Designing Health Care Solutions

It’s great to have modern health care in Canada, but we all know and have experienced that our Health Care System is excessively administered and not properly designed for people to understand and be empowered to lead their own health initiatives. In fact, we all have all found it to be overly confusing and too complex even for simple tasks. Have you often wondered if health professionals feel the same way? And how could designers help?

Health Care Design - Do you remember ParticipACTION?
Health Care Design – Do you remember ParticipACTION?

On February 13 Peter Jones and Paolo Korre (design consultant at Mount Sinai Hospital) held an open session for health professionals in various disciplines. The participants worked both in and outside the medical system and therefore represented a fairly good cross section of health care professionals. The name of this session was called “Healing Wicked Problems in Health”.

After an unusually long group participant introduction, each person was left to create a “wicked problem” in the realm of health care. Wikipedia defines this as “phrase originally used in social planning to describe a problem that is difficult or impossible to solve because of incomplete, contradictory, and changing requirements that are often difficult to recognize”.

The group created about 30 different wicked problems to solve. Out of these 30, five were selected to be further examined, but I will only look at three. Ideally each group was trying to create better practices that improved communication which would allow for better health. We presented real issues that hamper individuals and communities and tried to devise credible actions for health care engagement.

The three that I will focus on are:
1. How do we redefine how to be radically inclusive?
2. If physical inactivity is the root of all health evil, why not ban it?
3. How do we create maintain and own our own comprehensive health records?

The reason I am focusing on these three, is that they have so much in common. The result of any of these would mean that individuals become the drivers or agents of their own health. Ironically, the impact to the government’s financial system would be positive. Healthier more active participants would mean less health problems and wasted time in the offices of health care institutions.

How do we redefine how to be radically inclusive?

The first step to redefine health would be to ask what defines health now in our current culture. We would also need to define what “radically inclusive” would entail. Both questions would require meaningful dialogue with the government, health care professionals, spiritual leaders, patients and patient advocates, newcomers, artists and urban designers. The outcome of this dialogue would most likely support a nongovernmental institution/think tank to coordinate and champion future engagement. The resulting outreach and community commitment and how well it was facilitated would be paramount. Of course along the way this group would have to define the success criteria, all the while making it sexy enough for it to be seen as 100% inclusive.

This topic of “inclusivity” really sits at the heart of the health matter in Canada. If you draw an analogy as our individual health being our “lifetime currency”, I think you would agree that our health is our most important asset, but it certainly isn’t treated as such.

If physical inactivity is the root of all health evil, why not ban it?

Most of us can remember the health initiative by the government of Canada in the seventies towards improving the health of the average Canadian called “Participaction”. We were told that the average 30 year old Canadian was as healthy as a 70 year old Swede. And for time this initiative worked but it was eventually canceled.

We can blame McDonald’s and the rest the fast food industry for the convenience of cheap hot food, we can also blame the lack of time we all have on a daily basis. We live in virtual worlds and our children play video games which are more inclusive than the real games in the school yards with real people. But in other cultures, even at work there is communal, participatory physical activity at the beginning or during the day. Unfortunately our relatively solitary existence in Canada is the norm which leads us to our “normal” being overweight.

There is nothing stopping us from spending half an hour every 24 hours on physical activity, especially for our youth. English, math and gym should be mandatory in all our schools. It should be made fun, a game and inclusive. Our cities could be made easier to walk, and our families encouraged to play and explore together. We could even take out the glucose and fructose fillers in all our food and drink. Perhaps incentives such as tax breaks could be given to individuals and businesses that would help increase their health potential which would in turn increase the productivity of the each person at work. With these health practices we would no longer measure fitness in weight but improvement in health.

Much of this sounds like common sense and it can also be fun, but it would be a generational change with the government in charge as the early driver.

How do we create maintain and own our own comprehensive health records?

This was my question. I’m not quite sure if this can be defined as a wicked problem because I believe we have the tools, right now, to solve this problem. Unfortunately I do not think we have the will.

When we talk about a comprehensive health record, we mean a self-directed, self-maintained record that contains a combination of the physical and mental health of an individual. This record would also contain the individual’s family’s past. But most importantly the individual would be the central figure and only rightful owner of this record.

This record would be used to save time for health care providers so that less time was spent at health institutions regurgitating the same old information about the patient’s background to different clinicians. The individual in charge, the patient, could give any medical practitioner temporary access to their health record. No one, nor any business like a pharmacy, drug company, insurance company or even the government would have access or be allowed access without the consent of the individual who owns the record.

This record would have to be completely built upon open standards perhaps accessed by the individual’s (in the case of Ontario) OHIP number and databased by the Ontario government. As part of our taxes the government would house the database but not have readable access to it. While other organizations have tried to solve this issue, especially in United States they have all failed for issues of trust.

The result of this health care record would be that everyone would have a complete health care experience for their entire lifetime, they would be ensured efficient, lower cost, timely and appropriate care, they would have access to personalized guidance, they could opt in for health care alerts when intervention is required and when time came the health record could be administered by family health caregivers.

Common benefits

All three issues have a few things in common:
1. They empower the individual
2. They lesson costs for the government
3. They improve the future health of the individual
4. They make for a more engaged society

Of course any sane person would be asking why are we undertaking these initiatives today? Common sense would dictate that we would all be happier, healthier and more informed if we did. But I guess that’s why we call them “wicked problems”. Unfortunately too many groups that make too much money from individuals with health problems would lose, and I don’t think they will give up their control anytime soon.

I guess this is where designers can speak up and more effectively communicate to everyone why initiatives such as the three mentioned could help better our society. Designers could simplify the problem, the parameters, the solution and the message to a wider audience than the health industry or government could which would be seen as self-serving anyway.

Anyone with a few extra spare days?