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IS1 STUDIO
Designing the Healthcare of Tomorrow
The team
Maria Alejandra Altet
Shivani Bhansali
Lucia Chen
Ramey Chen
José Pablo Domínguez
Dana Duarte
Radhika Kale
Chrissie Kayode
Meshwa Kshatriya
MJ Kwon
Mikaela Li
Valentina Palacios
Soumil Panwar
Tako Sulakvelidze
Charloe Yu
Claire Zhuang
MS SDM Integrative Studio Spring 2022
Instructors Leah Cabrera Fischer Ankita Roy
We are Researchers Consultants & Strategists Experience & Service Designers Product & UI/UX Designers Branding & Marketing Strategists Visual & Graphic Designers
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Contents 01
02
03
04
How we got here
What we found
Opportunities
The path forward
▾ The journey ▾ Insights
▾ Design principles ▾ Opportunity areas ▾ Proposed solutions
▾ Roadmap ▾ Impact
▾ ▾ ▾ ▾
Context Our process Healthcare today Challenge
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01
How we got here
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THE CONTEXT
A strategic partnership
The largest integrated healthcare system in New York State commied towards caring for millions of individuals and their families
01 How We Got Here
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The number one design school in the U.S. and among the top three globally
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THE CONTEXT
Brief from Northwell Northwell partnered with Parsons SDM to look into how they could personalize and digitally transform patient and caregiver experiences while keeping SDOH in mind
01 How We Got Here
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OUR PROCESS
An insights driven approach
34 patients
5 insights
59 initial ideas
25 patients
12 caregivers
4 personas
7 prioritized ideas
9 caregivers
7 providers
4 opportunities
4 design principles
7 providers
4 experts
01 How We Got Here
3 experts
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HEALTHCARE TODAY IS…
Complex & ambiguous
33%
of U.S. adults went without recommended care, did not see a doctor when sick, or failed to fill a prescription because of costs
24 days
How might Northwell decrease entry barriers and increase accessibility in the healthcare system?
average wait time for a new patient-physician appointment
Source: The Commonwealth Fund, Arista MD 01 How We Got Here
8
HEALTHCARE TODAY IS…
Missing context
80%
of the factors that influence our health operate outside hospital walls
$200
average cost of no-shows per patient for health systems
How might Northwell oer care for social determinants of health (SDOH) that prevent patients from staying on top of their health?
Source: County Health Rankings Model, “Prevalence, predictors and economic consequences of no-shows.” BMC health services research 01 How We Got Here
9
HEALTHCARE TODAY IS…
Lost in translation
3.1m
immigrants in NYC, of which 50% have LEP
23%
of New Yorkers identify with having LEP and associated diiculties
How might Northwell improve the healthcare quality and access amongst patients with Limited English Proficiency (LEP)?
Source: MOIA Annual Report 2019 01 How We Got Here
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HEALTHCARE TODAY IS…
Not caring for caregivers
23.5%
of New Yorkers reported being a caregiver for family or friends
26%
How might Northwell oer support to patients and caregivers to improve treatment & health care outcomes?
of family caregivers have diiculty in coordinating care for patients
Source: Caregiving in the US 2020 01 How We Got Here
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THE CHALLENGE
Reframed problem space How might we create a more holistic, accessible, and inclusive patient experience with a focus on family and caregiving units through the use of digital tools?
01 How We Got Here
12
02
What we found
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THE JOURNEY
A patient’s healthcare journey ACCESS TO CARE
DELIVERY OF CARE
The initial step of awareness and action towards starting a healthcare journey
When a patient is actually receiving a healthcare service they need
EXTENDED CARE The path to recovery after a patient has been diagnosed and has left the hospital Diagnosis
Recovery
Check up
Get appointment Awareness Trigger
Tests & scans
Identify specialist Commute
Follow up
After care
Follow care
Paperwork
Pay bill
02 What We Found
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ACCESS TO CARE
DELIVERY OF CARE
EXTENDED CARE
INSIGHTS
AMBIGUITY BREEDS AVOIDANCE
People have a preconceived notion that the healthcare system is complex and inaccessible, which creates fear in their minds leading to avoidance.
“
So I had a strong migraine and went to the hospital, I made an appointment with a primary doctor, who later directed me to a neurologist and by the time I got my results back my headache was already gone and so were my dollars. Next time I am simply going to CVS. Priya Patient
02 What We Found
___ ▾ ▾ ▾ ▾ ▾ ▾
Perception of complexity Lack of precise and clear information Ambiguous estimates and costs Hard to figure out what doctors yours need Self-medication Distrust in the system
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ACCESS TO CARE
DELIVERY OF CARE
EXTENDED CARE
FAMILIARITY BREEDS COMFORT
“
The needs of patients with LEP are often multi-faceted, ranging from functional translation supports to emotional support, advocacy, and cultural bridging. I was about to deliver Emilio. I didn’t take the translator service because I was worried about the cost and I didn’t want another stranger in the room. As my contractions worsened, I struggled to understand what they were saying. I wished there was someone who could support me in Spanish, but it was too late.
___ ▾ ▾ ▾ ▾ ▾
Lack of empathy & belonging Unaware of eligible services & cost Lack of guidance to anticipate possible problems Service oered at the wrong moment or late Communication gap & language barriers
Sofia Patient
02 What We Found
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ACCESS TO CARE
DELIVERY OF CARE
EXTENDED CARE
INSIGHTS
TRUST IS FOUNDATIONAL
“
We think about people trusting us and we’re trusted messengers, but we don’t think about how they view trust. This is chronic behavior in health systems, community-based organizations. Everybody’s busy, but we forget to prioritize the people that maer. Lisa
Reaching patients most impacted by SDOH factors requires health systems to build trust in communities that have been historically marginalized / ignored and oer resources in a respectful, dignified way. ___ ▾ ▾ ▾ ▾ ▾
Distrust in the system Unaware of eligible services Misleading guidance Lack of belonging Feels unheard & self-conscious
Health Care Provider
02 What We Found
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ACCESS TO CARE
DELIVERY OF CARE
EXTENDED CARE
COORDINATION IS PARAMOUNT
“
Communication, between a patient’s care team of doctors, surgeons, nurses, and caregivers is fragmented and siloed, often leaving the patient or caregiver chasing for answers. While I was suering in pain, my doctor and specialist kept sending me back to each other. I felt like I was running in circles with no answers and real help! When I found a new doctor, I had to get more tests and scans because my old doctors never faxed them to the new one.
___ ▾ ▾ ▾
Siloed communication between doctors Lack of visibility into recovery timeline Limited ownership and control of medical report sharing
Rachel Patient
02 What We Found
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ACCESS TO CARE
DELIVERY OF CARE
EXTENDED CARE
INSIGHTS
CARE GOES BEYOND THE HOSPITAL
“
Patients with chronic care situations require extended care outside of the hospital premises, however, symptom management and emergency care are barely catered to outside hospitals. It takes a village to care for an unwell loved one and our family and friends support us by helping. But in certain situations, it breaks my heart to see my wife in pain. Us not knowing how to provide care or what to do to help doesn’t help. Jason
___ ▾ ▾ ▾ ▾
Ambiguous information on care Lack of emergency support & assistance Poor coordination between caregivers and care team Lack of visibility into treatment duration
Caregiver
02 What We Found
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THE INSIGHTS
A quick summary 01
02
03
Ambiguity breeds avoidance
Familiarity breeds comfort
Trust is foundational
02 What We Found
04
05
Coordination is paramount
Care goes beyond the hospital
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What resonated with you? What surprised you?
02 What We Found
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03
Opportunities
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DESIGN PRINCIPLES
Our north stars Holistic Care
Empathetic Communication
Cultivate Belonging
Cohesive Experience
Care for patients by providing not only functional but also emotional support, in a warm and familiar way that makes them feel at home
Request and deliver information in an empathetic, mindful and dignified manner, making patients feel heard while creating a judgment-free safe space that enables comfort and honesty
Provide inclusive and accessible experiences that cultivate a sense of belonging while keeping in mind patients cultural, social, economic and emotional aspects
Reduce friction by avoiding unnecessary, repetitive actions and proactively share information internally so that every touchpoint with Northwell feels like a seamless continuation of the last one
03 Opportunities
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OPPORTUNITIES
Opportunity areas and solutions How might we decrease entry barriers and increase accessibility in the healthcare system?
How might we oer care for patients with social determinants of health (SDOH) that prevent them from staying on top of their health?
How might we improve the healthcare quality and access amongst patients with Limited English Proficiency (LEP)
How might Northwell oer support to patients and caregivers to improve treatment & health care outcomes?
Specialist Connector
SDOH Screener
Cultural Advocate
Care Nest
Holistic Care
Cohesive Experience
Holistic Care
Cohesive Experience
Health Advisor
03 Opportunities
Empathetic Communication
Cohesive Experience
Cohesive Experience
Cultivate Belonging
Holistic Care
Cultivate Empathetic Communication Belonging
Holistic Care
Cultivate Belonging
Discover Nearby
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Let’s bring these solutions to life and see what a holistic journey could look like
03 Opportunities
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ACCESS TO CARE
01 Enable access with Specialist Connector
DELIVERY OF CARE
EXTENDED CARE
Pain Points Pain Points
Lack of precise and clear Lackinformation of precise and clear information ●Ambiguous Ambiguous estimates and costs estimates and costs ●Perception Perception of complexity of complexity ●HardHard to figure out which speciality to figure out which speciality of doctor is needed of doctor is needed ●
● ● ● ●
Opportunity Area Opportunity Area
Like when a kid comes to his mom and Like when a kid comes to his mom and asks asks for help to identify his pain, this for help to identify his pain, this tool takes tool takes patients through a series of patients through a series of steps, helping steps, helping them find the right them find the right specialist according to specialist according to their needs their needs and pains and pains
03 Opportunities
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01 ENABLE ACCESS
03 Opportunities
Specialist Connector
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01 ENABLE ACCESS
03 Opportunities
Specialist Connector
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01 ENABLE ACCESS
03 Opportunities
Specialist Connector
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ACCESS TO CARE
02 Care for SDOH with SDOH Screener
DELIVERY OF CARE
EXTENDED CARE
Pain Points
● ● ● ● ●
Distrust in the system Unaware of eligible services Misleading guidance Lack of belonging Feels unheard & self-conscious
Opportunity Area
Asking patients respectfully about external factors can help them reflect and help Northwell identify those suering from health disparities that can be geing in the way of accessing healthcare or recovering properly.
03 Opportunities
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02 CARE FOR SDOH
03 Opportunities
Screener
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02 CARE FOR SDOH
03 Opportunities
Screener
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02 CARE FOR SDOH
03 Opportunities
Screener
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ACCESS TO CARE
03 Care for SDOH with Discover Nearby
DELIVERY OF CARE
EXTENDED CARE
Pain Points
● ● ● ● ●
Unaware of eligible services Embarrassed to ask for help Feels unheard & self-conscious Lack of sense of belonging Feeling vulnerable
Opportunity Area
Northwell goes beyond expectations. Like a mother when her kids leave the house, Northwell cares for its patients, especially in the most diicult situations, and helps them figure out how to navigate a system and surroundings, until they are ready to do it by themselves. 03 Opportunities
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03 CARE FOR SDOH
03 Opportunities
Discover Nearby
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03 CARE FOR SDOH
03 Opportunities
Discover Nearby
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ACCESS TO CARE
04 Assist & guide with Health advisor
DELIVERY OF CARE
EXTENDED CARE
Pain Points
● ● ● ● ●
Unaware of eligible services Perception of complexity Lack of sense of belonging Lack of clear information Siloed communication between doctors
Opportunity Area
Most patients do research before visiting a doctor. However, some patients require additional support. The health advisor coaches patients according to their needs across the entire journey. “Like an advisor for college students”
03 Opportunities
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04 ASSIST & GUIDE
03 Opportunities
Health Advisor
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04 ASSIST & GUIDE
03 Opportunities
Health Advisor
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ACCESS TO CARE
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Pain Points
Assist & guide with Cultural Advocate
● ● ● ● ●
DELIVERY OF CARE
EXTENDED CARE
Lack of empathy & belonging Unaware of eligible services & cost Lack of guidance to anticipate possible problems Service oered at the wrong moment Communication gap & language barriers
Opportunity Area
Some patients need language assistance, while some also need to feel more understood. Having someone from their culture can make them feel at home, especially those patients who are going through long recovery processes
03 Opportunities
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04 ASSIST & GUIDE
03 Opportunities
Cultural Advocate
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04 ASSIST & GUIDE
03 Opportunities
Cultural Advocate
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04 ASSIST & GUIDE
03 Opportunities
Cultural Advocate
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ACCESS TO CARE
06 Support caregivers with Care Nest
DELIVERY OF CARE
EXTENDED CARE
Pain Points
● ● ● ●
Lack of information to take control for recovery Poor coordination between caregivers and care team Siloed communication between doctors Lack of emergency assistance
Opportunity Area
Recovery can be stressful. Taking things o of a patient’s plate to lighten the load would be highly appreciated by them. This journey tracker for patients aims to alleviate stress during a recovery process.
03 Opportunities
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06 SUPPORT CAREGIVERS
03 Opportunities
Care Nest
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06 SUPPORT CAREGIVERS
03 Opportunities
Care Nest
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06 SUPPORT CAREGIVERS
03 Opportunities
Care Nest
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06 SUPPORT CAREGIVERS
03 Opportunities
Care Nest
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06 SUPPORT CAREGIVERS
03 Opportunities
Care Nest
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06 SUPPORT CAREGIVERS
03 Opportunities
Care Nest
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PROPOSED SOLUTIONS
Solutions along the patient journey ACCESS TO CARE Symptoms survey
01
DELIVERY OF CARE
EXTENDED CARE
Specialist suggestion
Specialist Connector
Questions to identify SDOH risk
02
SDOH Screener
Resources near the patient’s location
Personalized recommendations
03 Expert helping patients navigate
Discover Nearby Personalized reminders and recommendations
04
Health Advisor Support for people from different cultures
05 Daily care routine checklist
06 04 The Path Forward
Cultural Advocate Journey tracker
Urgency video calls
Knowledge Hub & FAQ
Care Nest 51
04
The path forward
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ROADMAP
Implementing the solutions SHORT TERM 01
Specialist Connector ▾
MID TERM 03
Data integration and standardization
Discover Nearby ▾ ▾
02 SDOH Screener ▾ ▾
Develop questionnaire Build in patient touchpoints
06
04
Identify and onboard community partners Integrate resources into app
Care Nest ▾
LONG TERM
Onboard patients and caregivers
Health Advisor ▾ ▾
05
Cultural Advocate ▾ ▾ ▾
04 The Path Forward
Identify and appoint advisors Design and pilot program
Design program with Language services program team Identify priority patients Launch pilot with priority group
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THE PATH FORWARD
Business outcomes & impact Increased accessibility for LEP patients
Increased touchpoints for data collection
Cost savings by reducing no-shows
Improved caregiving coordination
Faster turn around for average care time
1.93m LEP NYC residents1 (23% of total NYC population) will prioritize Northwell services for cultural dierence support
Northwell will have access to 17 more data points per user which can be used for future service development as user needs evolve
Potential annual savings of $30m1 by oering support and resources, thus reducing no-shows by 5% of all appointments (assuming 2m patients per year2)
By incorporating extended care services, Northwell will improve caregiver coordination for at least 8% of family caregivers1
Reduce average time for specialized care from 24 to under 7 days by connecting patients and specialists eectively and directly
Source 1; Source 2
Source 1
Source 1
Source 1
Northwell championing holistic wellcare and making a unique business case in healthcare history
04 The Path Forward
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OPPORTUNITY AREAS
Key strategic shifts FROM Complex and ambiguous Missing context Lost in translation Not caring for caregivers Healthcare today
04 The Path Forward
TO Transparent and reassuring Identifying & addressing inequities Cultural bridging and advocacy Supporting both patients & caregivers Healthcare tomorrow
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Are you ready to build “healthcare tomorrow” with us?
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I like… Which opportunities stood out most to you?
I wish… What would you change or do dierently?
I wonder… What do you want to explore further?