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A Better Way to Health Care Reform: Is There a Designer in the House?

health care town hallAs I watch the debate over health care reform, I've begun to see clearly how designers can create a solution that wouldn't be such a bitter pill for so many and would help quiet the level of disagreement currently being experienced by so many.

Here's how my plan would work.

A top-tier design "dream-team," comprised of members from our industry's leading firms would be brought in by the administration to fully leverage their ability to understand the range of complex issues and transform them into meaningful, relevant "experiences." Market segments would be profiled and personas constructed of not only patients, but health care providers, insurers, and other industry participants. While these personas would initially review demographic market compositions, they would go deeper, identifying pleasure and pain points of various health care experiences. Day-in-the-life and week-in-the-life scenarios would help us uncover previously overlooked elements of the problem.

designer-think-healthcareThe current emotional uproar has revealed that the debate over health care is about much more than mere economics alone. To be certain, much of the positioning relates to financial exposure. But when you listen to the town hall meetings, you hear the debate is supercharged with emotion. Understanding those emotional needs of the various stakeholder constituencies is what will make it possible for designers to design positive experiences from process, financial, and emotional perspectives.

By employing a full designer's toolkit of methodologies, designers would understand and analyze our health care system and arrive at insightful solutions that go beyond logistics and economics.

Channels of delivery and engagement of health care services would also be examined. This should include the traditional doctor's offices, urgent care facilities, emergency rooms, and hospitals, and then push further to include emerging centers of wellness, including homes, workplaces, gyms, grocery stores, and restaurants. For, truly, these are the frontlines of health care where the decisions we make everyday can have a meaningful impact on our individual and collective well-being. In this way, we would help establish the U.S. as a thought leader and contributor to global wellness.

man-relaxingThen, a comparative competitive analysis would dive deep into both the economic and experiential efficacy of health care systems around the world. What cautionary tales can help steer us clear from making things worse? What positive lessons can be learned?

Clearly, we're already too far into the process to start from to the beginning—at least for this round of reform. But there is still time to instill a sense of order that can be agreed upon by all groups. We'd start by identifying the groups themselves and key triggers for all based upon emotional persona type: The Doubters, The Caregivers, The Fearful Fighters, The Blindly Optimistics, The Realists, and so forth. From there, emotionally relevant stories and experiences would be crafted to communicate and connect with the each group. Design, in the form of communication design or storytelling, will target the transformation of a bad situation into a range of positive experiences for all.

It's true, bringing in design to try to fix things now is a little like trying to treat a patient who hasn't visited the doctor until after he has pneumonia. However, design, like the best health care systems, can offer effective solutions both at the early preventative stage, as well as in the intensive care ward. With a top-tier, bipartisan design team supporting the White House, all interests of each stakeholder group can be addressed, problems solved, and great advancements realized.

[Photo of Town Hall Meeting by Bart Everson; Man Relaxing by Ed Yourdon]

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Read more of Ravi Sawhney's Design Reach blog
Browse blogs by other Expert Designers

Ravi Sawhney is the founder and CEO of RKS, a global leader in strategy, innovation, and design.

Since founding RKS nearly 30 years ago, Sawhney has earned a variety of top honors in the design industry, and assembled a client list that includes HP, Intel, LG, Medtronic, Seiko, Sprint, and Zyliss, among many others. In the process, RKS has helped generate more than 150 patents on behalf of their clients.

In 2004 Sawhney was named chairperson of the Industrial Design Excellence Award program, where he created the IDSA/BusinessWeek Catalyst award for products that generate measurable business results. Most recently, he was named Executive Director of Catalyst to direct its evolution into a program to develop case studies illustrating design's power to effect positive change.

Sawhney also invented the popular Psycho-Aesthetics® design strategy, which Harvard adopted as a Business School Case Study. He is a regularly featured lecturer at Harvard Business School, USC's Marshall School of Business, and UCLA's Anderson School of Business, where he teaches this business-driven design tool.

In addition to RKS, Sawhney has played an integral part in the founding of several other businesses, including Intrigo, an innovative computer accessory company; On2 Better Health, a health products company; and RKS Guitars, best known for its reinvention of the electric guitar.

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  • Ravi Sawhney

    Thank you for your responses and positive feedback.

    Doesn't it seem hard to imagine that Design is not part of the mix in topics as important as this? And, while, yes, this is Design Thinking… and the principles of design thinking can be used by non-designers, I do believe Designers bring a unique perspective and ability that could make a very real, very positive difference in health care reform and in our world.


  • Paul Schaffer

    I agree we have portions of our health care system that are broken. I believe the worst possible solution would be to summarily diagnose the cause as "not enough government control" I would say that we have a great health care system in the U.S. that is currently suffering under massive government intervention and a transition to over-insurance since the age of managed care was foisted upon the public as a money saving solution. Medicare & Medicaid have served to force price fixing on the medical system resulting in greater price inflation on the "unfixed" privately insured or self insured end of the market. As many states moved to manged care and layer upon layer of coverage mandates, competition dwindled and prices soared. Look to services that are traditionally uncovered by health insurance such as laser eye surgery or cosmetic surgery. Those fields have demonstrated a reductions in cost, improvements in efficacy, better technology and more availability, all motivated by profit seeking corporations and practitioners. Unencumbered by insurance companies or government health care. Managed care (HMO's, etc) and Government Medical coverage have turned our health care system into a sloppily run free clinic with everyone expecting first dollar coverage for every service and abdicating responsibility for actually knowing what any given service cost. We need to move to higher deductibles, higher coinsurance and 100% coverage for catostrophic illnesses or injury. Put the consumer back in charge of actually deciding how, why and when those first dollars are spent and a major portion of the health coverage issues would disappear in short order. If the managed care, low copay design makes so much sense why don't we include things like oil changes and tire rotations in our auto insurance or how about coverage for house painting in our homeowners policies? If we did we could all stand back in amazement over how the price of an oil change just magically grew to $400. Good thing the insurance company will cover it.

  • Nicolae Halmaghi

    Congratulations on your article. Well written and well argued. I would like to make two points: Firstly, on your presentation:
    You are applying Design Thinking as strategy to solve this problem: Your article exposes the eco-system in which the healthcare system resides, brakes it down in small federations of disciplines and stakeholders, zooms out to higher level in order to grasp the inter-connective relationships to the big picture and zooms in to focus on tiny details. Brilliantly done…
    Unfortunately, since you did not mention Design Thinking in your title, and your name is not connected with the usual suspects of DT, most people will not get it and tweet about it. Too bad… People have to learn that Design Thinking is not about generic slogans and that “everyone can do it”. Design Thinking is stealthy, only the results are visible. Your presentation is a beautiful template for the thinking behind Design Thinking.

    Secondly, on Design: I agree with you. The assets of design are underutilized, misunderstood, and many times not welcomed. The Health Care topic could be a great opportunity for D-schools and B-schools (w. DT departments) to engage in.
    Case and Point: The Townhall Meetings: A politician stands on a podium and pontificates for an hour or so, then he takes answers from people who are lined up like geese waiting to cross the street. People wonder about outbursts and a circus-like atmosphere… Logic and emotions have never been best of friends.
    How can design help?
    A couple of weeks ago I visited Fred Collopy, the chair of the IT department at Case Western University. He graciously took the time to show me the building, (designed by Frank Gehry). One of the lecture spaces blew me away: an oval room with segmented seating around it. No front, no back no place to hide, no place to pontificate from… a space pre-loaded with equal rights.
    Imagine if any of the healthcare debates would have been designed similarly; a basic space, with a simple oval (round) arrangement, based on the premise of evoking equality. I’m sure it would have changed the entire mood of the event... If you want to talk to the congressman, step inside the oval and talk to him; feel his personal energy, his compassion, or lack off, talk and communicate. Lets see how much b…s you have to scream at him in the middle of the room, without anybody next to you. Frank Gehry to the rescue!!!

  • Nathaniel Salzman

    I definitely think that this debate would benefit from some design thinking, some fresh perspective, and especially some influence outside the normal incestuous circles of lobbyists, politicians and pundits. As I examine the problem, the most apparent solution in my mind is to eliminate the profit motive. If we simply created massive tax incentives for private insurance companies and hospital systems to become non-profit businesses, their focus can quickly shift back to patient outcomes since they're not having to please stockholders or speculators. That renewed focus, as well as streamlined company structure would most likely contribute heavily to reduced overhead costs and better care-for-premium efficiency. What we'd have to let go of is the myth that non-profit businesses don't make any money. They do. They simply use it differently. A thriving example of this model exists here in Minnesota with Health Partners, a non-profit, member-owned health insurer and provider. This solution remains a free market, free choice system and if properly executed, could virtually eliminate the need for a public insurance option — instead creating a voucher program or similar way for folks who can't afford premiums to still have coverage provided by private companies. Such a shift could turn our system from one where success is measured by best stock return per premium dollar paid, to one measured by best outcomes per premium dollar paid. That's this designer's idea.