report yue

h e a l c a r d i oSYSTEM ORIENTED DESIGN A holistic solution for the cardiovascular

Yue Zou

SYSTEM ORIENTED DESIGN A holistic solution for the cardiovascular

h e a l c a r d i o

This project submitted to the Oslo School of Architecture and Design for System Oriented Design Studio cooperated with DNV GL

Yue Zou, author Linda Blaasvær, Manuela Aguirre, advisor

ABSTRACT

What is the future healthcare in future? Design itself is a important power to make the healthcare system change a lot. This project is aimed at exploring the future healthcare service in system thinking to make a holistic process and assumption of future system. Cardiovascular patients is a biggest group in the world. I hope working with this group can bring a lot of inspiration for other healthcare issue. In this project, I use strategy design, service design and interaction design method to create a hotlist service for cardiovascular patients out of the hospital. Nowadays a lot of people are suffering from longterm diseases and having high risk of cardiovascular. The food is a good way to address this problem. The meaning of the food and medicine are changing. The longterm medicine cause a mental problem at the beginning. The industry of medicine are struggling with their development, The goal of this project is to discuss the touchpoint food and medicine to address all the problems here, using system design methodology.

KNOWLEDGEMENTS

Thank you to my advisor Linda and Manuela for their support and guidance on this project. Thanks also for Mosse and Natalia for their tutoring of interaction design and service design.

Thanks a lot for my partners, Marius, Stephen and other people from DNV GL healthcare innovation center. We had great workshops during this project.

CONTENTS

• research 1

• leverage points 23

• prototyping 44

First Giga-mapping

research leverage point prototype

research

1

First Co-creation Workshop 2

WHY CARDIOVASCULAR

One in four deaths (12.9 million) was from heart disease or strike in 2010.

Two in three deaths worldwide were from chronic diseases in 2010

Most cardiovascular diseases can be prevented by addressing lifestyle - related risk factors.

It’s obvious that cardiovascular is the biggest groups which means most important..There are two things for me. Firstly, I hope other disease can also get some insight from my project. Secondly,it’s easily to contact the patients easily.

3

RESEARCH PROCESS

4

MY PARTNER

My partner DNV GL is quite a world leading group which is famous for give certification to organizations including hospitals. I’m working with healthcare innovation in DNV GL. Safer, smarter and greener is a process for the society to transformative. Sustainability needs transformative. This three words is a good evaluation for my project. Digitalization, localization are the good strategy for the branding.The main target group is China, USA, European(Norway).The evolution part is valuable as a starting point. Holistic care is necessarily.

5

DNV GL healthcare innovation center has done a lot of projects. They are focusing on human centered care. These general principle of patient centered care from DNV GL can give me a lot of inspiration to imply in my project. The principle has many different levels perspectives from individual level to system level.what is safety culture? It’s a big question. I use giga-mapping to figure out the DNA of safety culture. I found three words to support the DNA-SHARED EFFICIENCY TRUST.

6

CO-CREATION WORKSHOP

This is first workshop in DNV GL. Because healthcare is a big image and my client did not give me any limitation in direction at beginning. I think I should find a start point to work with. This co-creation workshop’s main goal is to find some general problem of the cardiovascular in professional’s perspective.

7

Using timeline is a good way to find different problems in a holistic perspective. I want to discovery which is more important in healthcare system between in hospital or out of hospital. Iceberg model is a good way to find a same solution to relevant problems. The process aims at find ing the basic problem.

8

CO-CREATION WORKSHOP

We had 8 steps in the the workshop, but we just finished 2 steps in the workshop. It is still meaningful. After the workshop, I collected the problems and continued the iceberg model. This process is to find the potential problems and from specific problem to new problem. Stand on the system to form a system solution for the new general problem.I use the iceberg model to find the basic and general problem. This is a good way narrow my user research. Standard information system/Suitable Diet/Money segment/Easy communication pipe/between doctors7Good understanding between patients and doctors/Rescue system/Bad rehabilitation quality/Family support

9

I interviewed with two patients deeply and a short random access interview with Ten People. One was at his home for 3 hours. Another was in a cafe near his working place for an hour. It is difficult for me to contact with patients in Norway due to the protection policy.

USER RESEARCH

10

INTERVIEW A

I design an interview based on problems from the first workshops, talking about overview,Things,Lifestyle&Drug,Relationships(community),family support and rescue.

11

‘I believe my doctors.I don't need my children to support me. My children visit me a lot, but I don't think they can support me for my troubles. They just gave me some regular suggestions.’

‘I put this fitness equipment very close to my bed. It makes me feel safe, when I do some excises.’

‘Healthy diet and nutrients work good for my trouble. 3 year ago, I followed a healthy diet routine. The doctor told me my heart trouble was better after that routine. I gave up, because it was a burden-money and a lot of steps, and doctors gave me some new medicine.’ ‘I use computer a lot. Mobile phone is important for me, because it means communication.’

12

INTERVIEW B

‘I am afraid to take medicine and it make me feel like a patient. Expect hypertension, I'm quite healthy. Sometimes I forgot to take the medicine.’

13

Based on the deep interview, I choose what I am interested in to do a short random interview. Two people is a small group for user research, but it is difficult to go on deep interview many times.

9/10 people believe Norway’s healthcare system. They believe doctors more than family members.Not like China, the healthcare are not very good. The people are more relied on family

7/10 people believe good diet can treat disease and keep healthy, but it is difficult to insist on a special diet.People can not insist on it because the diet is expensive and with more steps to follow. People not address a lot on diet.

9/10 people will forget to take medicine more than 4 times per month, especially longterm medicine. The longterm medicine cause social problem when they have medicine other people always ask their situation.

RANDOM ACCESS INTERVIEW

14

PROBLEM COMPARING MAP

Use this map to discover the problems. Eg; the communications between doctors Patient A agreed: he think it is not necessary, he can be a bridge between doctors.Patient B disagree: he told me they just share information not discuss my condition

15

I interviewed the leader of communication from LHL.LHL is special organization, because they are not only an organization but also owner of a hospital. They call this is a perfect healthcare model. We had a 2 hour talk. Kristin told me some cases about LHL- a social innovation for lung disease all around Norway which is an activity for healing mental problem and the balance between top-down structure and bottom up structure. They have a project to develop an APP for cardiovascular patients.

I only know one doctor is my doctor in Oslo kommune, Legevakten. She is always busy,but she sent me some paper materials about healthcare system in Norway.

INTERVIEW WITH DOCTORS

16

GIGA-MAPPING HEALTHCARE SYSTEM IN NORWAY

General Process

Management System

Economic Process

After the interview, I used the insights and paper materials to giga-mapping the healthcare system in Norway.

17

RESEARCH MAP

After finishing the research map, I put the potential problems in the whole map and see their relationships in different levels， and think some preliminary ideas.

18

DESIGN TREND

Based on structure in School of Design, CMU

Nowadays, design researcher divide the design area into three area. Based on this structure, I work out three different preliminary ideas.

19

Good Understanding between Patients and Doctors

Good understanding between patients and doctors is potential area. Opposite opinions and some same views make this area active. It can evolve in a long journey for patients in existing system.

PATIENT CENTERED CARE

SYSTEM

PATIENTS

GOOD CASES

using risk based approach to redesign service

empower individuals

organize care for needs not diseases

payments on results not activity

integrating care across doctors and patients

long investment for system

invest in climate adaptation

standard

develop safety cases

creating cultures and midgets

manage risk locally

PHYSICAL/PSYCHOLOGICAL/SOCIAL NEED

decision making

incorporating their abilities

preferences

lifestyle

own treatment

patient engagement

sustainable hospital

mobile health

health alliance

digital appointment

measuring true value

knowledge sharing

Patients’ Journey & Existing System

moderate change

Medical Case Paper

Visual Communication& Interaction Design

PRELIMINARY IDEA ONE

20

Culture Driven/Professional Power Service Design/Interaction Design


SYSTEM

PATIENTS

GOOD CASES

using risk based approach to redesign service

empower individuals

organize care for needs not diseases

payments on results not activity

integrating care across doctors and patients

long investment for system

invest in climate adaptation

standard

develop safety cases

creating cultures and midgets

manage risk locally


decision making

incorporating their abilities

preferences

lifestyle

own treatment

patient engagement

sustainable hospital

mobile health

health alliance

digital appointment

measuring true value

knowledge sharing

z

SAFETY CULTURE VALUE SAFETY

BELIEFS

ATTITUDES

PERCEPTIONS

Communications founded on mutual trust

Confidence in the efficacy of preventive measures.

Shared perceptions of the importance of safety

z

Patients’ Journey & Emerging System

significant change

Rehabilitation Based on Community

PRELIMINARY IDEA TWO

21

Change Medicine Industry Deign for Radical Change

There are lot of research about cardiovascular patient to map the new system based on trend study. Create new scenario to interact with people under patient centered care to promote the new system.I hope to use design method to promote the hospital or medicine industry can change their role in the system.

PRELIMINARY IDEA THREE

22

leverage points

23

First Co-creation Workshop 24

People

Resource

Interactions

Mechanisms of Change

Direction/Idea

IDEA ONE IDEA TWO IDEA THREE

preliminary idea

Use PRISM to Improve Ideas

1

2

LEVERAGE POINTS3Improve Ideas

PRISM METHOD from InWithForward

PROCESS

25

SpecialistNurse

Object/Display

in hospital

Patients

Interaction

APPiPhoneiWatch

Website

at home

Object

GP

collectdata

Visualization

Information


Contributing & Reciprocating to increase meaning & purpose Good touched visualization can increasing the meaning for experience and increase purpose frothier health.

Scale

Daily life/Hospital The young/Middle-aged Object/Environment Interaction/Product

IDEA ONE

27

DAILY LIFE Interaction Design Product Design

IN HOSPITAL Interaction Design Product Design

it is a good Kickstarter project. It is a real digital object or some object combined with iwatch or iPhone. In hospital maybe is a screen connected to customer’s app and doctor’s system. This is a holistic design involve in different scenarios.

IDEA ONE

28

Change the structure of information flows

IDEA ONE

29

Frida is a middle age guy. He is crazy about apple products. He has a great job in a band which means he is super busy everyday.

One day he felt bad, and go to see doctor. He was diagnosed with high blood pressure.

a was sad. He though he was too busy to notice his health condition, Although he had some apps for his health.

One day, he found a fabulous flower. He brought it to home.

That’s a magic flower. The feel bad, The flower will also be in super bad condition.That’s great visualization to make him realize his health condition.

HEALTH

TIME

HEALTH

TIME

IDEA ONE

30

Resources

DNV GL Research Resources (Standard of Health)

LHL (consultant)

People

Cardiovascular Patients

General Doctors

Specialist

Nurse

Interactions

CHECKLIST

LIFESTYLEGUIDE CHECKLIST

REHEBITATIONGUIDE

CHECKLIST NOTICE MEDICINE STORY BOOKOPERATIONPROCESS

his pack gift is a holistic interaction between customers and professionals.

Scale

Daily life-Hospital Male-Female Service-Management


Feedback to increase validation & motivation The goal is to use feedback to change and promote the experience during the process.

IDEA TWO

31

For the design part compare form and function like app or paper is important. The movie should be cartoon which not creates new mental problem. Medicine management can applied in the gift pack system.

CHECKLIST

LIFESTYLEGUIDE CHECKLIST

REHEBITATIONGUIDE

CHECKLIST NOTICE MEDICINE STORY BOOKOPERATIONPROCESS

APP Paper

Paper Cartoon

PaperDigital

Explore best form/materials/techniques/ideas for gift pack

Daily Medicine

IDEA TWO

32

The gain around driving positive feedback loops.

IDEA TWO

33

Laura is 50 years ago. She usually go to visit GP. At that time, she got a gift pack.

Yes, a gift pack for her current situation. A checklist to manage her diet and

CHECKLIST

LIFESTYLE

GUIDE

When her condition got worse and worse, she went to see her GP. The GP referred a special examination. At this time, she got a gift pack.

This gift pack has some CHECKLIST

NOTICE

MEDICINE

after the special examination, She need a surgery. Before the surgery, she got a gift pack. This gift pack have a story book to soft her emotion and a movie of the operation process.

STORY BOOK

OPERATION

PROCESS

After the surgery, she also got a gift pack.

In this gift pack, there is a check list and rehebitation guide book

CHECKLIST

REHEBITATIONGUIDE

IDEA TWO

34

Diversity and deep understanding of food and medicine change the role of food and medicine.Food can be a treatment.Medicine is for keeping health, not for treatment.More and more medicine companies evolve in food industry.

Resources

DNV GL Research Resources (Standard of Health/Patient Centered Care)

Designers (consultant)

IDEA THREE


Taster Experiences to shape preferences & goals

Barrier Busting to manage stressors & increase future orientation

This direction is aim at shaping the preferences and goals also increasing future orientation.

Trend

People

Cardiovascular Patients

General Doctors Specialist

Nurse

Hospital

Medicine Industry

DNV GL Research Group

Government

http://www.kenko.com/product/item/itm_6924185772.html

35

Food and medicine in future not just the object. It will will be with a lot of information on itself and its package or people’s APP. Regard this, use the food and medicine as a new touchpoint between the customers and professors.This also change the role of supermarket and Pharmacy in Future.Government should involve in it. DNV GL can be a certification provider in new area

Scale

IDEA THREE

Trend

36

Change the rules of system

IDEA THREE

37

Co-design is a very interesting process based on the background of DNV GL.

We can figure the form, function , techniques and ideas for different stage.

It also will create other relevant design evolve in this process, product and APP and service.

This is a good outcome to cause discussion of the unclear Border between the food and medicine.

IDEA THREE

38

CO-DESIGN WORKSHOP

39

We use the one way to identify the patients. We ignore the identity for health for people.In the workshop we used card sorting to do co-design workshop.

Touchpoint: Medicine and Food

Card sorting for form/function/techniques/idea in holistic process. Based on human centered design.

SEVERAL MONTHS

PREVENTION VISIT GP MAKE A TENTATIVE DIAGNOSIS RECEIVING S EXAMINATIONREFERS TO AN S DEPARTMENT GP/( PUBLIC HOSPITAL)

EXAMINATION

OPERATION

NECESSARY MEDICATION SURGERY

PUBLIC HOSPITAL

PRIVATE HOSPITAL

REHABILITATION AT HOSPITAL

SHORT TIME

HELFO

GP

VISIT GP

A

B

C

D

CO-DESIGN WORKSHOP

40

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Fish Oil

Collagen

Te�

Ve�et��

Fi��

F��i�

J�i�� Nu��nt�

Nu��nt�G��i�

Me�i�� f�� L�n�-��

ACEICaptopril/Enalapril//Perindopril/Benaz-epril/Iimidapril/Fosinopril/Ramipril

Me�i�� f�� L�n�-��

ARBLosartan/Valsartan/Olmesartan/Telmisartan/-Candesartan/Iirbesartan

Me�i�� f�� L�n�-��

B blockersMetoprolol/Bisoprolol/Atenolol/Esmo-lol/Propranolol

Me�i�� f�� L�n�-��

Calcium channel blockersNifedipine/Felodipine/Amlodipine/Dilti-azem/Verapamil

Me�i�� f�� L�n�-��

DiureticsFurosemide/Hydrochlorothia-zide/Indapamide/Spironolactone

Me�i�� f�� L�n�-��

Antiplatelet and anticoagulantsAspirin/Clopidogrel/Tirofiban Hydrochloride/Heparin/Warfarin

Me�i�� f�� p��n�

Coenzyme Q10

Me�i�� f�� p��n�

Cyclic Adenosine Monophosphate

Me�i�� f�� h��-��

A blockerPrazosin／Terazosin

Me�i�� f�� h��-��

Anti-ischemicNitroglycerine／Isosorbide Dinitrate

Me�i�� f�� h��-��

ThrombolyticUrokinase／Streptokinase／rt-PA

Me�i�� f�� h��-��

Lipid regulatingAtorvastatin Calcium／Rosuvastatin Calcium

Me�i�� f�� h��-��

Anti-arrhythmicQuinidine／Propranolol／Amiodarone／Verapamil

Me�i�� f�� h��-��

Inotropic agentsDigoxin／Cedilanid／Milrinone

Me�i�� f�� h��-��

Anti-shockDopamine／Adrenaline／Atropine

Treatment

Keep Health

NEW CLARIFICATION

41

IDEA FROM WORKSHOP

IT’S TIME TO HAVE A

IT’S TIME TO HAVE B

IT’S

For keeping health.

For keeping health.

For treatment.

(even through the chronic disease people have same image with normal people)

Treatment Keep Health

One day package

X days package After x days, people will have a examination

Interaction identity Package identity

IT’S IT’S IT’S

Health Map

good bad

Visual Report

42

DESIGN DEFINITION

A TOOL TO COMMUNICATE WITH DOCTORS

REDESIGN THE IDENTITY OF MEDICINE AND DIET IN SMART NOT JUST APPEARANCE

➤ Redesign the identity for medicine and food

➤ Design a professional way for people to communicate with doctors outside of hospital.

Norway has a good healthcare system. People believe the professionals than other pipes. The professional communication tools are necessary for people even through they are just at high risk of cardiovascular patients. It difficult to change the identity of medicine and food trough directly way package or appearance, but digitalization still provides some opportunities to change the identity of the medicine and food. All the things require me to regard App as a touchpoint to connect the different touch points to make a holistic service for customers. HELFO is making the patients information standard which play an important role on the App which can be easily set up in future. Design is increasingly important in healthcare system. App is also a good factor to change the whole system,

43

prototype

44

TREATMENTKEEP HEALTHYPREVENTION

HOLISTIC PROCESS

45

MAKE APP WITH MODULAR FUNCTION

46

an easy way to keep you from cardiovascular disease

Dear Lily,

Depending on your current situation ( see your document ), I think you are at a high risk of cardiovascular disease, but don't worry about it, it is not serious, if you follow these steps.

STEP ONE Suitable Exercise and a Balance Diet as possible as you can, this is not just for prevention but also a good daily life.

STEP TWO Most important things for diet are salt and fat. I recommended the max daily amount of salt is 6.00g and the max daily amount of fat is 6.00g.

STEP THREE

Download this lovely APP - healcaedio. This is a important bridge between us. 1. It can help you to track fat and salt. 2. You can use it to manage your body data. 3. You can use it to communicate with me, and share the data you like to share. I can give you

feedback as soon as possible and make a future plan.

Sign up Enter this code: 463284325324

Remember that we use healcardio together. Don't feel alone.

Your GP

PREVENTION

USER’S JOURNEY

Actually people can not have a talk about suggestion for their future healthy life. Depending on the user research, people prefer to listen to professional people suggestions. Due to this reason, creating a very professional scenario is necessary for people. This is easy way to make the people follow the suggestion for prevention. They will begin their prevention from GP., regarding the prevention process as a professional treatment.

Visual report is a strategy for engaging doctors. Doctors is very busy. Making a simple and meaningful image based on data is a good way to save time for doctors. The doctors can give a feedback in a short time, also creating a positive quick feedback for patients.

47

KEEP HEALTHY

In future, delivery medicine is a obvious trend. But people is afraid of delivery medicine. 4/5 people think they hope their doctor can make sure the medicine is correct through the delivery system. This point will create a new business model in future. Who can be in charge of the medicine to delivery.. This system should be very flexible for different customers.

48

tes t ing

c o l l e c td a t a

o k

o kc o l l e c td a t a

b l o o d p r e s s u r e

h e a r t r a t e

000mmHg / 000mmHg

000 /min

130mmHg

85mmHg

10/24

2015

10/24

2015

10/24

2015

10/24

2015

10/24

2015

10/24

2015

10/24

2015

10/24

2015

60/min

100/min

10/24

2015

10/24

2015

10/24

2015

10/24

2015

10/24

2015

10/24

2015

10/24

2015

10/24

2015

h e a l c a r d i oPM

TREATMENT

USER’S JOURNEY

There are already a lot of APPs tracking the body data. For simplifying the healcardio. healcardio can get the data directly from other APPs like ihealth, during the clickable prototype test, 4/5 people felt confused and difficult to use it, if they can use healcardio to collect data directly.

49

Comparing the APPs on the market, most of the Apps are green. To create a uniqle brand, I choose to use single main color red with a soft style. The basic principle of the Apps is simplicity. I will follow it.

h e a l c a r d i o

sign in

sign up

An angel for your heart.Gill Sans

Adobe Caslon

Avenir Next

Color Font

Soft

Sharp

Multiple Color

Single Color

BRANDING

50

IDENTITY OF DESCRIPTION

New Journeyforyou

01/10/1015 to 01/11/1015

Dear Lily,

As I said through healcardio, your situation is quite nice.Continue to take Aspirin & Metoprolol to keep health.

ASPIRIN

This is an element for prevent heart attacks, strokes, and chest pain. Take 1 tablet everyday at the beginning of happy days before breakfast.

Scan Code Put on your Aspirin Package

METOPROLOL

This is an element for prevent high blood pressure and chest pain. Take 1 tablet at the morning and 1 tablet at evening before diet everyday.

Scan Code Put on your Metoprolol Package

Your GP

THIS IS FOR PHARMACY OR SHOPPING ONLINE

CODE: DFBFSDA89DDA

Scan Code

Nitroglycerin

01/10/1015 to 05/10/1015

Dear Lily,

is Nitroglycerin is for a 5 days treatment, you should take it very carefully before next week examination. How

Take 1 tablet at 7:00am&9:00pm everyday.

Do NOT swallow, chew, or crush this tablet. Dissolve the tablet under the tongue or between the cheek and gum.To treat an angina attack, use nitroglycerin tablets at the first sign of chest pain. Sit quietly while the tablet is dissolving.

WHAT Preventing or relieving a sudden attack of chest pain caused by heart disease. Nitroglycerin is a nitrate. It works by dilating (widening) blood vessels. Chest pain occurs when the heart needs more oxygen than it can get. Dilating blood vessels allows blood to flow more easily. This reduces the heart's workload and the amount of oxygen needed by the heart.

NOTICE Do NOT use nitroglycerin tablets if: you are allergic to any ingredient in nitroglycerin tablets you have increased pressure in the head you have severe anemia

Your Doctor

!"#$%&'()*$"+ !"#$%&'()*$"+

,'%%-./*00*'0

!"#$%&'()*$"+

,%+&-*


Dear Lily,



STEP TWO Most important things for diet are salt and fat. I recommended the max daily amount of salt is 6.00g and the max daily amount of fat is 6.00g.

STEP THREE





Your GP

I asked users to make sequences based on professional. 1=not professional, 3=professional A:2 1 3/ B:1 2 3/C:2 1 3/D:2 1 3/E:1 2 3

Use color for different stages. Keeping Health and Prevention stages have the same color. Treatment is use another color to show the process should be paid more attention.

The illustration is very necessary. 4/5 users think it is useful.

51

5/5 users think they can use healcardio through doctors. They don't think they can use an APP through the APPs store directly.

I asked users to make sequences based on professional. 1=not professional, 3=professional A:2 1 3/ B:1 2 3/C:2 1 3/D:2 1 3/E:1 2 3

Use color for different stages. Keeping Health and Prevention stages have the same color. Treatment is use another color to show the process should be paid more attention.

The illustration is very necessary. 4/5 users think it is useful.

52

Two Action One Action

YES or NO


Two Action

53

Test with clickable prototype 9 54


accuratejoyful

Joyful

Accurate

Use professional way to address the importance on diet. People use this way to communicate with doctors and get encourage.Use the joyful interaction way to change the identity of long-term medicine and make this activity more relaxed.Checklist is the most familiar way for users. This way can provide professional and accurate interaction way.Test for accurate and joyful. This quality is low. Due to the test group are 5 people.

55

Salt

0.50g 0.50g 0.50g 0.50g 0.50g

IDENTITY OF FOOD

I sent my idea to my interviewees before through the e-mail. Surprisedly, they think this is a problem for them not just for salt and fat. Sometimes their doctors to ask them to have fix amount of food, but they don't have ability to measure them.

56

New Journeyforyou

01/10/1015 to 01/11/1015

Dear Lily,


ASPIRIN



METOPROLOL



Your GP


CODE: DFBFSDA89DDA

SHOPPING ONLINE

STICKERS

When people prefer to believe the professions, feedback becomes important. It doesn't mean doctor should do anything for their customers. We don't have enough medical staff to provide an extremely good user experience. Thus, the way of people to take the medicine, I choose empowering the individual to make a small change for future change. People use the sticks to manage the medicine by themselves.

IDENTITY OF MEDICINE

57

New Journeyforyou

01/10/1015 to 01/11/1015

Dear Lily,


ASPIRIN



METOPROLOL



Your GP


CODE: DFBFSDA89DDA

Scan Code

Nitroglycerin

01/10/1015 to 05/10/1015

Dear Lily,



Do NOT swallow, chew, or crush this tablet. Dissolve the tablet under the tongue or between the cheek and gum.To treat an angina attack, use nitroglycerin tablets at the first sign of chest pain. Sit quietly while the tablet is dissolving.

WHAT Preventing or relieving a sudden attack of chest pain caused by heart disease. Nitroglycerin is a nitrate. It works by dilating (widening) blood vessels. Chest pain occurs when the heart needs more oxygen than it can get. Dilating blood vessels allows blood to flow more easily. This reduces the heart's workload and the amount of oxygen needed by the heart.


Your Doctor

!"#$%&'()*$"+ !"#$%&'()*$"+

,'%%-./*00*'0

!"#$%&'()*$"+

,%+&-*

I sent a email to ask two interviewees before. Both of them think they feel the physical paper is much safer than the digitalization. They will print it by themselves if they just have digital edition. 4/5 users told that they can use the paper to check the information on app. This can set a safer scenario.

SAFETY CULTURE

58

PROFESSIONAL COMMUNICATION

5/5 people during the test, they are happy to use healcardio to communicate with doctors especially during the treatment stage. 2/2 doctors think this is a good way to communicate with patients. The doctors doesn't want to make a link through their private APPs like imassage, eve though a lot of patients want to add them. Communication part is difficult to test in a short time. The problem here is that should doctor can know anything. I just design one image for users to communicate with others, some people doubt that they don't want show some data to the doctors. If I make this apps just for cardiovascular patients. Users (5/5) can accept the data to share (salt fat blood pressure and heart rate) Share the image with others through other SNS apps is better than creating a fountain that they can use this apps with other family members and other same people. This can make the apps more complex agains the strategy simplicity. Through other platform can also make a better integration.

59

FUTURE SYSTEM

This is new system in future. I hope use this project to show the holistic process can not live without t system thinking. I found that it is difficult to do a holistic experience now in Norway because the institution under government is independent like helfo and public health center. There should be a innovation center in future. Obviously with DNV GL basic research on healthcare. more and more design industry will go into this system.

60

MAP

I W O R K W I T H

N E W I D E N T I T Y F O R F O O D A N D M E D I C I N E I N S Y S T E M T H I N K I N G

H O L I S T I C P R O C E S S F O R T H E C A R D I O V A S C U L A R

A P R O F E S S I O N A L P I P EB E T W E E N C U S T O M E R SA N D D O C T O R S .

I W O R K F O R

SAFETY CULTURE

VALUE SAFETY

BELIEFS

ATTITUDES

PERCEPTIONS

Communications founded on mutual trust

Confidence in the efficacy of preventive measures.

Shared perceptions of the importance of safety


SYSTEM

PATIENTS

GOOD CASES

using risk based approach to redesign serviceempower individualsorganize care for needs not diseasespayments on results not activityintegrating care across doctors and patientslong investment for systeminvest in climate adaptationstandarddevelop safety casescreating cultures and midgetsmanage risk locally


decision makingincorporating their abilitiespreferenceslifestyleown treatment

patient engagementsustainable hospitalmobile healthhealth alliancedigital appointmentmeasuring true valueknowledge sharing

professional

patients

researchers

policy makers

STATEHOLDERS INFLUENCE FACTORS

equality

sustainability

EVALUATION

environment

timeliness

costefficiency

person centered

safety

debt crsis/coherentaging population/equal

expandinggovernment leadingurban and rural

high cost/serious pressuregap between the rich and poor

MAIN MARKET

conservative culturepatient habits and preferencesector fragmentation

GENERAL PROBLEM

aging populationemerging disease patternclimate changerising costsinequitable accesspoor safety recordno holistic care

SPECIFIC PROBLEMS

1/10 patients harmed in hospitaldementia/chronic increaseICT is slowpoor coordinated effort

CARDIOVASCULAR

STATE/NATIONAL BUDGET

CITIZENS / EMPLOYERS/PATIENTS

REGIONAL HEALTH AUTHORITIES

LOCAL GOVERNMENT (MUNICIPALITIES / COUNTIES)

HELFO

PUBLIC HOSPITALS

PRIVATE SPECIALISTS

PRIVATE HOSPITALS

GP

NURSING HOMES AND LONG-TERM CARE

DENTAL CARE FOR CHILDREN AND OTHER DEFINED GROUPS

NATIONAL TAXES LOCAL TAXES

FINANCIAL SYSTEM

maritime

sustainable organisation(environmental/social/economic-longterm)

FOOD&WATER/OIL&GAS/ELECTRICITY&RENEWABLE/SHIPPING

SAFER

SMARTER

GREENER

SAFE AND SUSTAINABLE

FUTURE

oil and gas

energy

business insurance

software

AREABRANDING

MANAGE RISK

BUILD TRUST

HEALTHCARE INNOVATION

global impact

aligning split incentivesmanaging system risksempowering stakeholdersaccounting for valuetransforming mindset


Dear Lily,



STEP THREE Most important things for diet are salt and fat. I recommended the max daily amount of salt is 6.00g and the max daily amount of fat is 6.00g.

STEP FOUR





Your GP

New Journeyforyou

01/10/1015 to 01/11/1015

Dear Lily,


ASPIRIN



METOPROLOL



Your GP


CODE: DFBFSDA89DDA

Scan Code

Nitroglycerin

01/10/1015 to 05/10/1015

Dear Lily,



Do NOT swallow, chew, or crush this tablet. Dissolve the tablet under the tongue or between the cheek and gum.To treat an angina attack, use nitroglycerin tablets aW�WKH�ƓUVW�VLJQ�Rf chest pain. Sit quietly while the tablet is dissolving.

WHAT Preventing or relieving a sudden attack of chest pain caused by heart disease. Nitroglycerin is a nitrate. It works by dilating (widening) blood vessels. Chest pain occurs when the heart needs more oxygen than it can get. Dilating EORRG�YHVVHOV�DOORZV�EORRG�WR�ŴRZ�PRre easily. This reduces the heart's workload and the amount of oxygen needed by the heart.


Your Doctor

!"#$%&'()*$"+ !"#$%&'()*$"+

,'%%-./*00*'0

!"#$%&'()*$"+

,%+&-*

MANAGEMENT SYSTEM

NATIONAL INSURANCE SCHEME

MINISTRY OF LABOUR

HOSPITALS

HOSPITAL TRUSTS

REGIONAL HEALTH AUTHORITIES

MINISTRY OF HEALTH AND CARE SERVICES

GOVERNMENT

PARLIAMENT DENTAL PRIMARY CARE CARE PROVIDERS

PRIMARY CARE CARE PROVIDERS PROVIDERS

MUNICIPALITIES

COUNTIES

DIRECTORATE OF HEALTH (INCL. HELFO)

BOARD OF HEALTH SUPERVISION

INSTITUTE OF PUBLIC HEALTH

MEDICINES AGENCY

RADIATION PROTECTION AGENCY

BIOTECHNOLOGY ADVISORY BOARD

SYSTEM OF PATIENT INJURY COMPENSATION

SAK

NOKC

POBO

61

USER RESEARCH

CARDIOVASCULAR

PATIENTS

DIAGNOSE

EMERGENCY

RESCUE

EMERGENCY

RESCUE

EMERGENCY

RESCUE

REGULAR

INSPECTION

REGULAR

INSPECTION

STANDARD INFORMATION SYSTEM

ENOUGH DOCTOR AND NURSE

MONEY SEGMENT

EASY COMMUNICATION PIPE BETWEEN DOCTORS

GOOD UNDERSTANDING BETWEEN PATIENTS AND DOCTORS

RESCUE SYSTEM

BAD REHABILITATION QUALITY

FAMILY SUPPORT

YES

NO

PERSPECTIVE

PERSPECTIVEPATIENT A

PATIENT B PERSPECTIVE


Dear Lily,




STEP FOUR





Your GP

New Journeyforyou

01/10/1015 to 01/11/1015

Dear Lily,


ASPIRIN



METOPROLOL



Your GP


CODE: DFBFSDA89DDA

Scan Code

Nitroglycerin

01/10/1015 to 05/10/1015

Dear Lily,



Do NOT swallow, chew, or crush this tablet. Dissolve the tablet under the tongue or between the cheek and gum.To treat an angina attack, use nitroglycerin tablets aW�WKH�ƓUVW�VLJQ�Rf chest pain. Sit quietly while the tablet is dissolving.

WHAT Preventing or relieving a sudden attack of chest pain caused by heart disease. Nitroglycerin is a nitrate. It works by dilating (widening) blood vessels. Chest pain occurs when the heart needs more oxygen than it can get. Dilating EORRG�YHVVHOV�DOORZV�EORRG�WR�ŴRZ�PRre easily. This reduces the heart's workload and the amount of oxygen needed by the heart.


Your Doctor

!"#$%&'()*$"+ !"#$%&'()*$"+

,'%%-./*00*'0

!"#$%&'()*$"+

,%+&-*


Dear Lily,




STEP FOUR





Your GP

85-130

mmHg

60-100

/min

Salt:6g

Fat:66g

k e e p h e a l t h

blood

pressure

hear t

rate

62

reference

44

44

Giga-mapping: Visualisation for Complexity and Systems Thinking in Design. Birger Sevaldson

Dancing With Systems Donella Meadows

Types of Systemic Relations Birger Sevaldson

The Design Way Intentional Change in an Unpredictable World Harold G. Nelson

7 Reasons Why Our Social Services Keep Failing: An Argument for Grounded Change Dr. Sarah Schulman

Design For Care Peter Jones

Prototype Evaluation in Service Design A Case Study at an Emergency Ward Johan Blomkvist

Radical Redesign The Australian Center for Social Innovation

Healthcare 2050 DNV GL

Patient Centered Care DNV GL

Transitions to Sustainable Development: New Directions in the Study of Long Term Transformative Change Grin J, Rotmans J

reflections

44

44

This is a meaningful semester to know something new.

In the studio, I learnt system oriented design systematically. I know how to use the system to set up a design project from research to systematic impact step by step. I can use giga-mapping in different ways. At the beginning, using the giga-mapping to find a start point-ZIP. This is most important thing for the complex problems which is difficult to find a correct stone to carry on. After that, gaga-mapping can also be used as a tool to find the relationships between problems especially combined with iceberg model. Giga-mapping can also be used in design process which can make me figure out a holistic solution easily and know the relationships between different touch points. Giga-mapping is a great process crossing the whole design process.

Cooperation with DNV GL is a super happy process. They have done a lot of project about healthcare and are a global company. In this way, I can get a big picture of healthcare system all around world, and this is a great way to understand the different culture between Norway, China and other countries after the deep user researches this semester. I’m luck to visit Mayo Clinic which provide me a deep understanding of healthcare system.

I think the result of this semester is good, even through the design seems to be unclear and not very interesting. The meaningful part is that this result is from system thinking not just from a good idea. Seeing the whole system map, I think my design is effective and really can benefit people in a holistic perspective. This project is not addressing single design. I think my design can make the whole touchpoint work together for a systematic impact.

It is not enough time to understand the system oriented design just for one semester. It is obvious that I need a long time to practice the system thinking. I’m not familiar with the all the context of create a positive systematic impact for my design. There are so many method to create leverage points. In a real system, there are many methods which can be used together at the same time. When I consider the system impact, I often forgot to use multiple ways to create systematic impact on my own system. Using one design which can address different methods is quite difficult.

44

I’m struggling with the balance between system and design. Sometimes I will face a conflict between a good idea from creativity and a normal idea from system thinking. I don't know how to adapt them to each other and put the a good idea from creativity in system thinking. This process is quite difficult. Some good ideas are not very relevant with each other, but normal ideas can be seen as a group power. System oriented design is quite difficult to evaluate in real world for a student. It is difficult for me to say which is better.

Foreigner is difficult to do user research sometimes. Native language is important for interviews. This can make the interviewees into a familiar scenario. I met another interesting problem. This happened during my random access interview with 10 people. I ask them if they think Norway has a good healthcare system. 9/10 told me they think Norway has a great healthcare system. For me, my Norwegian friends complained a lot about healthcare service in Norway, but it is difficult for me to ask something bad in Norway’s healthcare system. I guess the reason is national pride.

Time management is urgent issue for me this semester. Everybody has the same deadline which gave me a lot of pressure. Everyone has different projects, in this situation I think the amount of work is different at different stages. The same deadline sometimes make me super busy and sometimes have little thing to do. I have no balance speed this semester. I used the textbook time to balance my time, but I will forgot the knowledge, if I didn't do any practice.

I hope I can practice system oriented design method more to understand this complex world.

report yue

Education