Designing the ‘Care’ into Health Care
Improving the user experience could inspire people to tap into the system more regularly to help stave off more serious illness
In the current political debate over America’s health-care crisis,
candidates’ solutions appear to be divided along party lines. Democrats
want to offer universal health care (but to varying degrees and in
slightly different ways) while Republicans, if they have commented on
the issue yet, promote a free-market approach. The debate boils down to
varying levels of commitment to universal coverage and ideas about
who’s going to pay for it.
To a designer’s eye, efficiently providing for a basic need is
indeed the fundamental issue. But it should be possible to go beyond
rudimentary solutions to achieve the overall objective of a healthy
population by also addressing an essential question: What does the
individual want and need from the experience of health care?
The fact is, even among those covered by insurance, no one is happy
with the American health-care experience today. It is an expensive,
complex system to which people resort only when a problem has grown
threatening. Focusing on improving the user experience could inspire
people to tap into the system more regularly to support healthful
choices that could help stave off more serious illnesses. Innovations
are called for that are relevant to people’s needs and encourage
compliance, improve communication between doctor and patient, and help
people help themselves be healthy. The candidates today have an
opportunity to put the "care" back into health care.
Consumers Want to Be Empowered
Of course, while wellness is a desirable goal, a health-care
redesign isn’t only about getting everyone to take care of themselves
before and as they get sick. It is also about the bottom line. Workers
are expensive. And as journalist Richard Seven noted in The Seattle Times
in 2006, "Unhealthy workers are the most expensive of all. In any given
year, 10% of them account for 70% of the health-care costs. Many of the
expensive chronic diseases such as some types of diabetes and cancer
are lifestyle-related, meaning somewhat preventable." Seven reported
that Caterpillar (CAT) projected its wellness program may save about $700 million on health costs by 2015 and that Motorola (
MOT) reported in 2003 that it was saving $4 in health-care costs for every $1 it spent on wellness.
Ziba Design’s research, conducted for a number of medical and
pharmaceutical companies, indicates that consumers want to be empowered
to make choices that enable them to live a long, healthy, happy life.
The health-care system has evolved from an "Age of Entitlement" (from
the 1930s to the 1970s, when employee benefits proliferated and group
health care gained popularity), through a have and have-not "Age of
Privilege" that existed from the 1970s to 2000, when health costs rose,
forcing many to go without health insurance, and cheaper, managed-care
plans replaced employer-sponsored group plans.
Today, we live in an "Age of Responsibility," when consumer-directed
health plans are gaining momentum to counteract rising health costs.
Consumers have the opportunity to exert more control over spending
their health-care dollars, and to judge their health-care outcomes.
Girding this trend is Web 2.0, which promises to empower consumers with
healthy lifestyle information and better communication with health-care
providers.
What the Future Looks Like
What lies ahead is an opportunity to design a health-care experience
that reflects our nation’s desire to help itself be healthy. Let’s call
it the "Age of Empowerment," when we innovate to create healthful
experiences that can save money, support better clinical outcomes, and
improve patient quality of life.
Design thinking can lead us there. Institutions like the IIT
Institute of Design in Chicago have begun researching design-based
solutions to the health-care problem. Their Rethinking Health
initiative aimed at creating human-centered, systemic solutions was
recently awarded a generous grant by Robert C. Pew, chairman of the
boards of both Steelcase (SCS)
and the Institute of Design, that will allow large-scale systems
design, economics and design, and user-centered design research.
Here are some examples of what health-care experience innovation looks like:
Empowerment through self-care: Home-based dialysis is
an example of self-care that provides a win-win solution for everyone.
A recent report published in the medical journal Peritoneal Dialysis International
recommends home-based services as the treatment of choice. The report,
written by Fresenius Medical Care, the largest provider of in-center
dialysis care in the country, states that "patient independence, lower
mortality, reduced hospitalizations, higher overall satisfaction by
patients, and lower costs are clear benefits to the [home] dialysis
provider. Providing patients with the option to choose is clearly the
right path, and exactly what we would want as patients."
Glucose monitoring for diabetics is a good example of self-care, with Roche (ROG),
Lifescan, and Abbott (ABT)
leading the way selling blood test strips for personal use. Experience
innovation in the design of easy-to-use glucose monitors and supporting
online services have replaced the days of cumbersome, multistep test
kits that provided limited information. Today, smart monitors provide
the patient with information related to diet, medications, and other
factors that enable them to better manage their glucose levels and are
connected to caregivers who can support a patient’s care.
Empowerment through service innovation: Company health programs can support employee wellness. Pitney Bowes (
PBI)
set up health clinics at its largest sites, with appointment hours
available before 8 a.m. and after 5 p.m., made healthy changes in the
cafeteria, encouraged workers to take the stairs rather than elevators,
and to wash their hands regularly. They have also given employees
pedometers to reach a goal of 30 minutes of exercise per day. Joseph
Straw at The New Haven Register explained the additional
boost to the bottom line: "The return comes in increased productivity,
fewer sick days, and reduced costs in worker’s compensation and retiree
health care, all of which they said should be viewed as part of
health-care costs."
Retail health clinics like MinuteClinic
offer patients quicker, more affordable, and more convenient diagnosis
and treatment of common illnesses. This provides a simple, cheaper
solution for many patients who tend to avoid the doctor’s office until
they are really sick because it costs too much and takes too much time.
Clinics are popping up everywhere, with over 200 clinics in more than
20 states.
Empowerment through Internet technologies: Online tools allow people to manage their own health records and maintain a comprehensive history. For example, Microsoft’s (
MSFT)
HealthVault will offer free, secure personal health records that, once
given permission by a patient, will be made accessible to doctors,
clinics, and hospitals. Reliefinsite.com allows doctors, clinics, and
patients to work collaboratively to map, monitor, and analyze pain.
Social networking and online community-building tools have the
potential to create healthy communities. Imagine a help desk that would
extend health care beyond limited office hours; the use of e-mail,
chat, or Twitter for drug regimen updates; RFID for monitoring and
medical device identification; visualization tools for patients to
chart sources and severity of pains, symptoms, and drug intake, to show
doctors during later visits. The sky’s the limit.
User-centric experience innovations need not be relegated to
businesses using design to establish a loyal bond with their customers.
Applying time-tested design methods to a national institution like
health care can help ensure that our citizens not only have affordable
care, but that the quality of the care actually empowers them to live
the lives they desire. Nothing much: just a long, happy, healthy life.
Ziba Creative Directors Eric Park and Jeremy Kaye contributed to this article.
Sohrab Vossoughi is Founder and President of ZIBA
Design, the company he started in 1984. The recipient of more than 30
patents and over 200 design awards, Vossoughi was named BusinessWeek‘s
Entrepreneur of the Year in 1992. He continues to direct projects for
clients including Nike, Microsoft, Xerox and Hewlett-Packard.
