How Can Design Contribute To Gaining Acceptance For Digital Health Tools?

11 October 2018
Digital Health
Why is design a success factor of digital health products like apps, patients platforms or telemedicine systems?             We know that if a person is not aware of a solution, or if they find it hard to use, or if it doesn’t provide them with real value in the context of their lives, then won’t use it. As technology has become more central to our lives, businesses first looked to make technologies beautiful… but soon it became more importantly about making sure things would work well for the people using them. At the same time, people began making decisions around who to do business with based not just on a digital interaction, but on the overall experience they have with an organization. To respond to this new “Experience Economy”, a practice called “Human-Centered Design” took off. Human-centered design is based on the idea that if we understand the needs of the people we are designing for, then we’ll become more effective in serving them. It puts people at the center and provides the vehicle for understanding their challenges, emotions, and goals. And it invites the end-user into the design process itself. And organizations have woken up to the value of design - understanding that providing customers with a great overall experience will yield results for their business.
First and foremost, we should understand the needs of the people we serve.
What methods can be leveraged in creating patient-friendly digital health solutions? We can make delivering value to the people served by the organization the focus. Some of the following methods will support our efforts: Understanding & Analysis: Conduct qualitative and ethnographic research to understand what will drive real meaning and value in the context of people’s lives – what will truly guide, comfort, inform, engage, and motivate. Conduct an audit of every touchpoint in the patient’s journey across the ecosystem to understand issues to address and opportunities to explore. Immersion & Collaboration: Invite individuals from across the organization to participate in research activities to foster both cognitive and emotional empathy and to ideation activities to foster understanding of design and innovation process. Exploration & Ideation: Experiment with different methods and tools like design studio, participatory design, service design, systems design, transition design, empathy mapping, journey mapping, service blueprinting, and generative toolkits to see what works best for your organization. Motivation & Inclusion: Design interventions, tools, and programs directed at helping people change their behaviors that align with their intrinsic motivation and address the human need for relatedness, competency, and autonomy. Adopt a universal design approach, which considers the needs of individuals who are at risk, vulnerable, underserved, or in crisis and addresses accessibility. [caption id="attachment_25245" align="aligncenter" width="977"] Case Study: ImagineCare is a virtual solution that allows clinicians to monitor and care for patients remotely and continuously, without a visit to the hospital. The solution was shaped by Mad*Pow’s classic research, design, and development process.[/caption]   Many digital health solutions aim to change the behavior of the user, but many fail. How do human-centered design and motivational psychology make them more effective? The system can tend to be demanding and autocratic in nature, wanting patients to “adhere” or in other words “be obedient” to the course of care recommended by the system and in many cases financially incenting or penalizing the behaviors the system is after. Penalties and rewards may stimulate behavior change in the short-term but are often not sustainable and do not needing to lasting change. Programs are often deployed without consideration for social determinants of health, life factors that may be contributing to what is happening with the patient and the intrinsic motivation that will need to be sparked to address those factors. A more comprehensive and realistic view of the patient’s challenges and desires as well as a more humanistic approach will support the creation of services that get people connected to the tools and resources that will support them, ultimately helping them to achieve the positive long-term outcomes they desire. Technology alone doesn’t make a product successful.  What does? The health industry can suffer from “shiny object syndrome”, interpreting innovation as adopting the latest piece of hardware or software to hit the market, convinced that a new technology with a slick design will deliver sought after results – without a sense for the context within which they will need to function. Emerging technology and great aesthetic design can support our efforts, but should not be our focus. A decided focus on all the interactions which shape the patient’s journey across the ecosystem of interaction including how relationships and conversations are improved through better connection, and how confidence and competence are improved through the right people having the right information at the right time are all required. What are some new methods for gaining input from the target audience on the solutions we create? There is an evolution happening in terms of how we practice human centered design – patients, families and caregivers are now being invited to the table of innovation. Research inspired design has helped us better understand the people we serve so that we were able to design better solutions for them. As things move forward we will be designing with people more than we are designing for them – working alongside them to design solutions to the problems we face and building understanding along the way. Through participatory design activities like empathy mapping, generative toolkits, and game storming, we build understanding, make context, help translate and build consensus, and help others imagine the possibilities.   [caption id="attachment_25246" align="aligncenter" width="981"]
Early home screen ideas for the ImagineCare patient app.[/caption]   You said once that the digital solutions should be "designed for the people at their worst". What did you mean by that? Sara Wachter-Boetcher tells us in her talk “Everybody Hurts: Content for Kindness” that we need to design for people at their worst. She says “… if we’re able to consider users at their worst, and if we’re able to make experiences feel good for people at their most vulnerable, most difficult moments, then we can make them work for everybody." We can consider the full range of emotions and situations people will bring to their experiences. It is in our best interest to not factor out the “edge cases”. You have spoken about the power of purpose driven design. How might health organizations identify and manifest their purpose? We need to become “Students of the Problem,” intent on listening so that the right purpose and outcome will emerge – driven not by the assumptions of one group of people in a vacuum but discovered and desired by the people across the entire network. Creating a culture of health and helping the populations we serve to achieve greater human vibrancy is a noble purpose and long-term objective for health organizations to collaboratively work toward and embracing design can help us get there. The following steps can be taken to begin to form, grow and strengthen purpose driven and human-centered design practice in an organization: Purpose & Principle: Define the purpose that guides the organization, its reason being, understanding that delivery on that purpose will lead to profit. Roy Spence, explains in his book “It’s not what you sell, but what you stand for” that great companies have an authentic sense of purpose — “a definitive statement about the difference they’re trying to make in the world.” — and a workplace with the “energy and vitality” to bring that purpose to life. Translate that purpose into design principles that shape the experiences, products, and services delivered to stakeholders. Outreach, Training, and Measurement: Identify organizations with shared objectives and explore opportunities to collaborate. Train the organization in the benefits and practice of human-centered design. Measure the organization’s empathy quotient and the impact of human-centered design initiatives.
I believe collaboration is the new innovation.
It is extremely difficult to build a solution that fits to a very complicated health ecosystem, rules, law restrictions. How might collaboration help? Right now the patient is left in a very disconnected ecosystem to navigate on their own. The health system functions but doesn’t come as close to whole health as we would hope possible considering our human capacity to care, to connect, and to innovate. The system is often designed for the patient to serve it as opposed to it serving them. Each organization has individual objectives, but they also have shared objectives and together their opportunity for impact can be amplified. I believe collaboration is the new innovation – and that modern innovation isn't just about creating shiny new technologies but instead springs from brilliant and often surprising connections. Through purpose-driven design, we can make those connections by tracing people's pathways through the ecosystem of interaction – and understanding what other companies and other industries they touch throughout their journey and looking to identify unmet needs, obstacles, and opportunities. What concrete advice would you give those creating a digital health solution? First and foremost, we can do seek to understand the needs of the people we serve. In getting outside of the four walls of our typical environment and getting face time with the people we serve we can come to a deeper understanding of what will drive real meaning and value in the context of their lives – what will truly motivate, engage, inform, guide, and comfort. Some of the outputs we often see post-research are personas, mental models, mind maps, and journey narratives. These help us clarify our understanding of what people are dealing with, their stressors, what they think, who they communicate with, what they do, and how they feel. Journey maps can help us synthesize our understanding of the current situation as well as figure out what the future state experience can be like. In health there are other facets of the analysis to explore. We can examine the interplay of emotional intensity with health status, their path through the system, and through life.   [caption id="attachment_25247" align="aligncenter" width="962"] Landing screens for each of the four major tabs within the ImagineCare app.[/caption]   Where will design take us in the future? What trends can we expect? Human-centered design has helped us begin to humanize the health system. Purpose driven design will help us take things to the next level, exploring new ways to transform the system to one that delivers whole health. For example, what if the health industry collaborated with the food industry to deliver food with good nutritional value and help change the Standard American Diet, which is now also known as “SAD”? And what if we engaged patients and families in the waiting room so that they’re better prepared for the conversation with their doctor… instead of leaving them to fill out paperwork while their kids go stir crazy? And could doctors someday soon be prescribing apps that help us develop healthier behaviors in addition to the drugs they prescribe… or even in place of them? When you reorient companies toward purpose things change. New opportunities come to light. Purpose driven organizations will win in the marketplace and purpose driven design will help them get there.