We often see a disconnect between the way innovators and clinicians think and approach change across the industry. How do we design health care thoughtfully for physicians and patients? Where is the disconnect between design thinking and health care? Join the conversation with our experts for answers to these questions and more.
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When you asked "are we speaking the same language" and listed the tech community, physicians, and the health system as stakeholders, I wondered why patients and tax payers did not make the list. If any constituency is baffled and nonplussed by the language of health science and health care, it is the one that pays the bills: consumers. By some measures, 90% of Americans lack basic health literacy. Why?
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Good point Robert. Until patients are seen as a key stakeholder the tech community, physicians and systems are talking to and among themselves. Could be part of the health literacy issue.
Thank you for writing this Mr Becker! I was going to pose a question as “how many devices and tech ideas would not involve patients? “ (excluding remuneration & reimbursement software) Patients are the crux of healthcare and in most instances, the end-users of health tech.
As others have mentioned, patients and their overall well-being should be the primary focus of health technology innovation. For decades, the medical community often disregarded the needs and preferences of patients when providing medical care. Hence the more contemporary terms and goals of providing “patient-centric” and “patient-focused” healthcare. However, new advancements in health technology do not have to follow a similar fate. Developing new technology that considers patients’ health conditions, demographics, and social determinants can result in thoughtfully designed technology that will make a significant impact.
Focus on patient stakeholders could actually be its own discussion. Possibly breaking it down by different types of patients, how they rate existing technologies, and what types of innovation are still needed such as tools to promote self-management, engage with their healthcare providers, understand the connection between mind and body, examine their symptoms and treatment options, understand their insurance coverage, etc.
Physician
elsevier.com/journals/patient-...
Patient Education and Counseling has its subsection on Patient Centered Innovation .
Check it out
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Academic/Faculty
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Professor at University of Colorado School of Medicine and Business School
Organizational innovation happens when employees with an entrepreneurial mindset can play in a culture of innovation. There are many things that contribute to the latter, but perhaps the most inportant is having a leaderpreneur at the helm. Without that person, it's just innovation theater
Stephen, this is such an important issue. Until healthcare leaders foster a culture of innovation - beyond lip service; innovation will remain ethereal. What is often lacking, is not only encouragement for innovation, but recognition and processes for employees to make ideas a reality with the support of the organization.Support for employee ideas is also one of the key elements of employee engagement.
I agree, Kristin! Such leaders are likely to be open-minded and have respect for alternative views. There's much potential value in bringing together people with wide diversities of knowledge, experiences and points of view, and in fostering meaningful opportunities for multifaceted discussions, out-of-the box thinking, and sharing creative ideas. This is a good way to stimulate innovation.
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How is it not impacted? This is when we trey to fit the user to the environment rather than designing the environment to fit the user. There are all sorts of potentially compromised outcomes: safety, efficiency, satisfaction, quality of care, costs...
History provides numerous examples of what happens when the stakeholder is the consumer. Consumerism then paves the way for the development of new products and services. One example is urgent care. Consumers need access to care after 5 pm. That unmet need opened the market for freestanding urgent care centers that are often disconnected from the patient-centered medical home leaving gaps in the medical record and history.
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Professor at University of Colorado School of Medicine and Business School
University of Colorado Care Innovation Center
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Professor at University of Colorado School of Medicine and Business School
Physician
Matter Chicago
matter.health/
OSF Innovation
osfhealthcare.org/innovation/
Discovery Partners Institute
dpi.uillinois.edu/
I've seen presentations about this project. tmc.edu/news/2018/04/tmc3-a-ne...
Good examples. What are examples of interdisciplinary/interprofessional collaboration, such as integrating behavioral health and SDoH to address the needs of the whole person?
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She/Her/Hers
Creating a budget that will include all stakeholders at the table, including patients and carepartners, to voice what they value, prefer, and need. Hire patients to be part of the decision-making team!
Physician
Great question! I think their role should evolve out of a singular philosophy. That philosophy is the essence of service leadership. In a previous response I mentioned that healthcare deliver happens at the junction of the patient/client and the clinician. Everything else is there to support that. The management or leadership of a health system should understand that in their core. Their job is to facilitate that encounter(s). Give the providers the best tools they can afford, and remove all the obstacles they can from the process. In this case they can evaluate potential solutions from that angle. Is it making that interaction easier, better, more fruitful? And then find the best ways to implement it.
So much of health policy and implementation is all "stick"... where is the "carrot?" and to that I say - screw carrots. We eat them because they are good for us (some of us even like them) - so they aren't even necessarily rewarding. What would the "carrot cake" look like?
Physician
A critical portion of sussessful design is gap analysis. The health systems can inform (often begrudgingly or unwittingly) design.
What would it be like if the relationship was to mentor and guide design, provide seed funding, and invest in good products co-developed by tech?
Outcome: Reduce the energy gradient to design and development and create products that are relevant and can achieve scale.
Health systems should engage with consumers to identify their real pain points and then find meaningful solutions.For example: I was just conducting focus groups with consumers who are very frustrated with access. They want to make appointments online and yet, many healthcare organizations have not implemented online scheduling. I think we sometimes ask consumers what they want then find a dozen reasons why we can't or won't give it to them. Healthcare has a long way to to in this arena.
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Professor at University of Colorado School of Medicine and Business School
Start with the end in mind: improved patient outcomes, lower cost, better access and improved doctor and patient experience. THat will require aligning the value creating value chain. It is not either/or but and.
She/Her/Hers
Without the patient, no other stakeholder in the healthcare ecosystem exists.
In a recent question about how we decide if innovation is good, bad, worth it (innovationmatch.ama-assn.org/p...), we determined that it depends on the purpose and the users of that innovation. A good list of stakeholders that comes from PCORI (pcori.org/about-us/our-program...) is: patient (and their family members, caregivers, and the organizations that represent them), clinicians, community members, healthcare purchasers, payers, industry, hospitals and other health systems, policy makers, training institutions, and researchers.
Considering the different criteria (definitions and metrics) these stakeholder groups use to evaluate an innovation's value/worth, the question are:
1. Which groups share similar criteria and what does that imply?
2. Which groups have dissimilar or opposing criteria and what does that imply?
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Academic/Faculty
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Professor at University of Colorado School of Medicine and Business School
One of the biggest challenges for sick care entrepreneurs, particullary non-sick care entrepreneurs that come from tech, is to determine 1) who is the customer and what is the job they want done, and 2) how do you create product market fit that satisfies the interests of not just one, but multiple stakeholders. Solving or failing to solve that Rubick's cube is the reason your product will succeed or fail.
She/Her/Hers
Continuously aligning priorities with fee-for-service provides a conduit for innovations that risk not bringing authentic value to patients, that undermine the doctor patient relationship, that do not support Do No Harm, and ultimately continue to contribute to the demise of our healthcare system.
He/Him/His
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Physician
Always amazed when I hear insurance leaders state that they don't see the value to the medical home. By word and action (payment) too often we incentivize fragmented care. Fee for service aligned to convenience and not continuity or expertise is a real problem.
The different points of view should strengthen innovation, but it takes time to synthesize what is being learned and what knowledge is being created. Andersen and Broberg conducted an interesting study on participatory simulation. If we can think about the process of creating an outcome, not just the outcome itself, we might better evaluate the sequential relationships between the activities of simulation participants sharing experiences; experimenting with scenarios; and reflecting on the consequences. Andersen, S. N., & Broberg, O. (2017). A framework of knowledge creation processes in participatory simulation of hospital work systems. Ergonomics, 60(4), 487–503. doi.org/10.1080/00140139.2016....
Synthesizing divergent views through PS to create lessons learned and disseminate that knowledge for decision support makes good sense to me. It would be good to make the collection and sharing of such information for analysis a fundamental capability of innovative products.
How can innovators deal with issues regarding Fee for Service, Value to Patient, and Clinical Outcomes?
Academic/Faculty
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Professor at University of Colorado School of Medicine and Business School
It's important to keep in mind that innovation doesn't always have to be the big tech ideas. We need for all employees and providers to be innovative. I have found that it is often the ideas from the front line employees that can pay huge dividends in improving the patient experience. When we can place a challenge in their hands and give them the tools and support, many employees will find solutions to everyday problems. One of the biggest challenges healthcare faces when trying to foster innovation is that it is a risk-averse industry.
Academic/Faculty
· Entrepreneur
· Physician
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Professor at University of Colorado School of Medicine and Business School
1, Everyone has good ideas
2. There are many ways to create value other than a product
3. Necessity might be the mother of invention. Innovation, however, is often an orphan