yourself “How might we…improve the workflow, change the process, etx” does a few things. One, it opens up the world of possibilities. Instead of starting with, How do we do this one particular thing?, we say How might we explore this topic? We go through a process called divergence where we are just trying to open the aperture. Just try to keep trying to know more and more about this person's life about this problem. The other thing about “How might we…”, is it the word “we”. It helps facilitate a much more collaborative process. After we've gone through divergence, we start to convert and we start to get more specific around the questions and into the problem.”

How to create a scalable solution for different environments? 

The challenge with designing a solution that will scale across organizations is that for example, different hospitals have different processes in place. This is where modularity comes into play. “Modularity is a very important design concept. You can create a scalable system that will address 80 or  90% of the use cases. And then within that, you can give the users the ability to modularize and change what their user interface looks like.” The 10% of modularity can be addressed with for example low-code solutions, where the users can design what they need. “From there, as you're watching people use and develop solutions, you can detect trends and convert those trends into the high code part of your system. In this way, users become part of your product. That's something that's I think extremely important to talk about: your users are part of your product team, and the product team doesn’t need to observe the users to translate what needs to be built into the high code part of engineering.” 

This is only an exception.

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