Point of View

What Difference Does Design Thinking Make in Healthcare Services?

October 9, 2017

Interview with Dr. Pracha Eamranond, SVP, Medical Affairs and Population Health, Lawrence General Hospital

 

As the healthcare industry moves toward value-based care from the traditional fee for service, the “value” of healthcare takes on a new meaning. “Value” shifts from being about a person or insurance company paying for services regardless of outcome to a healthcare provider being paid based on outcomes. It puts greater emphasis on the quality and timeliness of services and the impact they generate for the human involved – as a patient, caregiver, physician, pharmacist, or community member.  This move needs to be about bringing humanity to healthcare, which in turn will change the health, medical, and financial outcomes for the better. In business operations, a framework or method is useful for making a change and design thinking can be that approach. Traditionally, service providers that help companies operate more efficiently use reengineering, Lean Six Sigma, and custom methodologies that focus on process and technology. Design thinking plays a complementary role.

 

Design thinking is a way of putting a person at the core of the way everyone involved thinks and works

 

Design thinking starts with understanding what individuals are feeling, thinking, and doing at a point in time and updating or redesigning business operations behaviors, work activities, workflow, interactions, and systems to make it better. It provides a way of enabling all the partners in an ecosystem to take a more conscious effort to focus on shared outcomes and create a human experience that is more effective than what we have in place today. It means that everyone in hospitals, insurance companies, pharmacies, and communities need to be thinking beyond their own job, because at some point all of these people and others too, have an impact on results. In short, using design thinking in business operations in healthcare is about bringing empathy – for patients, co-workers, and others in the healthcare network – to work. And that’s a big ask.

 

Healthcare is a challenging environment for a variety of reasons. So, we need innovative thinking to move us forward with value-based care. Design thinking gives us a framework that puts the customer, the patient experience, where it should be for care – at the center – and the approach gives us a shared pathway: shared within the hospital between departments, with the community, and with partners.”

 

– Dr. Pracha Eamranond, SVP, Medical Affairs and Population Health, Lawrence General Hospital

  

Dr. Eamranond is a physician by trade, earned his Master’s in Public Health, and is now pursuing another Master’s in Management, both at Harvard. He also teaches Harvard medical students, performs research, and, at Lawrence General Hospital (LGH), manages the physician network and population health initiatives and platform. LGH is a level III trauma center that serves one of the largest and poorest Latino populations in the U.S. Since reinvigorating the effort to better understand and proactively engage with its community, LGH has been able to provide more tailored care and move on a path to better use its resources for impact. This hospital is on this path because it is good for people in the hospital and the community.

 

Incorporating empathy and journey maps from design thinking into every day work at Lawrence General Hospital

 

In March 2017, Dr. Eamranond participated with other members of LGH staff from across different departments in a one-day, on-site patient experience design-thinking workshop, described in Inside the Patient Experience Design Thinking Workshop with Lawrence General Hospital and Sutherland.  Sutherland Global Services provides patient access and financial management operations support for the hospital. During the workshop, teams developed journey maps to represent the experience of their community members who become patients in the hospital – what do they go through on their visit, what are their needs, wants, feelings, expectations, and how does it change during their time there. “It helps us visualize what the patient is going through,” Dr. Eamranond shared, “and how to improve care.”

 

In a recent interview, Dr. Eamranond shared what he sees as the value of using design thinking in healthcare business operations – that every community member and patient is on a journey before, during, and after a visit to LGH.

 

Barbra: Dr. Eamranond, as you think about bringing design thinking into LGH, what stands out to you?

 

Dr. Eamranond: Design thinking and journey mapping is helping us conceptualize for all the roles in the hospital what the patient is experiencing and how to intervene and improve care. As an example, in the workshop, we separated into four groups, all with representatives from different units in the hospital, and we came up with similar types of patients. It made us realize that while we work in different areas, we share a common bond – the patient, often a Latino Spanish-speaking community member.

 

When we came back into our next operations meeting at the hospital, we were able to focus on this patient profile and how to best serve them from our different perspectives, jobs, and departments. When we took a look at the first patient access point, for example, we realized that we were not identifying the Spanish-speaking patients as such because sometimes they can’t or won’t talk to us when we ask them if they speak English. Now, we ask them what language they prefer to speak at home – it raises their comfort level for conversing with us, and for following up in care plans and performance surveys. When people are at the most vulnerable moment in their lives, we want them to feel as comfortable as possible under our care.

  

“When people are at the most vulnerable moment in their lives, we want them to feel as comfortable as possible under our care.”

 

– Dr. Pracha Eamranond, SVP, Medical Affairs and Population Health, Lawrence General Hospital

  

Barbra: A lot of that care extends outside the hospital walls – how is design thinking and journey mapping help you bridge to the community?

 

Dr. Eamranond: At LGH we have a patient family advisory council (PFAC) that includes hospital staff, administrators, and local community members; we are working to bring in more Spanish speaking members as well. We meet inside the hospital and also in the neighborhood; we had our last PFAC meeting at the senior community center. It’s helping us develop relationships that continue to give us insight and ideas for what’s working and what to change. One of our PFAC members was hospitalized recently and shared his first-hand experience. It can be hard to get people to share in this way, and it provided us with valuable insights on care, comfort, interactions, and more, all of which impacts his overall health and well-being and our ability to care for and with him. Although he was extremely satisfied with his experience, he gave us instances where we should have done better. Again, his insight from the patient’s perspective showed us that while we also strive to keep a safe environment through hospital security, we also need to ensure this is performed in a sensitive, culturally-appropriate manner. This kind of conversation is also giving us further insight into the challenges that create the health and medical issues that we used to only see when they came through the hospital door, such as drug crises.

   

“Journey mapping helps us frame and segment experience – not just for our patients but also with our colleagues and partners like Sutherland.”

 

– Dr. Pracha Eamranond, SVP, Medical Affairs and Population Health, Lawrence General Hospital

  

Barbra: What is one of the biggest challenges or frustrations you have today and how does design thinking help?

 

Dr. Eamranond: I still feel that we struggle with making change happen fast. But journey mapping helps us frame and segment experience – not just for our patients but also with our colleagues and partners like Sutherland, which provides patient access and financial management support for our hospital. It gives us a framework and helps us break down a problem and arrive at a solution more quickly. We have all improved in terms of how we communicate; design thinking is an important aspect of that. It changes the focus from “dealing with each other” to working together because we know we have the same vision and a shared pathway. This is critical because no matter where we are in the hospital, our work touches the patients and their experiences in some way.

 

Barbra: According to our research, encouraging teams to work across business functions to achieve seamless end-to-end processes is a critical aspect to achieve real-time customer alignment: “mission critical” or “very important” per 60% of healthcare professional survey respondents (n=31). More than half also believe that design thinking can play a role to help meet customer needs and impact outcomes. How are you measuring the impact of design thinking?

 

Dr. Eamranond: With all that we are doing, it is difficult to isolate the impact of design thinking alone, but we are looking at the patient experience scores for responsiveness of hospital staff. We are applying design thinking around this particular measure hospital-wide and will report at the end of the year. We are also isolating the responses from the Spanish-speaking patients as well as the total, so that we can understand the overall impact of the population health work we are doing – patient experience and design thinking are an integral part of it. The bottom line is that we need to provide an experience that patients and community members appreciate and an opportunity for them to keep getting better and healthier; it’s challenging to do this, and the approach we are taking now is speeding up what we want to accomplish.

 

HfS: Dr. Eamranond, thank you for taking the time to share your experience with us. We hope to circle back around with you in a year and find out more about the progress and impact of design thinking population management at LGH.

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