designing pathways around people
TRANSCRIPT
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.
Pathways around People @thomas_thinks
Supporting Health Journeys: Emerging Best Practices
Pathways around People @thomas_thinks
5
Secondary Care Primary Care Non-medical Care Self Care Lifestyle
Extending care teams beyond the clinical environment.
EMERGING BEST PRACTICES
e.g. HealthLoop, Noona
Pathways around People @thomas_thinks
6
Secondary Care Primary Care Non-medical Care Self Care Lifestyle
EMERGING BEST PRACTICES
e.g. Sherpaa, Babylon Health
Primary Care 2.0: the always-on health navigator.
Pathways around People @thomas_thinks
7
Secondary Care Primary Care Non-medical Care Self Care Lifestyle
EMERGING BEST PRACTICES
e.g. HomeTeam, Patient-centered Wiki’s
Coordinating services around the individual.
Pathways around People @thomas_thinks
8
Secondary Care Primary Care Non-medical Care Self Care Lifestyle
EMERGING BEST PRACTICES
e.g. Skinvision, Mediktor
Shortening the path to specialty care.
Pathways around People @thomas_thinks
9
Secondary Care Primary Care Non-medical Care Self Care Lifestyle
EMERGING BEST PRACTICES
e.g. Amicomed, Omada Prevent
Personalised coaching and lifestyle change.
Pathways around People @thomas_thinks
Designing (for) pathways: Design Fundamentals
Pathways around People @thomas_thinks
Confused Supported
Stressed Frustrated
11
UNDERSTAND THE PATHWAY | INVESTIGATE SUBJECTIVE EXPERIENCES
Pathways around People @thomas_thinks
12
UNDERSTAND THE PATHWAY | REAL-WORLD BEHAVIOUR, WORKAROUNDS AND TACIT PROCESSES
Pathways around People @thomas_thinks
13
UNDERSTAND THE PATHWAYS | VISUALISE AND VALIDATE
Pathways around People @thomas_thinks
14
CO-DESIGN IMPROVEMENTS | DESIGNERS AND CLINICIANS, RETHINKING PATHWAYS TOGETHER
Pathways around People @thomas_thinks
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?
Pathways around People @thomas_thinks
16
DEFINE YOUR CONTRIBUTION | MAP SOLUTIONS INTO THE PATHWAYS
Pathways around People @thomas_thinks
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
Pathways around People @thomas_thinks
21
Secondary Care Primary Care Non-medical Care Self Care Lifestyle
BEFORE YOU BUILD ANOTHER APP…
1. Understand the pathway. 2. Co-design improvements. 3. Define your contribution. 4. Implement, measure, iterate.
Pathways around People @thomas_thinks
frog is a company of Aricent. © 2014 frog design inc.
@thomas_thinks @frogdesign