Why We Need Design Thinking In Healthcare

getting more people to understand what design is, and why it matters, is worth whatever insult to the profession I'm about to cause.

Design Isn't Just For Gurus

Design isn't some mystical skill that some people are born with. Unfortunately for a field dedicated to making things intuitive, the design world doesn't do much to dispel this notion. The profession is carved into dozens of subfields with acronyms (UI, UX, CE, etc.), each of which has considerable overlap. Fortunately, a quick peek behind the curtain reveals that the process of designing things is not nearly as ambiguous. Here are four concepts that offer a core to understanding design, and how it can be applied to today's healthcare reform:

Design is about understanding, not assuming. Smart people responsible for solving problems typically, and often without knowing it, skip ahead to what they would want in formulating a solution to a problem or product. Instead, good design is about first understanding users, uses, and environments, then doing research deep enough to break through stereotypes and assumptions. This sort of deep dive can lead to a dramatically different understanding and thus, different potential solutions.  

Here's an example of such learning. Academic medicine can be a real grind, and the prevailing assumption is that keeping doctors from feeling burned out requires better benefits that support work-life balance. In 2010, Stanford University hired strategy consulting firm Jump Associates to understand what was really going on with burnout, and what the university could do about it.

Jump shadowed and interviewed doctors and researchers from the time they woke up, through the workday, and until they and their families went to sleep. In one interview, a doctor in her eighth month of pregnancy told researchers that she was signing up for more on-call shifts than ever. While she wasn't required to do the extra work, she said she hoped it would give her a clear conscience when she took a few months off with her baby.

In this case, the real problem to solve isn't inadequate benefits. The stated benefits -- like the time off permitted after having a baby -- are great. But the guilt that doctors feel in actually taking that time off can be overwhelming. So the team focused on ways to redesign cultural and organizational systems, perk programs, and development initiatives in order to better support doctors. Had the team just focused on making better benefits, they would have completely overlooked the real problems and needed fixes.

Design is a process. The design process is a series of steps intended to:

1. Solicit and understand the users' needs
2. Identify and try technically feasible solutions

The approaches tend to include the following steps:

1. Form the team
2. Define the problem
3. Define the users
4. Develop and iteratively test the solution

Some designers might switch the order of my No. 2 and No. 3. Designers may differ over the choice of ethnographic studies, shadowing, interviewing, or embedding users on the design team in order to elicit user needs. There are also different approaches to testing proposed solutions. None of the designers I spoke with were dogmatic about these differences. They mostly emphasized that, as long as you end up at the destination, your preferred mode of transportation is less important.

To those familiar with software development, the role of the designer may sound similar to that of a business or systems analyst. I suspect that good analysts would find considerable overlap in some of the methods (e.g., storyboarding, interviews, rapid iteration, etc.) and philosophies (e.g., user-centered concepts) of designers. And just as designers would benefit from learning more about how healthcare works, analysts would benefit from expanding their understanding of design. Which leads to my next point.

Page 3: Use "design thinking" to solve problems

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