designing data for dignity stratarx

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LUMINARY LABS @JENVANDERMEER @LUMINARYLABS DESIGNING FOR DIGNITY IN HEALTH TECH Jen van der Meer STRATA RX - SEPTEMBER 2013

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Is it enough to design for a great patient experience, improved health outcomes, and overall cost reductions in health care? While incentives may soon change, the idea of data-driven solutions to improve health care is not a new one. Yet why have technological solutions so frequently fail on all three of the triple aims? We need to be able to ask deeper questions, and experiment with more humanistic approaches. Looking at specific interaction examples from incumbents and startups in health tech, I will contrast the current approaches for data-driven solution development, and how they fall short at the moment of interaction. Incumbents deploy top down approaches that comply with regulation, and meet the needs of payers and providers, but famously fail to deliver engaging patient and practitioner experiences. New entrants want to disrupt the entire system, but often struggle to understand deep unmet patient needs, and how to demonstrate evidence-based outcomes. For each solution born onto the health tech scene, can we ask: Are patient’s lives enhanced by the addition of data? Do doctors become more wise? Do nurses feel more empowered? Do spouses know how to effectively intervene? Do adult children of aging parents get more time in their overly stretched days? And do these collective interactions actually result in improved population health? This talk will outline an approach to design for a higher aim and enhance the lives of everyone who seeks care from the health care system.

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Page 1: Designing Data for Dignity StrataRx

LUMINARY LABS @JENVANDERMEER @LUMINARYLABS

DESIGNING FOR DIGNITY IN HEALTH TECH Jen van der Meer

STRATA RX - SEPTEMBER 2013

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Jen van der Meer@JENVANDERMEER

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Jen van der Meer@JENVANDERMEER

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&

DOES THE TRIPLE AIM SEEM UNATTAINABLE

Improve population health

Improve the patient experience

@JENVANDERMEER

Reduce the per capita cost of health care

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Leslie Patricelli

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Meaningful use.

Accountable care.

Can we set the bar higher?

The names of the following incumbent EMR/EHR providers and the names of patents and doctors are redacted to protect privacy and mediocrity.

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HIGHER

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HIGHER

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HIGHER

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THE COST OF TECHNOLOGY

Thomas Murphy, MD 2001

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So here come the startups.

The internet kids.

To the rescue.

Full disclosure: I am one of those kids.

@JENVANDERMEER

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To change the world.

And we actually think this way –as if we could hold the world in our hands. More ego-maniacal than surgeons, we are.

We come, inspired.

And improve human lives.

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But we are not without fault.

@JENVANDERMEER

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We tend to design for the motivated, and the healthy.

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We get too excited about startup traction, not excited enough about evidence-based outcome

Paul Graham’s Startup Curve

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We have a huge learning curve to figure out how to disrupt the cost curve

Data: OECD Health Data 2005 and 2006. Commounwealth Fund National Scorecard on US Health Performance 2006.

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Cost + Compliance

Incumbents vs. New Entrants

Lifestyle

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LET’S SET A HIGHER BAR

@JENVANDERMEER

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@JENVANDERMEER

For each solution born onto the health tech scene, we ask:

Are patient’s lives enhanced by the addition of data?

Do doctors become more wise?

Do nurses feel more empowered?

Do spouses know how to effectively intervene?

Do adult children of aging parents get more time in their overly stretched days?

And do these collective interactions actually result in improved population health?

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DATA DESIGN PRINCIPLESTHAT SET A HIGHER BAR FOR HEALTH AND HUMAN DIGNITY

@JENVANDERMEER

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8 PRINCIPLES: DESIGNING DATA FOR DIGNITY

Ethical Sharing

Sacred Habits Deeper MotivationData Calming

Eye Contact Double Loops The Herd

Utility in Context

Design for…

@JENVANDERMEER @LUMINARYLABS

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DESIGN FOR UTILITY, IN CONTEXT

@JENVANDERMEER

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mHealth apps are only beginning to show the benefits of contextual awareness

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Ambient intelligence will become more anticipatory, adaptive, and transparent

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Technology that knows to behave differently in context to where you are

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Simulating a better future mental state

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Ambient Commons, Malcolm McCullough “Preontological awareness is faster”

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DESIGN FOR DATA CALMING

@JENVANDERMEER

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The problem of alarm desensitization

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The problem of data noise

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The problem of the quantified parent – how to become calm and engaged parent

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The payoff when visualization delivers wisdom, not just noise

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DESIGN FOR SACRED HABITS

@JENVANDERMEER

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The smart phone…

The perfect BF Skinner box?

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“You want minty refreshing taste now, you benefit from tooth health later.” – Dan Ariely

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Right thing, wrong reason: quantified dog could lead to self-understanding

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DESIGN FOR DEEPER HUMAN MOTIVATIONS

@JENVANDERMEER

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Insert gratuitous Fogg Behavioral Model chart here

A Behavior Model for Persuasive Design. BJ Fogg. Stanford University 2009.

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mHealth apps often fail the motivation test, never reaching the unhealthy

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Deeper motivators: “It feels good to volunteer simple answer to real questions people have”

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Will altruistic motivators be the most powerful? “Contribute to Science”

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DESIGN FOR ETHICAL SHARING

@JENVANDERMEER

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You have the right to not be sensed

From: Seven Principles for Big Data and Resilience Projects. 9/23/2013By Kate Crawford, Patrick Meier, Claudia Perlich, Amy Luers, Gustavo Faleiros and Jer Thorp2013 PopTech & Rockefeller Foundation Bellagio Fellows.

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Even if the value of that data delivers a larger public good

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Startups will not necessarily learn the difference between Informed consent and permission marketing

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The true north: be transparent about data sharing

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DESIGN FOR EYE CONTACT

@JENVANDERMEER

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Facilitate human contact: does this chart review increase or decrease their understanding?

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Does this device increase engagement, understanding, and trust? Or distract?

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Aim higher. Diminish the use of screens: wear and forget sensors

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DESIGN FOR DOUBLE LOOP LEARNING

@JENVANDERMEER

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Single loop learning

Consequences

FeedbackDecisionActions

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Single loop results, where is the “why”

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Double loop learning

Consequences

FeedbackDecisionActions

Mental Models Of Real World

DecisionRules, Strategies

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Time until death @amikahmad NYU ITP

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Standing at work today

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DESIGN FOR THE HERD

@JENVANDERMEER

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Social proof = Positive peer pressure

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Caregivers are not just a target segment, They are an interaction paradigm

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VA Caregiver pilot distributing 1000 iPads to caregivers of veterans

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My herd watches out for me

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To save everything, click here:

HealthDataChallenges.com

@JENVANDERMEER | @LuminaryLabs | @HDChallenges

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My herd come join us: