Avinash Birnale, is a digital technology leader, entrepreneur and evangelist who has played various roles to help achieve digital transformation for Fortune 500 companies. Most recently he worked with Endeavour Software Technologies and then Genpact leading their digital transformation journey for Retail, Healthcare and Banking customers. After serving as a consultant for Welldoc, in mid-2018 he joined full time as Chief Technology Officer.
On December 10, 2018, IDEO U, offered the webinar, “How to Reimagine the Healthcare Experience through Design and Collaboration.” Suzanne Gibbs, Dean of IDEO U, interviewed Chris Waugh, Chief Innovation Officer of Sutter Health. Waugh shared his perspectives on how design teams are optimizing healthcare delivery. In this Insights Avinash share his 7 key takeaways.
- Think of Primary Care as Everyday Health: Every person must increasingly consider their health as an everyday vs. occasional experience. To help people manage a chronic condition, design teams must engage with people with chronic conditions to understand their challenges. A goal in the healthcare business must be to keep people outside of the physical structures of the health care system as much as possible. Design teams should ask the question: do people need to come to the facility? Absolutely not, says Waugh. Technology-driven tools offer ubiquitous continual observation and can be paired with in-person visits as necessary. Digital technologies can be used to deliver personalized, human-centered care across the care continuum for a person’s entire lifetime.
- Humanize the Technology Experience: When choosing to innovate in healthcare, Waugh applies the “human experience filter” to determine if a new feature, technology or program will make the experience more or less human. Design teams must bring humanity to the design process. They must prioritize psychological factors rather using intellectual thinking as a design starting point. He detailed a project at Sutter Health to reimagine end of life care. He discussed how the design team applied machine learning to identify when and why people do not get or maintain advanced directives. They used this knowledge to inform their design solution. An overarching mandate within the Sutter Health design team is that simpler and more engaging design results in more human design.
- Social Determinants of Health Matter: Innovation in healthcare delivery must consider the person’s social determinants of health. Waugh refers to these as the “undercurrent of each individual’s existence” and suggests these have significant impact on a healthcare system’s expenditures, particularly a non-profit like Sutter Health. Geography is one social determinant of health. Determining if a person lives in a rural, suburban or urban location? What are their means of transportation to utilize healthcare services? Socialization and the person’s support system is another critically important social determinant of health. Social isolation can result in large healthcare expenditures. At Sutter, Waugh notes, they think a lot about people’s human needs.
- Minimize Burden, Maximize Passivity: Using health care services must become a more passive experience. That means people should be able to take fewer actions and encounter less burden while they still receive quality care. Less intrusive may be a better word than passive. I’ll use the example of Welldoc’s BlueStar, of which I have intimate knowledge. Our design team wants BlueStar to cause minimal disturbance in a user’s life. To achieve this, for example the logbook is populated automatically and builds comprehensive daily, weekly and on-demand reports for users and their healthcare providers. BlueStar can collect data from the user’s phone to record steps, activities, blood pressure, pulse, glucose levels, medications and other data. With this data BlueStar creates and continuously evolves a user’s personalized plan. We intentionally develop and continue to work to minimize burden and maximize passivity.
- Focus on Metrics to Determine Impact: Waugh warns that design teams must know the metrics they are driving towards or they can start to spin their own web and get caught up in it. A key metric at Sutter Health is the number of lives touched along with the associated impact. Another metric is indicators of user (or person) engagement. Measurement of clinical outcomes, economic viability and integration into the care continuum are also critical metrics to demonstrate the success of a program for a particular population. Measuring these metrics helps design teams determine when and where to iterate for further improvement.
- Balance Small and Large Changes: A significant challenge for design teams is to balance the scale of a change with the disruptive (potentially positive and/or negative) to the system. Waugh advocates that design teams start with small changes that affect change for small numbers of individuals. He believes this approach allows design teams to be more disruptive or progressive. It also allows them to test, learn, iterate before going full scale. At the same time he recommends making small changes to what is essentially a broken system. As design teams explore opportunities to innovate he detailed McKinsey’s Three Horizon’s Framework. Horizon 1 is making incremental change now. Horizon 2 is emerging opportunities for incremental changes that can, overtime get you to the ultimate future. Horizon 3 encourages asking what is the ultimate future you want to build. Waugh notes, design teams can’t just work in Horizon 1 if they’re truly innovating, but balancing small and large changes is imperative.
- Partner for Success: Many types of partners and partnerships help design teams achieve success. Waugh says, don’t reinvent the wheel. Seek out experts with the desired and demonstrated expertise. Do a scan of similar entities that have solved the particular problem. Explore their solutions to determine if they may fit your needs. Hold your true north, recommends Waugh. In the work at Sutter Health this means talking to healthcare providers and users of systems or technologies to determine their wants, needs and expectations. He also notes that mutual respect among people with different expertise and vantage points is critical. Everyone needs to come together and design together with humble interchange and a unified vision.
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