Integrating Design Using the Native Language of Healthcare
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This document discusses integrating design thinking into healthcare. It describes Joyce Lee's background in pediatrics, clinical research, and participatory design. It outlines efforts to engage students in design workshops and create apps for managing diabetes. The document proposes achieving greater adoption of design in healthcare and measuring return on investment. It presents a quality improvement project using interventions like depression screening and shared decision making to improve diabetes outcomes. Throughout, it emphasizes designing with patients and caregivers and not accepting the status quo.
Integrating Design Using the Native Language of Healthcare
- 1. Integrating Design Using the Native Language of Healthcare Joyce Lee, MD, MPH Robert Kelch Professor of Pediatrics http://www.doctorasdesigner.com/ Twitter: @joyclee @joyclee
- 3. Pediatrician/Diabetes Specialist Health Services/Clinical Research Clinical Translational Research Participatory Design/Maker Movement BACKGROUND @joyclee
- 4. @joyclee
- 5. This is not my reality @joyclee
- 7. Don’t fix the problem, make the USER Do a workaround @joyclee
- 8. Don’t Change the Default, Send an email Reminder Hide Admin Docs Email: “The EHR made ”Hide Admin Docs” the default which hides lots of documents. If you are unable to find something that was imaged, first look to see if the “Hide Admin Docs” box is checked and uncheck the box if it is”” @joyclee
- 9. ”Do not follow these instructions-it will create the most work possible” Give instructions that go against the user’s best interest @joyclee
- 11. Engaged Learning for Students from UMSI/Art & Design Design Thinking Workshops for Medical Students @joyclee
- 12. Design/Maker Workshops Apps Design by Teens Participatory Design/ Maker Workshops @joyclee
- 13. MakeResearch: Mastering Adolescents’ Knowledge and Engagement in Research @joyclee
- 15. How Might We Achieve GreaterAdoption of Design in Healthcare? @joyclee
- 16. Design in Tech 2015, John Maeda @joyclee
- 17. How Do We Measure ROI in Healthcare? @joyclee
- 18. @joyclee
- 19. “Patients, caregivers, clinicians and researchers work together to choose care based on best evidence; together they drive discovery as natural outgrowth of patient care; and ensure innovation, quality, safety and value, all in real-time.” -C3N Project A Learning Health Care System @joyclee
- 21. Quality Improvement Measure and improve the ROI Science of Improvement
- 22. Push boundaries, surprise, and delight Design Thinking Quality Improvement Measure and improve the ROI
- 23. Aim: To decrease the % of the population with HbA1c ≥ 9% and increase the % of the population with ≥ 0.5% HbA1c interval improvement Preference driven treatment and effective self- management Enhanced registry population management & Pre-visit planning Peer/community support Education/training to support technology use and patient viewing and problem solving with blood glucose data between visits Interventions/toolkits for addressing barriers to adherence Efficient use of technology and data to support care Access to care and regular follow-up Screening for depression Psychosocial Support Shared decision making Partnership between engaged patients and the care team Effective use of EHR by diabetes team for population management Care Process Measures • % of pts testing ≥4 times/day or using CGM (6/7 days/week) • % of pts giving 3 or more short- acting boluses/day • % of pts reviewing data between visits • % pts setting, documenting, and reviewing goals • % completed pre-visit planning • % with ≥ 4 visits per year • % of pts with annual CDE/RD/SW visit • % of pts on case mgmt pathway • % pts screened for depression Developing a Clear Measurable Aim and a Theory of Change @joyclee
- 24. Assembling a Team QI Director Associate Director Visual Designer Patient/Family Advisor Data Analyst Research Associate Project Manager Marketing Specialist Physicians Diabetes Educators Social Work/Psychology Admins/Office Manager Patient Advisory Board @joyclee
- 25. Implementing Interventions to Support Evidence-based Care Depression Screening Patient Portal Enrollment High-Risk Follow-up Shared Decisionmaking for Blood Glucose Monitoring @joyclee
- 26. Studying the Science of Patient Engagement Website and Newsletter Surveys @joyclee
- 27. Creation and Maintenance of a Data Registry @joyclee
- 28. Caldwell P, Mother Jones @joyclee
- 29. Unstructured Data Missing Patient-reported Data Underutilized Data Design (Too many clicks!!)
- 30. @joyclee
- 31. Unstructured Data Missing Patient-reported Data Underutilized Data Design (Too many clicks!!) Flowsheets/Smartforms Patient Portal Questionnaires Reporting for Population Management Clinical Interface Redesign @joyclee
- 32. Improving the Patient Experience @joyclee
- 35. @joyclee
- 36. “I’m reaching my last year at Stanford and I’ve run into an issue: I can understand why physicians should have design thinking as a tool. But when I think about the schooling and training to be a doctor I can’t help but imagine my creativity being crushed by endless memorizing and “this is exactly how you do this” kind of thinking. I gave up medicine for design, and I want to know if I even needed to make that choice.” @joyclee
- 37. I think in my institution since they don’t know what design is, I am better off being a doctor who practices design as designers wouldn’t even be able to set their foot in the door (they would never know to hire one!), I can be a “peer” or “one of them” that can hopefully help convince them of the ROI. But that’s inside a healthcare delivery system.” @joyclee
- 38. “I do think that there is a lot about medical school that is a pain; but it does gain you credentials, a deeper understanding of the “mindset” of medicine, and continuous exposure to users. Being immersed in that is very instructive from an ethnographic point of view. I only have clinic a few times a month. I savor those times because I always learn new things.” @joyclee
- 39. “One last thing, I do think systems design is important for design and in particular learning health systems. When you are trying to move outcomes and move multiple levers like policies, recalcitrant medical professionals, patients, it does sometimes help to have the clinical perspective and authority to guide the design and development of clinical medicine as well as patient experience.” @joyclee
- 40. DESIGN IS A MINDSET Don’t accept the status quo DESIGN IS A MULTILAYER PROCESS DESIGN WITH PATIENTS AND CAREGIVERS @joyclee
- 41. www.doctorasdesigner.com Medium: https://medium.com/@joyclee Twitter: @joyclee joyclee@med.umich.edu Ashley Garrity, Emily Hirschfeld, Valeria Gavrila, Michelle Wichorek, Lilia Verchichina, Dorene Markel, Amy Ohmer, Jacob Dwyer, Ram Menon, Pediatric Diabetes Team ACKNOWLEDGMENTS @joyclee