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Shelley Evenson | Interaction & Service | School of Design | Carnegie Mellon University © Evenson AHRQ Annual Conference Monday September 8th 2008
Design thinking for innovative
healthcare service
Shelley EvensonSchool of Design
Carnegie Mellon University
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Shelley Evenson | Interaction & Service | School of Design | Carnegie Mellon University © Evenson AHRQ Annual Conference Monday September 8th 2008
Overview
What is design thinking?
Two case studies
• intel research technology
•
University of Pittsburgh Medical Center (UPMC) patient Underlying methods
3 Big needs
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Shelley Evenson | Interaction & Service | School of Design | Carnegie Mellon University © Evenson AHRQ Annual Conference Monday September 8th 2008
what is design thinking?
a discipline that uses the designer’s sensibility and methodsto match people’s needs
with what is technologically feasible
and what a viable business strategy can convert
into customer value and market opportunity.”
Tim Brown
“
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Shelley Evenson | Interaction & Service | School of Design | Carnegie Mellon University © Evenson AHRQ Annual Conference Monday September 8th 2008
intel research+Simon King | Casey Helfrich | Anu Melville | Adil Wali
Mentors: David Westfall | Art Boni | Laurie Weingart | Shelley Evenson
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technol
business
design
(people)
Shelley Evenson | Interaction & Service | School of Design | Carnegie Mellon University © Evenson AHRQ Annual Conference Monday September 8th 2008
The project began with giving the team a choice of
open-source algorithms from intel research
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Shelley Evenson | Interaction & Service | School of Design | Carnegie Mellon University © Evenson AHRQ Annual Conference Monday September 8th 2008
They selected the Diamond algorithm for interactive
search through non-indexed dataTraditional exhaustive search—the burden of discarding is on the person
With Diamond—discarding happens in the background relieving the burden on the pe
query
results
computer
discard
disk
data
query’
data
early discard
query
results
computer
discard
disk
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Shelley Evenson | Interaction & Service | School of Design | Carnegie Mellon University © Evenson AHRQ Annual Conference Monday September 8th 2008
They looked with fresh eyes at what the
technology had to offer...
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Shelley Evenson | Interaction & Service | School of Design | Carnegie Mellon University © Evenson AHRQ Annual Conference Monday September 8th 2008
They looked with fresh eyes at what the
technology had to offer...
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Shelley Evenson | Interaction & Service | School of Design | Carnegie Mellon University © Evenson AHRQ Annual Conference Monday September 8th 2008
They looked with fresh eyes at what the
technology had to offer...
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Shelley Evenson | Interaction & Service | School of Design | Carnegie Mellon University © Evenson AHRQ Annual Conference Monday September 8th 2008
They looked with fresh eyes at what the
technology had to offer...
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Shelley Evenson | Interaction & Service | School of Design | Carnegie Mellon University © Evenson AHRQ Annual Conference Monday September 8th 2008
The team then looked at social, econom
and technical trends and applied other
business analysis methods.
They saw Diamond-enabled medical
imaging as having the greatest potentia
value—financially as well as socially.
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Shelley Evenson | Interaction & Service | School of Design | Carnegie Mellon University © Evenson AHRQ Annual Conference Monday September 8th 2008
They focused down even more, concentratin
on melanoma because it is a leading cause odeath, but early detection dramatically increa
survival rates...
One person dies of melanoma every hour.One in every 62 Americans will die of melanoma.
Incidence of melanoma has more than doubledsince 1973. Melanoma Statistics, 2006, CCMAC (http://www.ccmac.org/statistics.html)
Cancer Facts and Figures, 2006, American Cancer Society (http://www.cancer.org/downloads/STT/CAFF2006PWSecured.pdf),US
Census Data 2000, chapter 20
Melanoma Basics, 2005, Melanoma Center (http://www.melanomacenter.org/basics/statistics.html)
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Shelley Evenson | Interaction & Service | School of Design | Carnegie Mellon University © Evenson AHRQ Annual Conference Monday September 8th 2008
The team then conducted interviews and observation
research in dermapathology services. They discoverethe current workflow often fails for difficult cases...
view search compare diagnose
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Shelley Evenson | Interaction & Service | School of Design | Carnegie Mellon University © Evenson AHRQ Annual Conference Monday September 8th 2008
They designed a new workflow and interface, “onPat
onPath
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Shelley Evenson | Interaction & Service | School of Design | Carnegie Mellon University © Evenson AHRQ Annual Conference Monday September 8th 2008
“You can actually compare apples to apples
and not just apples to oranges. This is really great!” A Director of Dermatopathology, University of Pittsburgh Medical Center
They evaluated it with real users
Th h d i d h b i f
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Shelley Evenson | Interaction & Service | School of Design | Carnegie Mellon University © Evenson AHRQ Annual Conference Monday September 8th 2008
The team then designed the business fo
building and delivering onPath (including
designing the company’s organization)produced a marketing strategy
developed a financial strategycrafted a business pitch to interest investors in m
onPath a reality
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Shelley Evenson | Interaction & Service | School of Design | Carnegie Mellon University © Evenson AHRQ Annual Conference Monday September 8th 2008
3 months,3 students, and a viable newbusiness that has the potento transform practice andimprove patient outcomes.
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Shelley Evenson | Interaction & Service | School of Design | Carnegie Mellon University © Evenson AHRQ Annual Conference Monday September 8th 2008
UPMC +
I t M Ki f 2000 ti t
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Shelley Evenson | Interaction & Service | School of Design | Carnegie Mellon University © Evenson AHRQ Annual Conference Monday September 8th 2008
In a recent McKinsey survey of 2000+ patient
with commercial insurance, 75% would considswitching hospitals to become better informed
about treatments or if appointments were kept
on time. If forced to choose between informatioand timeliness, 3 times as many patients said
they valued information more...
Source: Grote, Newman, and Sutaria, A better hospital experience, McKinsey Quarterly November 2007
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Shelley Evenson | Interaction & Service | School of Design | Carnegie Mellon University © Evenson AHRQ Annual Conference Monday September 8th 2008
UPMC
Dr. Kassam
Neurosurgery clinic staff
Center for Quality Improvement
and Innovation
A collaborative project to improve experience
while seeing as many patients as possible.
Carnegie Mellon Students
Kip Lee | Kara Tennant | Leanne Libert | Jamin Hegeman | Melissa Cliv
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Shelley Evenson | Interaction & Service | School of Design | Carnegie Mellon University © Evenson AHRQ Annual Conference Monday September 8th 2008
what’s being communicated here?
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Shelley Evenson | Interaction & Service | School of Design | Carnegie Mellon University © Evenson AHRQ Annual Conference Monday September 8th 2008
what’s the patient experience?
is that your foot or mine?
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Shelley Evenson | Interaction & Service | School of Design | Carnegie Mellon University © Evenson AHRQ Annual Conference Monday September 8th 2008
is that your foot or mine?
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Shelley Evenson | Interaction & Service | School of Design | Carnegie Mellon University © Evenson AHRQ Annual Conference Monday September 8th 2008
what’s the staff experience?
Students combined observations an
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Shelley Evenson | Interaction & Service | School of Design | Carnegie Mellon University © Evenson AHRQ Annual Conference Monday September 8th 2008
Students combined observations an
interviews with quantitative research
They created a model of the patient’s journey
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Shelley Evenson | Interaction & Service | School of Design | Carnegie Mellon University © Evenson AHRQ Annual Conference Monday September 8th 2008
They created a model of the patient s journey...
D e t e c
t i o n
P r e - o p v
i s i t
S u r g e
r y
F o l l o w
F o l l o w
- u p v i s i t
P o s t -
o p v i s i t
P r i m a
r y c a r e
v i s i t
D i a g n
o s i s /
fi r s t v i s i t
>
Generative: interactive experience research
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Shelley Evenson | Interaction & Service | School of Design | Carnegie Mellon University © Evenson AHRQ Annual Conference Monday September 8th 2008
Generative: interactive experience research
and produced a summary of needs
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Shelley Evenson | Interaction & Service | School of Design | Carnegie Mellon University © Evenson AHRQ Annual Conference Monday September 8th 2008
and produced a summary of needs
Feeling welcome Actual wait time
Respect
Space and comfort
Distractions
Better workflowLocating Dr. Kassamand each other
Communication
Making a difference
Spend qualitytime with patient
See everyone
Support staff
Manage time
Opportunities for all constituents
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Shelley Evenson | Interaction & Service | School of Design | Carnegie Mellon University © Evenson AHRQ Annual Conference Monday September 8th 2008
Opportunities for all constituents
Embrace Wait Time Improve Workflow Balance Kassam
Evaluative: concept validation with patients
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Shelley Evenson | Interaction & Service | School of Design | Carnegie Mellon University © Evenson AHRQ Annual Conference Monday September 8th 2008
Evaluative: concept validation with patients
Dr Kassam fact sheet to inform engage and comfo
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Dr. Kassam fact sheet to inform, engage, and comfo
patients, and provide a model for their experience
Shelley Evenson | Interaction & Service | School of Design | Carnegie Mellon University © Evenson AHRQ Annual Conference Monday September 8th 2008
A welcome booklet that embodies the spirit of the physician, previthe experience for the patient of the Neurosurgery Clinic, and at th
time positions the staff to help with broader delivery role
I know you don’t want to be here.
I know you don’t want to know me.
But the best thing that could happen
is to know me.
I’ve performed more than 3,000 neurosurgical procedures. More than800 are what’s called minimally invasive endoscopic procedures.
And I’m a person first. I’ll be direct and treat you like a friend.Occasionally, I may even make you laugh.
D e t e c t i o n
P r e - o p
v i s i t
S u r g e r y
F o l l o w - u p
v i s i t
F o l l o w - u p
v i s i t
P o s t - o p
v i s i t
P r i m a r y c a r e v i s i t
D i a g n o s i s / fi r s t v i s i t
I work with a great team, and could
not do my job without them. They can
answer a lot of your questions. Trust
them as you trust me. We’re here for
you the whole way through.
2 days - 2 weeks
2 days - 4 weeks
1 month - 1 year
6 months - 1 year
My staff and I see a lot of pa
and provide attention and c
all. We know this sometimes
backups. But I hope you’ll u
and trust I’ll see you as soon
C h e c k - i n
C h e c k - o
u t
W a i t i n t h e
W a i t i n g
R o o m
W a i t i n t h e
E x a m
R o o m
M e e t a R e s i d e n t o r N u r s e
S e e m
e
Embrace wait times with a clinic chat system
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Patients can send messages to Clinic Chat
from their phone, personal computer or kiosk
in the waiting room, exam room or at home.
Dr. Kassam can re
Staff have access via hall d isplays.
Shelley Evenson | Interaction & Service | School of Design | Carnegie Mellon University © Evenson AHRQ Annual Conference Monday September 8th 2008
University of PittsburghMedical Center
Minimally Invasive endoNeurosurgery Center
UPMC
Clinic Chat
God bless
send me questions
good news
no incisions
within two days
great team
good hands
learn more
clinic website
hello everyone
Common Patient Phrases Common Dr. Kassam Phrases
Join the Conversation
Embrace wait times with a clinic chat system
to provide information updates even whenthe patient isn’t being touched
patients have the
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Shelley Evenson | Interaction & Service | School of Design | Carnegie Mellon University © Evenson AHRQ Annual Conference Monday September 8th 2008
patients have theinformation to understand the
journey and build communitie
so they can become more
active in codesigning their car
Our projects lead to innovative results
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Shelley Evenson | Interaction & Service | School of Design | Carnegie Mellon University © Evenson AHRQ Annual Conference Monday September 8th 2008
Our projects lead to innovative results.
Three things drive the way we work that we
believe can continuously lead to innovation
in healthcare services - simultaneous interdisciplinarity
- modeling-based process - user-centered methods throughout
Most innovation starts with a technology
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Shelley Evenson | Interaction & Service | School of Design | Carnegie Mellon University © Evenson AHRQ Annual Conference Monday September 8th 2008
techno
business
design
(people)
Most innovation starts with a technology…
Better companies start from people
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techno
business
design
(people)
Shelley Evenson | Interaction & Service | School of Design | Carnegie Mellon University © Evenson AHRQ Annual Conference Monday September 8th 2008
Better companies start from people…
We believe in simultaneous interdisciplinarity
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technol
business
design
(people)
Shelley Evenson | Interaction & Service | School of Design | Carnegie Mellon University © Evenson AHRQ Annual Conference Monday September 8th 2008
We believe in simultaneous interdisciplinarity
We use a modeling-based process
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Shelley Evenson | Interaction & Service | School of Design | Carnegie Mellon University © Evenson AHRQ Annual Conference Monday September 8th 2008
We use a modeling based process
interpret
describe
abstract
Existing—Implicit (current) Preferred—Explicit (future)
w at s
researching prototyping
w at
“could be”
mo e owhat
“could be”
concrete
mo e o“what is”
d i s t i l l e d
t o
suggests
e m b o
d i e d a s
Analysis-synthes
Hugh Dubberly
Shelley Evenson
Rick Robinson
Interactions
March/April 2008
and we focus on user-centered methods
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Shelley Evenson | Interaction & Service | School of Design | Carnegie Mellon University © Evenson AHRQ Annual Conference Monday September 8th 2008
...and we focus on user centered methods
throughout the design process project research
design processform the
framework
and
strategy
discover implementcreate | express
refine
socialize
exploratory generative evaluative
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Shelley Evenson | Interaction & Service | School of Design | Carnegie Mellon University © Evenson AHRQ Annual Conference Monday September 8th 2008
but there is more todesign thinking...
design
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Shelley Evenson | Interaction & Service | School of Design | Carnegie Mellon University © Evenson AHRQ Annual Conference Monday September 8th 2008
design
thinking... understanding
integration
openness attention
exploration
envisioning
understanding (in the small and large)
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Shelley Evenson | Interaction & Service | School of Design | Carnegie Mellon University © Evenson AHRQ Annual Conference Monday September 8th 2008
g ( g )
a focus on deeply understanding
people’s expressed and latent needviewed in the context of broader
social, economic, and technical tren
integration
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Shelley Evenson | Interaction & Service | School of Design | Carnegie Mellon University © Evenson AHRQ Annual Conference Monday September 8th 2008
integration
the ability to organize and integrate
disparate information into somethingmany stakeholders—with different
viewpoints—believe is better
openness
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Shelley Evenson | Interaction & Service | School of Design | Carnegie Mellon University © Evenson AHRQ Annual Conference Monday September 8th 2008
p
fearlessness with regard to
listening to another person
or learning from anotherdiscipline or division’s perspective
attention
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Shelley Evenson | Interaction & Service | School of Design | Carnegie Mellon University © Evenson AHRQ Annual Conference Monday September 8th 2008
respect for emotion and its
importance in driving rational choiceand satisfaction
exploration
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Shelley Evenson | Interaction & Service | School of Design | Carnegie Mellon University © Evenson AHRQ Annual Conference Monday September 8th 2008
p
letting creative extremes take you
into ever-richer solution spaces
envisioning
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Shelley Evenson | Interaction & Service | School of Design | Carnegie Mellon University © Evenson AHRQ Annual Conference Monday September 8th 2008
g
leaps of faith as to what might
work and creating quick, tangible,examples of it,
while being unafraid to discarddesign options along the way
Bringing design thinking to healthcare services
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Shelley Evenson | Interaction & Service | School of Design | Carnegie Mellon University © Evenson AHRQ Annual Conference Monday September 8th 2008
Bringing design thinking to healthcare services
will enable the creation of customer-centeredinnovations for healthcare and provide the skill
needed to explore new organizations, business
models, and healthcare service delivery
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Shelley Evenson | Interaction & Service | School of Design | Carnegie Mellon University © Evenson AHRQ Annual Conference Monday September 8th 2008
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