Toronto Design Festival: Designing beyond the clinical health service

Toronto Design Festival is Canada’s largest cultural celebration of design and innovation; bringing together researchers, practitioners and thought-leaders from across the world to talk, debate and speculate the future of the design discipline. Last month our Design Director travelled to Canada to join a lineup of speakers to share insights and experiences on the topic of ‘Design and the Pursuit of Wellbeing’. In this blog post, Robbie shares some of the insights he discussed on the topic of ‘designing beyond the health service’ at the festival’s closing symposium.

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Design like someone else’s life depends on it, because when it comes to health it most likely does.

Living with a long-term health condition (LTC) is hard work. As most people with an LTC will tell you; the daily treatment plans, clinic visits and hospital admissions are time consuming, often chaotic and testing on a person’s mental well-being.

As evidenced in a 2013 Pew Centre Research report, people with LTCs are spending at least 2 hours a day managing their health condition(s)1.  This equates to a whopping 672 hours a year; almost a month in fact; making ‘patienthood’ equivalent to a part-time job.

In contrast a person with a long-term health condition spends on average just 4 hours each year directly interacting with their health provider or clinician2. This leaves around 3650 hours where people are living with their condition(s), and managing their health needs independent of clinical health professionals.

When we consider these figures alongside a dramatic increase in multimorbidity (the number of people with three or more long-term conditions is predicted to rise from 1.9 million in 2008 to 2.9 million in 20183), there is a significant need to find better ways of supporting people with LTCs beyond their direct interactions within the clinical health setting. These are the opportunities to design services and systems that account for life and not just for illness; designing for the person, not just the patient.

Although not a new insight, these figures still make my jaw drop every time I hear them. It’s widely recognised that we urgently need to shift away from reliance on acute and episodic care, toward more supportive services that foster an increase in personal responsibility and better management of LTCs at home. However, how do opportunities to design for life and not just episodes of acute illness manifest themselves into tangible design challenges?

I wanted to use this blog post to share a few of the insights we discussed at the Toronto Design Festival’s closing symposium in reaction to this question. From my personal and professional perspective at the intersection of designer-patient, I offered up 5 opportunities for design to better support people with long-term health conditions beyond the clinical health service:

  • Design ways to refresh the treatment journey
  • Fuel imagination to consider an alternative health scenario
  • Improve feedback loops that go beyond the healthcare context
  • Design with both data and story
  • Consider patients and caregivers as innovators

I haven’t aimed to offer solutions here, nor an exhaustive list, but rather position the challenges facing people with long-term health conditions as, in part, opportunities for design.

Design ways to refresh the treatment journey 

As Pew Centre research cites, people with long-term health conditions spend significant amounts of time and energy managing their own health and care needs independently or with the support of those around them. Over long periods of time treatment plans and routines become tedious and repetitive, often resulting in a reduction in treatment adherence and in subsequent episodic health exacerbations.

With a greater need to increase self-management and personal responsibility of health and care outcomes, there is an opportunity to find ways to refresh and reenergise these daily treatment journeys.

Opportunity: How might we find new ways to continually engage patients in their daily treatment and care plans, and refresh often repetitive treatment routines?

Fuel imagination to consider an alternative health scenario

We’ve been spending a lot of time recently exploring how speculative approaches to research can help reframe challenges and identify latent opportunities for health innovation. Arguably, these approaches needn’t be reserved for stakeholders charged with shaping health policy or delivering health services.

‘Design fiction’ can play a significant role in empowering patients and caregivers to imagine alternative health scenarios and invite them to shape improvements to their personal health and care journeys. Getting patients to consider the alternatives available to them using scenarios may provide opportunities to increase patient engagement with their future health and allow them to make more informed decisions about their treatment today.

Opportunity: How might we use design fiction to fuel imagination to consider alternative future treatment pathways, where patients are empowered to own their future health?

Improve feedback loops that go beyond the healthcare context

Feedback loops within a health or care context are often limited to the time patients spend within the clinical environment or service. Courses of action or treatments are often dictated based on clinical assessments or data gleaned during visits through in or outpatient episodes.

With people spending increasing amounts of time managing their care at home, there are significant opportunities to improve the feedback loops and the flow of data between patients and their clinicians beyond these clinical episodes. These feedback loops could enable clinicians to identify acute exacerbations earlier, provide increased transparency of information and allow more informed treatment choices for both patients and their health providers.

Opportunity: How might we create new feedback loops that put people at the centre of their own care, and provide them and their health professionals with increased choices for early intervention?

Design with both data and story

Narrative rich data is an important factor in understanding and improving the patient experience and designing services that are responsive and adaptable to individual needs. Although in isolation it may not constitute for reliable decision making, when used in conjunction with more quantitative metrics, it plays a significant role in helping us to understand the motivations, barriers and challenges facing patients with long-term health conditions beyond the clinical context.

This narrative rich data can help us understand ‘the why behind the what’ and provides opportunities to design whole experiences that are more empathic, compassionate and responsive to the increasingly complex needs of those living with long-term health conditions.

Opportunity: How might we design products, services and systems that leverage both quantitative and narrative rich data to support patients beyond the clinical healthcare environment?

Consider patients and caregivers as innovators

Better than most, patients and their caregivers understand the complexities, challenges and barriers facing them in relation to management of long-term conditions within their day-to-day lives. They offer personal and unique lenses on what it means to live with chronic conditions and how to best adapt to the often chaotic changes in treatment and care plans.

At a Digital Health London event last week, we heard a panel discussion emphasise this point, with patients sharing ways they were using consumer technologies in innovative ways to help them better manage their health needs.

Moving beyond the fundamental principles of participatory design, there are opportunities to recognise and acknowledge the role that patients and caregivers play as experts in their health needs and in identifying, shaping and championing new health or care innovations.

Opportunity: How might we better acknowledge patients and their caregivers as innovators in new healthcare services, products or strategies?

 

We’d love to hear your thoughts on these opportunities, and what else you think could be added to this list. We’ll be exploring a number of these topics through our Ideas and Innovation Lab over the coming months. If you’d like to be involved, or to receive the latest insights coming from the Lab, then get in touch via Robbie@uscreates.com.

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1 The Pew Research Centre (2013). Report. The Diagnosis Difference.

2 Patient Information Forum: National 2016 Conference (2016)

3 Department of Health (2012). Report. Long-term conditions compendium of Information: 3rd edition

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