Design thinking is a human centered approach to problem seeking and problem solving.

Using Design Thinking to Solve Hospital Readmissions

Greg Nelson Analytics Competencies, Healthcare Analytics, Healthcare Technology, Our Thots

Healthcare has seen its share of fads over the years. Often, management will roll in something new for us to try and we oblige. Examples of these fads include lean manufacturing and Six Sigma, Business Process Re-engineering, Matrix Management, Management by Objectives, and Activity Based Costing, just to name a few.

My theory is that if we can take the best ideas of from methodologies that work for us and continue to learn, innovate, apply, and learn some more, then why not at least get to know the latest craze? After all, we are going through another massive shift in healthcare that creates a sense of urgency to do something. For example, see this article on bringing value based care to hospitals and radiology.

Whether you are in quality and patient safety, accountable to new federal reporting guidelines, or optimize how service lines deliver value to patients, I think most would agree that they are open to methods which help them:

  • See their work through a different lens
  • Prioritize the important over the urgent, and
  • Transform communication with both partners and patients
(Call out with Pic: Our team placed into the top tier for the competition and walked away with a cash prize for our solution!)

Cash Prize Winners of UNC Innovation Summit

Recently, we had an opportunity to participate in a program with The Institute of Healthcare Design Thinking and the UNC Health Care Center for Innovation in which we worked to solve one of the biggest challenges in healthcare: readmission reduction for heart failure patients. Our problem was centered around how do we educate and support heart failure patients before, during, and after discharge into a home health setting to maximize their chances of successful recovery?

The approach that we used was rooted in Design Thinking.

What is Design Thinking?

Design Thinking is a way of thinking that enables you to design solutions that start with empathy. Design Thinking is essentially a way to get out of our own heads and forget our pre-conceived notions about what someone wants or needs, instead forcing us to define problems from the “user’s” perspective. In the case of heart failure readmission, the most obvious “users” are the patients, but if we simply designed for the patient, then we would miss out on addressing the entire picture that shapes why a readmission would occur. To paraphrase one of my favorite mentors, Professor Kenneth Boulding, the world is a total system!

Forgetting that fact in the context of healthcare can be devastating. Service is characterized by highly coordinated care and it is necessarily multidisciplinary as patients receive care across multiple disciplines, care providers, care sites, and time (Morrow et al., 2012). Responsible parties include primary care providers, cardiologists, interventional cardiologists, and cardiothoracic and vascular surgeons. Beyond the traditional care teams, we have nurses, pharmacists, community care specialists, paramedicine, family and other support systems. Finally, we must also consider the role that the payer has in our solution.

Design Thinking Takes the User Journey Into Account

The myriad of participants, perspectives and incentives makes a solution impossible without consideration of that system in total. In design thinking, we exercise our minds by documenting the user “persona” and their “user journey” in ways that help us emphasize with them along their route so that the problem definition is clear as well as what we must consider along the way.

A Closer Look at the User Journey

Below is an example of the user journey that we developed for the readmission reduction problem. This was a fantastic experience and our team placed into the top tier for the competition and walked away with a cash prize for our solution! If you want to try your hand at a competition, here is a healthcare design challenge you might enjoy from MIT where they are asking teams to cure chronic diseases.

Below is an example of the user journey that we developed for the readmission reduction problem. (Call out with Pic: Our team placed into the top tier for the competition and walked away with a cash prize for our solution!)

Example Journey Map Created for UNC Innovation Sprint

Documenting the journey is a process which not only helps us document the problem, but also aids in problem solving as we can identify the points of friction and begin to see the problem as an entire system of connection, events and interactions—with people and technology.

While I don’t pretend to imagine that Design Thinking will stay in its current form forever, I do think it will help us focus on the important elements in our transformation to value.

Real World Examples of Design Thinking in Action

In our work with hospitals and health systems, we are seeing the tremendous impact of design thinking in how healthcare is delivered and the role that analytics has in supporting innovation. This is what being people-centered is all about. In fact, dozens of healthcare systems have adopted the concept of innovation centers to help do just that. Here are a few examples from systems large and small that we have gotten a chance to know—all making a difference through empathy, collaboration and iterative prototyping of solutions:

  • Brigham and Women’s Brigham Innovation Hub. The Brigham Innovation Hub, called the iHub, launched in September 2013 as a resource center for internal and external innovators.
  • Froedtert & the Medical College of Wisconsin’s Inception Health. Inception Health LLC is the hub of Froedtert & the Medical College of Wisconsin’s health networks’ digital health services.
  • Kaiser Permanente’s Sidney R. Garfield Health Care Innovation Center. The Garfield Center opened in June 2006 and has served as grounds for developing ideas and testing innovations.
  • Mission Health System’s Mission Center for Innovation offers innovators business planning and feasibility analyses, opportunities to connect with appropriate partners and, in some cases, funding.
  • Penn Medicine Center for Health Care Innovation. Unique to this innovation center is its Penn Social Media and Health Innovation lab that conducts research focused on the intersection of social media, mobile technology and health.
  • University of Utah Spark Innovation Lab along with the University of Utah Patient Experience Think Tank.

Interested in Exploring Design Thinking Further? We Can Help

If you are interested in learning more about Design Thinking and how it can be applied in healthcare analytics, please contact us. In addition, please join us for a webinar outlining the 9 Healthcare Analytics Competencies that Matter and learn how you can incorporate design thinking into your own set of Healthcare Analytics Competencies.

 

References:

Morrow, D. A., Fang, J. C., Fintel, D. J., Granger, C. B., Katz, J. N., Kushner, F. G.,  Winkelman, C. (2012). Evolution of Critical Care Cardiology: Transformation of the Cardiovascular Intensive Care Unit and the Emerging Need for New Medical Staffing and Training Models. A Scientific Statement From the American Heart Association, 126(11), 1408-1428. doi:10.1161/CIR.0b013e31826890b0