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Triple Aim Design Thinking - Stanford MedX 2014

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James Dias, CEO, and Lucas Dailey, Senior User Experience Designer, will present a workshop, “Designing connected care solutions at the intersection of medicine and finance” on Saturday, September 6th from 2:20-3:50 PM PDT.

The workshop will explore how the business of performance-based healthcare requires a balance between giving patients the best possible quality outcomes and doing it in a cost effective manner. This emphasis on value-driven medicine is producing the opportunity for new technology solutions that address both care and costs. Designing effective solutions for “Connected Care” requires an interdisciplinary approach that brings together the disparate fields of healthcare economics, patient engagement, and digital technology.

Veröffentlicht in: Gesundheit & Medizin
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  • Interesting slides. Thank you for sharing. At TechSpring, the Baystate Health Technology Innovation Center, we aim to bring Triple Aim, lean startup, design thinking, together in one big melting pot. Healthcare innovation is complex, easy to get bogged down. At the end of the day, it helps just to put a premium on getting something done. Done is better than perfect, as they say.
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Triple Aim Design Thinking - Stanford MedX 2014

  1. 1. Designing connected care solutions at the intersection of medicine and finance James Dias – CEO Lucas Dailey – Senior UX Designer
  2. 2. 1. Introductions 2. Audience Survey 3. About us - Who is Wellbe
  3. 3. Agenda Part 1: A Healthcare Framework for Design Part 2: A Case Study of Good Design Part 3: A Workgroup Exercise (30 mins)
  4. 4. Fire starter Patient-Centric design isn’t enough
  5. 5. Pop Quiz What is Meaningful Use Stage 2? The final rule for meaningful use Stage 2* intends to increase health information exchange between providers and promote patient engagement by giving patients secure online access to their health information. HealthIT.Gov
  6. 6. Pop Quiz
  7. 7. Design Framework
  8. 8. The Triple Aim 1. Improving the patient experience of care 2. Improving the health of populations 3. Reducing the per-capita cost of healthcare http://www.ihi.org/Engage/Initiatives/TripleAim/pages/default.aspx
  9. 9. The Triple Aim Population Health Experience of Care Per Capita Cost
  10. 10. Background - The Triple Aim • Framework developed by the Institute for Healthcare Improvement • An approach to optimizing health system performance • Conjoin models about healthcare and financing • Create stakeholder accountability for all three dimensions, simultaneously
  11. 11. A Foundational Concept The Triple Aim is a prevalent influencer in all major healthcare transformational initiatives ONC CMS CHT ACA Triple Aim
  12. 12. Office of National Coordinator The mission of ONC is to optimize the paths to reach these five health IT goals along with interoperability to support the Triple Aim. • Achieve adoption and information exchange through meaningful use of health IT • Improve care, improve population health, and reduce healthcare costs through the use of health IT • Inspire confidence and trust in health IT • Empower individuals with health IT to improve their health and the health care system • Achieve rapid learning and technological advancement
  13. 13. Metrics
  14. 14. Metrics
  15. 15. Experience Metrics
  16. 16. Experience Metrics Health Care
  17. 17. Cost Metrics
  18. 18. Reducing Costs 1. Lower the cost of therapies and treatments 2. Improved efficiency in care delivery 3. Improved choice-making 4. Mitigating risks
  19. 19. Improving Experience 1. Quality of the care 2. Patient Satisfaction, HCAHPS 3. Alignment of expectations
  20. 20. Improving Outcomes 1. Measurable Functional Achievements 2. Patient reported Outcomes Measures (PROM) 3. Monitoring Activities of Daily Living 4. Clinical Indicators, health status By 2015, health care providers participating in accountable care organizations will have to provide evidence that the care they've delivered produced value for the patient—as reported by the patient.
  21. 21. Evaluating Technology
  22. 22. Primary Focus Evaluated technologies that serve value-driven delivery and reimbursement models Improve the Patient Experience Improve the Health of Populations Reduce Per Capita Cost of Care Evidence? Investment?
  23. 23. Findings The vast majority of companies did not meet the intent of the Tripe Aim “The most striking finding of the DHSF is that the vast majority of digital health companies do not simultaneously emphasize achievement of all three Triple Aim Components. This limited emphasis on the Triple Aim may reflect a lack of awareness or perceived value of the entire Triple Aim for health technology entrepreneurs. This finding may also indicate a market in transition from technology products that currently serve dominant fee-for-service, volume-driven health care organizations toward technologies that serve value-driven delivery and reimbursement models in the future.”
  24. 24. More findings Missing the mark! “Most technologies targeted toward Patients focus on trying to improve individual health outcomes. Very few focus on Decreasing the Costs of Care, which may be an opportunity for technology developers to create innovative applications to make consumers more fiscally informed about their health care decisions. Technologies focused on Payers and Providers are more oriented toward costs and outcomes, but suffer from a major lack of emphasis on Improving Patient Experience. “
  25. 25. Case Study Refilling Prescriptions in a Patient Portal
  26. 26. Case Study – MyChart • EPIC’s patient portal • Most used EMR and patient portal in US
  27. 27. Case Study – Screens Screen Shots
  28. 28. Case Study – Key Points • Doesn’t fulfill Triple Aim – Patient Experience: Helpful, Convenient – Population Health: marginal effect – Cost: marginal effect • Single Use • Replaces an existing process with an online process – incremental
  29. 29. Design Approaches • Lean Design – good for process efficiency • Design Thinking – good for product design • Agile – good for software development
  30. 30. The 5 Basic Steps The Stanford d.school Design Thinking Process
  31. 31. The 5 Basic Steps The Stanford d.school Design Thinking Process 1. Empathize See the problem from the perspective of the user’s experience 2. Define Use the 5 Why’s to define the problem, then the success criteria 3. Ideate Brainstorming solutions to meet the goals 4. Prototype Build prototype(s) of the solution as fast as possible 5. Test Measure the impact of your solutions, then iterate
  32. 32. The 4 Basic Steps The Rotman School’s “Business Design” 1. Empathy: Being able to see challenges and opportunities from others’ perspectives and understand what people truly need. 2. Multi-Disciplinary Collaboration: Leveraging the creativity and intelligence of diverse perspectives to see the bigger opportunity. 3. Ideation & Prototyping: Exploring many possibilities to get to the breakthrough idea. 4. Experimentation: Testing new solutions early and often to increase the chance of marketplace success
  33. 33. Keys to Success DT • Integrative Thinking – hold two opposing thoughts in mind – simultaneously • Encourages divergent thinking to create new choices that haven’t existed before • Challenging prevailing assumptions - Devils Advocate, Black Hats, 10th Man.
  34. 34. Successful Design Thinking How DT Turned Around AirBnB • Growth flat lined in 2009 and they went broke • Founder Joe Gebbia went to RISD • DT analysis helped identify the problem: Photos sucked • DT helped them find and test a solution: Photograph spaces themselves • Test worked: revenue jumped
  35. 35. A New Framework
  36. 36. Forging A New Framework Triple Aim Design Thinking
  37. 37. Forging A New Framework Methodology of Design thinking Framework Of the Triple Aim Popula on Health Experience of Care Per Capita Cost
  38. 38. Triple Aim Design Thinking Two strategies
  39. 39. Use Three-stakeholder Lens Provider Patient Payer
  40. 40. Design for the Future
  41. 41. The Value of Triple Aim Design Thinking • Better alignment with systemic challenges • Creates clear and compelling value • Unveils new avenues for transformation • Opens commercial opportunities
  42. 42. Pop Quiz Name one of the more popular apps or sites that people use for their healthcare. iTriage WebMD YouTube
  43. 43. Healthcare Challenges
  44. 44. A Seeming Contradiction Improve quality and lower cost. Oftentimes, quality, profitability and sustainability operate at odds with each other.
  45. 45. No Two Patients • Vast differences in demographics • Changing Expectations • No one wants to be there
  46. 46. Fragmentation Everywhere • Siloed, disconnected processes and systems • Diverse, un-coordinated care delivery • Compartmentalized data and limited visibility • Poor patient experiences across transitions
  47. 47. Healthcare Culture • Necessarily, Risk averse • Deference to authority • Submissive patients
  48. 48. Pop Quiz What is the largest segment of the healthcare consumer market?
  49. 49. Pop Quiz
  50. 50. Showcase - Virtuwell
  51. 51. Showcase 1 - Virtuwell Screenshot
  52. 52. Showcase 1 - Virtuwell Screenshot
  53. 53. Showcase 1 - Virtuwell Screenshot
  54. 54. Showcase 1 - Virtuwell Screenshot
  55. 55. Showcase 1 - Virtuwell Screenshot
  56. 56. Showcase 1 - Virtuwell Screenshot
  57. 57. Virtuwell – Triple Aim Positive Experience: High convenience Population health: Quick diagnosis and treatment; better health outcomes Cost: Savings with a new delivery model
  58. 58. Pop Quiz In 2014, what percentage of US Physicians communicate electronically with their patients? a) 74% b) 39% c) 15% d) 7%
  59. 59. Triple Aim Design Thinking Exercise
  60. 60. Triple Aim Design Thinking Empathize Define Ideate Prototype Test Exercise
  61. 61. Case Study – Screens Screen Shots
  62. 62. Triple Aim Design Thinking Exercise Redesign the medications refill element of a patient portal.
  63. 63. Triple Aim Design Thinking Exercise Focus on Cost: An 2013 NEHI study found medication reconciliation cost the industry $26 billion An Institute of Medicine found medication reconciliation to be the most common medical error
  64. 64. Exercise - 25 Minutes 1. Why don’t patients take their medications (properly)? 2. How could the medication refill part of a patient portal help, while reducing costs?
  65. 65. Nota bene: Ignore technical constraints!
  66. 66. Exercise - 25 Minutes 1. Why don’t patients take their medications properly? 2. How could the medication refill part of a patient portal help, while meeting the Triple Aim? Ignore technical constraints!
  67. 67. Exercise - 5 Minutes 1. Share your tables’ ideas with the room
  68. 68. Wrap-Up Discussion What did we learn? What insights did we uncover?
  69. 69. Restate the Takeaways Triple Aim Design Thinking Take away 2 Takeaway 3
  70. 70. James Dias – CEO dias@wellbe.me Lucas Dailey – Senior UX Designer lucas.dailey@wellbe.me Deck on Slideshare – tweet #TripleaimDesignthinking

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