designing pathways around people

FRONTIERS HEALTH 2016 DESIGNING PATHWAYS AROUND PEOPLE

NOVEMBER 18, 2016 @thomas_thinks @frogdesign

2

Appointments

Prescriptions

Referrals

Discharges

Primary Care

Specialty Care

Many #digitalhealth solutions inherit and perpetuate the fracture between healthcare and everyday life.

HEALTHCARE VS. EVERYDAY LIFE

Pathways around People @thomas_thinks

3

Secondary Care Primary Care Non-medical Care Self Care Lifestyle

SUPPORTING INDIVIDUAL HEALTH JOURNEYS

#digitalhealth should aim to integrate health in daily life, by supporting individual health journeys across domains.


Supporting Health Journeys: Emerging Best Practices


5


Extending care teams beyond the clinical environment.

EMERGING BEST PRACTICES

e.g. HealthLoop, Noona


6



e.g. Sherpaa, Babylon Health

Primary Care 2.0: the always-on health navigator.


7



e.g. HomeTeam, Patient-centered Wiki’s

Coordinating services around the individual.


8



e.g. Skinvision, Mediktor

Shortening the path to specialty care.


9



e.g. Amicomed, Omada Prevent

Personalised coaching and lifestyle change.


Designing (for) pathways: Design Fundamentals


Confused Supported

Stressed Frustrated

11

UNDERSTAND THE PATHWAY | INVESTIGATE SUBJECTIVE EXPERIENCES


12

UNDERSTAND THE PATHWAY | REAL-WORLD BEHAVIOUR, WORKAROUNDS AND TACIT PROCESSES


13

UNDERSTAND THE PATHWAYS | VISUALISE AND VALIDATE


14

CO-DESIGN IMPROVEMENTS | DESIGNERS AND CLINICIANS, RETHINKING PATHWAYS TOGETHER


15

When care is provided as part of a system, the patient will experience not only consideration and competence at each consultation, but also the feeling of following a pathway (i.e. a route) through the system, rather like being on a guided tour to a foreign country.”

“

CO-DESIGN IMPROVEMENTS | WHAT DOES “BETTER” MEAN?


16

DEFINE YOUR CONTRIBUTION | MAP SOLUTIONS INTO THE PATHWAYS


17

IMPLEMENT, MEASURE, ITERATE | OPERATIONALISE PATHWAYS AT THE POINT OF CARE

18

IMPLEMENT, MEASURE, ITERATE | COMMUNICATE PATHWAYS TO PATIENTS

Screening Meeting

Person

Location

Contact

Notes

Csapa, ParisNicholas Guerch

+33 1 7772 2200

12 06/15:30

Screening Meeting allows you to get a first orientation on which infections are active in your body.

We will help discover the best practices for using drugs and evaluate with you your current practices.

If further followup is required we explain the next steps and book the necessary appointements for you.

Come to this meeting for fast testing of multiple infections and advice to stay on top of your and your loved ones’ health.

!

"

#

Confirmation Meeting

Buddy Meetings Defining an action plan Picking up my medication Final Screenings

Person

Location

Contact

Notes

We will communicate you the results of the test and explain what they mean.

We will indicate and book the next appointements for you if needed and desired.

In this meeting we will provide you with an accurate confirmation of the lab test results and evaluate next steps.

!

"

Person

Location

Contact

Notes

You will be guided with additional indications and directions of where the meeting with the hepatologist will ocur and what will happen.

Your companion will help you in taking care of the logistical operations.

In these meetings you will be provided with information about the disease, why it is relevant to treat now and how to handle it.

!

"

Person

Location

Contact

Notes

Person

Location

Contact

Notes

Person

Location

Contact

Notes

Additional tests will be performed with the to check what influence the virus or infection has had on your body.

The results of these tests will be evaluated by medical staff in the next days to propose the right action plan.

The hepatologist will communicate you the results from the medical panel review and provide you with the matching prescription. Together you will create the action plan of further steps required.

Each month you will be picking up a monthly dose of medication at the hospital pharmacy.

Each month you will be picking up a monthly dose of medication at the hospital pharmacy.

Come to these meetings to evaluate treatments and check up on other health parameters.

Come to these meetings to get your medication for each month and review how the past month has gone with the pharmacist.

Having gone through your medical procedures, we will perform the final tests to make sure that the medication has worked.

! ! !

" " "

Whoto see

Whyto go

Whatto expect

19

IMPLEMENT, MEASURE, ITERATE | ENABLE SHARED DECISION MAKING AT THE HEART OF THE PATHWAY

LET’S EVALUATE FEW OPTIONS

Option 1PROS:

CONS:

Option 2PROS:

CONS:

Option 3PROS:

CONS:

Who & how?

It’s important for me that...

ME AND MY SUPPORT NETWORK

Let’s think about who can support me...

MY PLAN:

SAFETY NET:

MY PLAN:

SAFETY NET:

MY PLAN:

SAFETY NET:

My plan

today: next visit: next visit:

name: age: today,

(Eg: smoking, food, movement)

What does this mean for me?

CARDIOVASCULAR RISK

BASIC INFORMATIONLIFESTYLE:

chronic condition

SBP (Systoic Blood Pressure)

others (eg: cholesterol,...)

Use simple words and drawings to make it clear and easy for the patient to understand and interpret. If you’re using a validated risk

score, make sure to document it here. Try using both drawings and text.

Check the patient’s understanding of the risk assessment. Consider asking open-ended

questions like “do you understand why I’m concerned?”

Contextualise the risk assessment and potential for risk reduction in plain language

for the patient.

Try to highlight the day-to-day reality of each option. If it’s medication, describe how

often you have to take the tablet, for example. Also summarise the main pros and cons, which could include side effects, cost,

population-level benefits, benefits, and harms.

Ask the patient what is most important to them with respect to the risk reduction

options. Summarise these main points and check accuracy with the patient. If appropri-ate, you can ask the patient to complete this

section, with your input afterwards.

Here we help the patient map the people, institutions, or tools, around them and ways

in which they may support the patient’s goals for risk reduction.

This could include children, family, health insurance, workplace initiatives, etc.

Summarise the plan that you and the patient have created in

simple, clear points. Check with the patient that these reflect

their preferences and goals.

The safety net section can outline what the patient can do or try if they are not sticking to plan.

This could include calling on any of their social, psychological, or occupational supports, or trying

less intensive risk reduction activities.

Diabetes

140

137

smoking 1 pack per day,

walk 1h per week at the park

STATIN

EXERCISE

lower cholesterol I can eat my favourit fruit

I don’t eat pills

Son: he makes me moving

Sarah, my wifeshe cooks for me

sometimes causemuscle pain.

good to lower your risk

might hard for yourkees...try swimming!

DIET Read NICE guidelinesyou risk to have an heart attach in next 10 year is 12%.

We can lower your risk!

walk 2times per week

eat more veggies for dinner

talk to my wife about the plan

ask my son to walk with me

pills

eat less suger

Risk score:

12%

1 pill per day

eat more fruit and vegless fat,less sugar

20

IMPLEMENT, MEASURE, ITERATE | PROVING HEALTH SYSTEMS VALUE


21


BEFORE YOU BUILD ANOTHER APP…

1. Understand the pathway. 2. Co-design improvements. 3. Define your contribution. 4. Implement, measure, iterate.
