Weitere ähnliche Inhalte Ähnlich wie Managing Healthcare Innovation as a Design Process (20) Kürzlich hochgeladen (20) Managing Healthcare Innovation as a Design Process 4. The Innovation Landscape in Healthcare
• Information Technology & Online Services
• Devices & Medical Products
• Services & Experiences
How might we design for …
• Clinical practice / Care models?
• Organizational structures & Business models?
• Government Policy & Shared Services?
Copyright © 2014, Peter Jones
10. Wicked Problems in Healthcare
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Large, aging & BIG demographic looming …
Expense of complex diseases
Universal Health Records / Platforms
Coordination of Care
Managing costs at practice AND payer levels
Medical Innovation – costs & integration of tech
• (It should be easy to name others …)
• Useless to manage by traditional analytical means
Copyright © 2014, Peter Jones
12. We aren’t lacking design
or solutions …
Farrow Partnership ‐ From Archinnovations
Peel Regional Cancer Centre, Credit Valley Hospital
Copyright © 2014, Peter Jones
Bridgepoint Hospital
Toronto Star photograph
13. A complex design problem.
• High‐tech isn’t helping ‐ Technology increases costs
• Information is fragmented ‐ Too many apps (> 70K!)
Too many IT systems (> 750 EMRs in 2010)
• Care experience is fragmented ‐ Risks to quality, care
delivery, population health, cost of care
• Healthcare business models fragmented, fragile
• (In most cases) Installing old care models into world‐class
facilities
Copyright © 2014, Peter Jones
14. Complex care is managed like design.
Sequential
Iterative
Mission
Efficient delivery of known solution
Evaluation and management of
complex care for difficult problems
Beliefs and values
An ideal exists
Uncertainty is reduced before care
Ideal state is unknowable
Uncertainty is reduced during care
Scope of service
Narrow
Higher capacity (throughput)
Diversified
Lower capacity
Processes
Standardized
Assembly‐line model
Nonstandard, or no protocols
Job shop approach
Management policy
Centralized
Broad span of control
Reduced variation in performance
Decentralized
Narrow span of control
Improvements learned by variation
Human resources
Conforming, conservative employees
Repetitive tasks
Problem‐solving experimenters
Development of new variations
Technology
Specialized
General purpose
Adapted from R. Bohmer. Designing care: Aligning the nature and management of health care. Boston: Harvard Business Press.
Copyright © 2014, Peter Jones
15. But very few designers
live in Healthcare
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Architectural Design
User Experience / Interaction Design
Information Design
Service Design
Evidence‐Based Design
Environmental Design
Visual Design
Industrial Design
Copyright © 2014, Peter Jones
16. 3 Locations 3 Contexts
SERVICE
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Copyright © 2014, Peter Jones
17. Design process from Discover - Develop
Field Research
Design Research
User Testing
Copyright © 2014, Peter Jones
18. “Innovation” without Design
• Innovation Centres have exploded since 2012
• In 2010 they were only at Mayo, CCF, TGH
Are now being explored everywhere
• Without a real customer, innovation is just
creative process improvement
• Without design, innovation is shallow.
• Without research, innovation impact is blunted.
• Consider the best cases …
Copyright © 2014, Peter Jones
24. Demand Side Innovation
• Technology‐based innovation is supply‐driven
• On the customer side we have wicked problems
Let’s just pick one: Lack of effective primary care.
• Results in avoidable blindness, amputations, strokes, heart
attacks, & premature death.
• US residents receive only ½ recommended medical services.
Only 43% of diabetics are treated
37% with hypertension
• Care delivery hindered by Electronic Records (EMRs)
Frieden, TR and Mostashari, F. (2008). Health Care as If Health Mattered. JAMA, 299 (8):950‐952
Copyright © 2014, Peter Jones
26. Solution: Innovate the Business Model
Michael Porter & Thomas Lee
The Strategy That Will Fix Health Care
HBR, October 2103
Toby Cosgrove
CEO, Cleveland Clinic
Value‐Based Health Care Is Inevitable
HBR, Sept 2013
Brookings Institution, RWF
Bending the Curve, 2013
Copyright © 2014, Peter Jones
27. Redesigning the Big-Box Healthcare Model
• Patient‐centred Care:
Organizing care for medical conditions rather than specialties
• Value‐based Care: Measuring costs & outcomes for each patient
• Bundled prices for the full care cycle
• Distributed Care: Integrating care across separate facilities
• Expanding geographic reach
• Building enabling IT platforms
Obamacare policies have positioned the US for Value‐Based Care
Copyright © 2014, Peter Jones
28. A Shared Value Healthcare Business Model
Copyright © 2014, Peter Jones
29. Getting to Innovation
• Design 1.0 – 4.0
• Design at org / system level requires a rare
skillset ‐ among designers or doctors
• Risks outcome of other “deep” practices
(BPR, Systems thinking)
• Innovation must be driven by real needs –
Patient pop, Care models, Technology
• Not just improvements!
Copyright © 2014, Peter Jones
30. Is Innovation a New Process
Movement?
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Quality movement has matured
Every hospital has PI, 6 Sigma, Lean
Lean has optimized value streams ‐
(And) now metrics are universal
• Analytical mindset optimizes
• Design mindset synthesizes
Copyright © 2014, Peter Jones
31. You’ve heard about …
• Culture eats strategy? (Attributed to Drucker)
• Healthcare must innovate the organization
before it can radically innovate
• Today’s drivers are cost, efficiency (cost), risk,
& patient satisfaction.
• All cost drivers.
Copyright © 2014, Peter Jones
33. Guidelines for leading what’s next
• Understand value of each type of innovation
Radical, incremental, disruptive, sustaining
• Lead by innovating the organization!
• IT is a partner, not the lead.
New service & business models drive new IT
• Don’t layer “design thinking” onto a process
improvement model. Hire designers.
• Discover your own value‐based models
Copyright © 2014, Peter Jones