The words “putting patients first”—or some variation—can be seen on the walls or in the promotional literature of nearly every health care company in the country. I don’t question the intent, but if we are going to help solve health care’s most entrenched challenges, this idea should be at the heart of our business.
Human-centered design is a mindset and discipline that puts the person, rather than the person’s health condition, at the center. But this idea should mature beyond the typical marketing departments or pet projects. Human-centered design can bring with it a much needed humanity, curiosity, and commitment to solving systemic problems.
Here’s an example of human-centered design in health care: Doug Dietz designed MRI machines for GE Healthcare. He was happy with his designs until he learned that many kids needed to be sedated before going into one. Doug went back to the drawing board and put the end user—a child—at the center of the design. He transformed these machines into pirate ships and submarines, and he taught the technicians to take their young patients “on an adventure.” He turned something scary into something bearable—and even fun—for kids dealing with cancer and other illnesses.1
Putting the human at the center may seem obvious. But often it’s not. In health care we tend to start with the problem, or the illness, and try to address that, rather than taking a step back to look at the broader problem from the patient’s perspective.
MA is becoming more human centered
Medicare Advantage (MA) is an example of how the health care industry is looking to human-centered design to achieve more affordable, higher quality care. From the start, MA plans have tapped into a risk-based reimbursement model that emphasizes total value. Having engineered out many of the “quick fixes,” MA is beginning to try to address complex human behaviors. One major result has been an increased focus on the role of the caregiver, and a recognition of the role social determinants can have on a person’s overall health.
In a final rule released April 2, the US Centers for Medicare and Medicaid Services (CMS) expanded the definition of “primarily health-related” benefits for MA plans. This means products and services that aren’t directly related to medical treatment can be covered. Beginning next year, MA plans will be allowed to subsidize a beneficiary’s groceries, or pay for a ride-sharing service to help ensure members make it to scheduled appointments.
These changes to MA could serve as a roadmap for other health care stakeholders. The challenge is to avoid viewing this as just a quick-fix benefit, or as another box to be checked. Consider a person who needs to get to a medical appointment. Human-centered design can help us avoid framing this as a transportation problem. Instead, this model addresses deeper needs, such as a sense of dignity, independence, and not having to rely on others. The resulting solution will likely include transportation, but could also smartly integrate this into a broader care plan built around the patient’s personalized motivations and care team.
Health care’s humanity moment may have arrived
It is one thing to put the human at the center of your business decisions. It is quite another to actually drive change from those insights. There is often little agility in health care, and there are many reasons health care stakeholders face barriers when trying to implement bold ideas. These barriers commonly include fee-for-service reimbursement, the sacred promise of “do-no-harm,” and a difficult-to-measure near-term ROI.
The ground is shifting on several dimensions. Many industry veterans are beginning to take a serious look at potential disruptors—using their actions as further proof to challenge internal assumptions about what is possible. Early this year, Amazon.com, Inc., Berkshire Hathaway, Inc. and JPMorgan Chase & Company announced the formation of a new organization to try to reduce health care costs and improve satisfaction among their collective employees.
For these and other customer-centric companies, human-centered design is not a slogan. It is part of their DNA. Several factors could help health care stakeholders become more human-centered:
- Transparency and shared information: It can be difficult to be patient-centric if there is limited insight into a patient’s needs and medical history. Government (e.g., BlueButton 2.0) and private sector (e.g., FHIR standards) are helping to break down some of these silos and giving stakeholders more power to share information.
- Alignment of incentives: Value-based care is commonly moving from being an industry pilot to becoming core to all future transformations. The Amazon partnership is just one example of where companies are looking to address total costs and patient needs.
- Flexible, rentable, and modern technology: For every great idea, there are often two or three reasons why it is costly or would take too long to implement because of legacy IT systems. But many new cloud-based platforms have created cost-effective toolkits for delivering responsive and personalized experiences.
Unlocking the power of these and other new capabilities can help stakeholders build trust and empathy. If we don’t transition to a human-centered model, we could eventually bankrupt the health care system. And if the industry doesn’t make these changes on its own, change could eventually be mandated by regulation.
We don’t need to build submarines and pirate ships around our technology to move toward a human-centered design. We might not need technology at all. What we likely need is a change in philosophy where our decisions revolve around what is most important to the patient. The transition to human-centered care can be a multi-year journey. But I believe that when you treat someone as a human instead of a patient, you can lower the cost of health care and bring a new humanity to the industry.
PS, if you are the AdvaMed Digital Conference this week, my colleague Jim Guszcza will be discussing why medical technology should use human-centered design this morning from 9:30-10:30 am PT. Hope to see you there!