designing for and creating better healthcare systems and services
DESCRIPTION
This presentation based upon the book "No Straight Lines: making sense of our non-linear world" was made at the CareWare conference in healthcare innovation in Aarhus Denmark – The presentation argues that when we design around the needs of humanity, we can create better healthcare systems, which are also more resilient, sustainable, adaptable and in fact less expensive to run. That better much better does not need to cost the earth. We need to be able to hold in play at the same time considerations about how to design for the needs of humanity, to deal with systems thinking and complexity, organisational capability, technology and even data. www.no-straight-lines.comTRANSCRIPT
SEEING, CONNECTING TO, AND, DESIGNING FOR OUR BEST POSSIBLE FUTURE IN HEALTHCARE aarhus denmark 2012
This presentation is based upon the book No Straight Lines: making sense of our non-linear world.
Available as:
Open Access Participatory version via this link: http://read.publification.com/b/no-straight-lines
Paperback and Kindle versions: http://ht.ly/7OAod
The challenge: Be realistic imagine the
impossible paris 1968
alan moore | www.smlxtralarge.com | no straight lines introduction 2012
Why? do we
experience such difficulty even imaging a different sort of society?
Why is it beyond us to conceive a different set of arrangements to our common
advantage?
tony judt
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |
Why? are we
not able in the 21st Century to design
more adaptive and sustainable intelligent systems
for health?
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |
HOW? | www.no-straight-lines.com | making sense of our non-linear world | 2012 |
n o t ‘ w h at i f ’ b u t …
How do we create a service to better manage people’s chronic health care. Reducing; wrong diagnosis, over prescription of drugs, clogging up hospitals and specialist time?
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |
It is because of specialization: the power of modern medicine is also the powerlessness of professionals
Only the patient has enough information to co-ordinate care across specialists
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |
Markle Foundation’s ideal PHR:
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |
1. Access controlled by patient
Markle Foundation’s ideal PHR:
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |
1. Access controlled by patient
2. Lifelong records
Markle Foundation’s ideal PHR:
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |
1. Access controlled by patient
2. Lifelong records
3. Information from all
Markle Foundation’s ideal PHR:
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |
1. Access controlled by patient
2. Lifelong records
3. Information from all
4. Universal access
Markle Foundation’s ideal PHR:
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |
1. Access controlled by patient
2. Lifelong records
3. Information from all
4. Universal access
5. Private and secure
Markle Foundation’s ideal PHR:
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |
1. Access controlled by patient
2. Lifelong records
3. Information from all
4. Universal access
5. Private and secure
6. Transparent
Markle Foundation’s ideal PHR:
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |
1. Access controlled by patient
2. Lifelong records
3. Information from all
4. Universal access
5. Private and secure
6. Transparent
7. Easy exchange
Markle Foundation’s ideal PHR:
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |
Who wants to build a barn in a day?
The economics, efficiency and effectiveness of sharing
3 t y p e s o f s h a r i n g
Sharing data increases safety
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |
Sharing data increases safety
Clinicians need patients to know what is happening
Patients tell other clinicians what they have learned
Patients cannot self-manage if they do not have the information
Only small number of tests, only at diagnosis, require seeing clinician before seeing result
Knowledge of the safe ways to give patients their data
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |
Sharing data saves clinical time
Focus appointment time on explanations and treatment
Clinicians rarely have time to go through all the test results
Patients often schedule follow-up to ask questions they only think of outside the room
Relatives call to ask what the patients had been told
Patient will save other clinicians’ time with their knowledge
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |
Sharing data is a process
Commit to to everything long-term, but start with test results
Test results are structured data with crucial benefits to patient with long-term conditions
Add on prescriptions, letters, and patient-submitted data
Medical notes require retraining of clinicians, but they already know this is happening
Increase sharing as generate benefits and confidence
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |
Design
Conduct online consultations
which are seen by all clinicians
in team
Detailed explanations for patient save clinician’s time
Personal health plans Teach patient to teach team
1. Designed as a platform
2. Designed for sharing: sharing data increases safety, sharing data saves clinical time, sharing data is a process
3. Truly empowering patients
4. Designing for individual and participatory learning
5. Sustainable, highly effective to an order of magnitude of 2
6. Better much better does not necessarily cost the earth
Why is PATIENTS KNOW BEST relevant to you?
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |
The ‘WHAT’S NEXT’ for HEALTHCARE SERVICES
How do we discover our best possible future for the territory of Ontario’s health care system – when we are faced with challenges that are highly complex and deeply ambiguous? How do we discover and harness the deep knowledge that resides in the many people that both run and use that healthcare system?
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |
Our best possible future resides in the minds and hearts of the many not the few
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |
Participatory Leadership
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |
Root question: What is happening in the world/this organization that requires us to get together to do this work?
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |
A chaordic process: building shared awareness, co-creating a shared vision, harvesting outcomes / perspectives co-building an action plan, Execution
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |
“Cooperation is the foundation of human
development, in that we learn how to be together before we
learn how to stand apart”
erik erikson
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |
Faster Alone, Further Together
designing for cooperation
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |
1. Use of participatory leadership 2. Harnessing of collective intelligence 3. Human technologies that unlock individual knowledge into deep collective insight
that translates into collective action 4. Process of connecting to an emergent best possible future by connecting into deep
human wisdom 5. People embrace what they create 6. Innovation + social cohesiveness 7. A lot less expensive than McKinsey
Why is the process of the Nova Scotia story relevant to you?
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |
The ‘WHAT’S NEXT’ for HOSPITALS
How do we design and build a hospital which enables patients to recover from operations at much greater speeds, with a reduced need for drugs?
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |
1. Designing around the needs of humanity not the needs of utility: place, space and people
2. Design thinking / systems thinking / complexity
3. Strength of Craftsmanship
Why is DOWNE HOSPITAL relevant to you?
| www.no-straight-lines.com | making sense of our non-linear world | 2011 |
Summary
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |
the limits of our language is the limit to our world “ “
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |
I + We = why? a design challenge.
How we make context and meaning, about the webs of relationships and how we derive value from those relationships and connections are central to human beings.
And all human beings participate in co-creating the complex social networks that we live in and engage with.
The social environment is a dynamic field that interacts with human consciousness changes in that environment affect us psychologically.
o t t o s c h a r m e r
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |
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Human nature is not a machine Successfully designing a medical system requires not just technical and medical
knowledge it requires us to have a deep understanding of human nature.
“Me We” designing for human systems
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |
System Upgrade
alan moore | www.smlxtralarge.com | no straight lines introduction 2012
the Human-OS alan moore | www.smlxtralarge.com | no straight lines introduction 2012
WHAT DOES THIS
HUMAN OPERATING SYSTEM WANT?
ITS WANTS WHAT WE WANT…
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |
OPPORTUNITY FREEDOM
EMPOWERMENT MUTUALISM DIVERSITY
EFFICIENCY INDEPENDENCE
BEAUTY
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |
Knowledge flows Networks
Organisations as platforms Adaptive systems
Multiple outcomes
designing for:
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |
strengthen the sources of health
our epic goal:
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |
@alansmlxl
www.no-straight-lines.com