Anna Spencer, MPH and Audrey Nuamah, MPH

November 7, 2019

Human-centered design is a concept combining creativity with empathy. To identify creative solutions to a problem, you must first understand the perspective of those experiencing the problem. Although this concept was initially popularized in the worlds of advertising, business, and technology, it is making its way into the health care and social service sectors. The Center for Care Innovations (CCI), an Oakland-based nonprofit, uses human-centered design and other innovative strategies to strengthen the health and health care of underserved communities. Through its Community Partnership Pilot project, made possible through support from the Robert Wood Johnson Foundation, the Center for Health Care Strategies (CHCS) recently spoke with Veenu Aulakh, CCI president, about the organization’s approach to human-centered design and how they collaborate with patients, staff, and other stakeholders in successfully redesigning care while also telling a meaningful story to the community.

Q: What is it about the human-centered design process that specifically makes it a good tool for eliciting and incorporating consumer and community feedback?

A: The power of human-centered design (HCD) is to include the human lens when examining a problem. Oftentimes in health care, we make assumptions about patients’ needs and then design health care improvement strategies based on those assumptions. HCD is rooted in empathy and collaboration, and allows us to listen to the voices of consumers, reframe problems, and collaboratively develop solutions.

Q: What are the key elements in the HCD process?

A: The whole point of HCD is to be open to what the end-user wants. It’s not uncommon for health care organizations to come into the process thinking they want to solve one problem but, through talking to the consumers, learn that the problem is something totally different. Using strategies such as open-ended interviews, brainstorming, observations, shadowing, and journey mapping allows you to understand consumer experiences and perspectives. When you start with an outcome in mind, it really stunts innovation. HCD, on the other hand, collaboratively engages patients, caregivers, health care staff, and other stakeholders to generate new ideas for care delivery and turn those ideas into actionable plans.

Human-Centered Design in Action

The Ravenswood Family Health Center in East Palo Alto, California, provides culturally sensitive, integrated primary and preventive health care to all community members, regardless of immigration status or ability to pay. Despite offering free care, Ravenswood staff noticed that patients often chose to go to the local emergency department (ED) rather than seek care at the clinic. In an effort to better educate patients about the health center’s available services and what health issues actually warrant a visit to the ED, the Ravenswood team (in collaboration with CCI) engaged in a human-centered design process to develop strategies to help patients make more informed decisions about when to seek care in the ED. After several brainstorming sessions, the staff and patients co-developed an informational flyer in English and Spanish that detailed scenarios of when parents should take a child to the ED and when it is more appropriate to bring them to the health center. This prototype was then refined with additional patient feedback. Ravenswood found the process to be helpful in tackling ED overutilization that it is developing other forms of the tool, such as refrigerator magnets and wallet-sized cards.

Q: For others in the health care field interested in using HCD, what key strategies would you share?

A: First and foremost, be patient. The HCD process requires time, iteration, and a willingness to adapt. While it’s important to listen to consumers, what’s even more important is the commitment on the part of health care organizations to act on what they are hearing. The health care field tends to be rigid and committed to doing things a particular way, but there needs to be a certain amount of flexibility in trying new approaches if using this process as an innovation tool. Failure can be part of iterating to new solutions so you also have to be prepared to try things a few times before you give up.

For health care organizations new to this approach, a good strategy is to start small and learn fast.  Before diving in and attempting to make major institutional changes, it is a good idea to start with something within your own team or organization and then, after there is some mastery, broaden your efforts.

Q: Are all organizations equally equipped to use an HCD approach to engage the community, or are there different starting points for organizations?

A: Using a human-centered design approach is an investment. It requires significant staff time to build internal skills and commit to effective implementation.  It also requires a commitment to act on the information that is gleaned throughout the process, which is incredibly important to building trust and partnerships with the communities being served.

This work is still new to health care but people are slowly becoming more aware of how powerful this strategy can be. Business and design sectors have long used HCD to test and innovate around products, which means there is a lot we can learn from other industries, so we don’t have to reinvent the wheel.  There are lots of opportunities to learn about HCD, including CCI’s Catalyst program.

Additional Resources

  • CCI’s Catalyst Program – This program provides health care organizations with practical advice for using human-centered design. Through trainings, coaching, peer learning, and online resources, the program emphasizes “co-design,” where all stakeholders affected by the problem — consumers, caregivers, frontline or ancillary staff, or community partners — play a role in co-creating new paradigms.
  • Design Kit – This online learning platform, created by IDEO.org, has a wide array of resources on how to apply HCD in any context. Alongside The Field Guide to Human-Centered Design, there are also various web pages to explore and free online courses for teams to participate in.
  • Engaging Consumers and Communities to Meaningfully Transform Care – This blog post features CHCS’ Community Partnership Pilot initiative, which is focused on identifying best practices for engaging community members within the healthcare system. Using human-centered design is one of the main project goals.
  • What Is Human-Centered Design? – This article, by the social impact design firm DC Design, highlights the basics of all things human-centered design and describes the five key phases of their HCD model.

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