Human Centered Care – The Delivery Model of Now

1. Why are healthcare delivery systems so significant?

If you look at the definition of system, it is “a set of things working together…as parts of an interconnecting network”. The basic premise of a healthcare delivery systems is just that, “working together and interconnection”. When healthcare delivery systems fail in doing such, healthcare harms and hurts the very individuals that have entrusted them. That is the significance of healthcare delivery systems. They must be interconnected not by computers, but by synergy of the very people who are the interconnectors within the system. Human centered healthcare is designed to maximize synergy.

2. What were the most significant impacts of the COVID-19 pandemic on the business during this period of transformation?

What didn’t the pandemic impact? The Supply chain, delivery and standards of care, revenue streams, workforce, every operational system, and everybody associated has been impacted, and still are being impacted. The impact has caused a tsunami of changes, some not for the betterment of healthcare. That cause and effect has led to what I believe is the most significant of impacts, trauma. Trauma is a lasting emotional response that results from living through a distressing event. Human beings, who are the business of healthcare have lost trust, and belief in the system of care because of all they have witnessed or experienced. Leaders must focus not only on business recovery, but also recovery of trust.

3. What are the two main objectives of a healthcare delivery system?

Reading any health systems document, you will see strategic statements committed to quality, patient safety, excellence, care, compassion, and stewardship of resources. When you distill the words written it comes down to two main objectives:

Perform to grow and maintain revenue streams. Do no harm.

Do no harm, is the hardest objective for healthcare delivery systems to meet and exceed. Healthcare is one of the most highrisk complex industries with a million or more points of failure that contribute to error. Do no harm must be the top objective of delivery systems with the engagement of all involved to strive to protect those who seek care and treatment from medical errors. Leaders must strive for human centered care.

4. From your perspective, what does excellence in healthcare mean to patients?

Excellence is defined as the quality of being outstanding or extremely good. What quantifier(s) do you use then to measure the quality of being outstanding? Measurements of outcomes such as reduction of infections, adverse outcomes from procedures or treatments, management of chronic disease states, individual & family experiences and other metrics is typically used to define excellence. I would argue that metrics are just statistics. Healthcare has built its reputation on metrics and grades. While those are part of the equation of excellence, it is not the total definition. The total definition must include organizations/leaders who remain committed, curious, and willing to continually elevate performance, engagement, and connectivity of human centered design and care. It is the experience of care that matters the most to patients.

5. What, according to you, are the major challenges in healthcare delivery, and how can we avoid them?

Chaos theory describes the qualities of the point at which stability moves to instability, or order moves to disorder. Every system in healthcare has been disrupted by events of the past few years. The challenge is moving healthcare out of instability to capability of adaptation to meet the emerging demands of a new era for healthcare. I would flip the question of how can we avoid the challenges, to how can we best use the challenges to create what healthcare should be in this new era? The creative energy that was needed during the pandemic to meet needs with constraints is what must be channeled now towards a human centered designed health system.

6. Could you provide us with the five major sectors of the healthcare delivery system?

Healthcare delivery systems are typically defined as acute, senior living/ long term, community/home, technological and products/ retail sectors. I would argue that instead of thinking of healthcare in sectors, think of it as a series of circles interconnected, such as a spiral. There is no sector that can function without some form of connectivity of other sectors. When you analyze sectors using systems theory methodology, the degree of intertwined systems throughout sectors shows the magnitude of interdependence. For example, think of the system of getting healthcare products to the point of care. Typically called supply chain as it is a series of interlocked circles connect to assure delivery. Think about what happened when supply chained fail. That is the point of interconnection.

7. Can you describe how challenges with medicine regulation affect patients’ access levels?

Certainly, within some countries, tightened regulations and payment have caused providers to leave underserved areas, or healthcare all together. Statisticians were projecting a global provider (Doctor/Nurse/Therapist/Pharmacist) shortage prior to the onslaught of the pandemic. When examining access issues, the level of complexity shows in the data. Woven into regulation issues is disparity of race, social economics and other determents that drive access availability. I believe access is one of our top priorities for healthcare.

8. What role can the healthcare industry play in the establishment of a robust medicine regulation system?

Regulations come about for two reasons, an event or events have occurred and the only way to assure it will not happen again is through rules. The second reason is to control costs. Healthcare industry must play a leadership/partnership role with others in the development and revision of regulatory systems. Healthcare must be aware of biases deeply embedded into their systems of care. Example of bias driven care is assigning a diagnosis based upon age, versus remaining curious and exploring causations. My father fell and hit his head, knocking him unconscious. He was sent home with the diagnosis of edematous ligaments. Several days later he was having urinary retention, the urologist put him on a medication to help his urine flow. I argued that this was new onset since his fall. The urologist stated he was an 89-year-old male, urinary retention is normal for his age. He had fractured his neck when he fell. The bias of ageism harmed my father through misdiagnosis and unnecessary medications/treatments.

9. What are your hopes for future collaboration and innovation in the healthcare space?

Healthcare must collaborate to innovate or be left behind as others bring disruption to this space. I have heard no one who states that healthcare is fine in its current state. Healthcare is typically described as costly, fragmented, complex, inaccessible, high risk, and antiquated. Investors are loving disruptive innovative ideas within the healthcare space and are salivating at the possibilities. My hope is that these disruptions use the principles of human centered design, making healthcare affordable, connected, and safe.

10. What would success look like for you in a few years’ time?

Success is defined as the accomplishment of an aim or purpose. My aim or purpose is simple, healthcare needs to be safer and affordable. Healthcare is not designed for the consumer; it is designed for the system itself. Healthcare must morph and transform to emerge to meet the demands of the future.

11. What is your final message to our readers around the world?

Embrace human centered design which will transform your health systems towards human centered care. Do not lean into past performance as your standard, be curious and willing to implode systems and processes to design for the future. Lean into your customers, team members, and fresh outside perspectives to help you envision what can be, what should be and what will be. Healthcare is at a bifurcation, one road is filled with sinkholes of the past, the other road promotes change and transformation. Do not let yourself fall into a sinkhole.