Illustration by Vanessa Jimenez

Is healthcare a global challenge, or a design opportunity?

By María Ana Barrera

Healthcare systems all over the world are struggling with aging populations, chronic diseases, and medical and technological developments that save lives but don’t necessarily cure illnesses. All of this points towards a healthcare system that’s extremely complex, but not equivalently efficient. As a result, healthcare has become expensive for everyone, including all the actors involved. It is expensive for people, payers, and governments.

But I’d like to think there is a better way to approach healthcare. Medical and technological innovation around new treatments and diagnostic methods, and new drug developments, have taken us to the point where even conditions that could not be cured a century ago, can now be dealt with in a matter of minutes (like infections that require antibiotics), and some conditions can be prevented altogether (like contagious diseases that require only a vaccine). There’s no doubt that progress in the scientific and technological fields of healthcare has come a long way.

Nevertheless, all of these breakthroughs occurred within a system that was designed to address acute care, meaning:

1. You suffered from an illness, accident, etc.
2. You were examined and diagnosed.
3. You were given treatment.
4. You were cured.

Today, the healthcare landscape is extremely different. There’s still a need for acute care, and that is unlikely to change (ever), but circumstances like the growing aging population, and chronic diseases that require long-term treatment (quite the opposite of acute care), are some of the variables that now demand big changes in a system that cannot deal with these circumstances because it was never intended to do so. It was designed with a different objective.

Then, what needs to change?

At Designit, we don’t have the perfect formula to fix this (yet). Still, we have a pretty good idea of where to start. Here’s a hint of what we’ve been working on with service designers and design researchers including Javier Canalda, Renzo Vallejo and Lautaro Aragon:

1. Health ≠ Healthcare

• In order to properly address health issues, the healthcare system cannot stand alone. Health implies a combination of variables that include genetics, environmental, cultural, and social factors. Healthcare is one of many other variables. Meaning, the “caring for health” should not solemnly be handed over to healthcare services and medical care exclusively.

2. Episodic care ≠ long term care

• We are currently dealing with different levels of healthcare needs: episodic and long-term, and these two cannot be addressed in the same manner. This is easier to understand by applying service design to the notion of caring. At Designit, we defined a different care cycle that goes beyond the 4-step model previously mentioned for acute care.

3. The healthcare system needs to be a human-shaped system.

• By focusing the healthcare system on people, we can define policies, processes, systems and even spaces according to the real needs of people. This shift might sound distant, but it starts with simple steps:

4. From patients to people:

• People who suffer from a condition, especially a chronic one, should not be defined by a disease. Beyond the disease, people have social, emotional, and physical needs that cannot be put aside while focusing on a disease. For example, trying to deal with a diabetic patient without the support of his family can easily be a waste of time.

5. From provider to team:

• Care has become more complex than ever. There are conditions that cannot be addressed by one provider, or by focusing on only one field of medicine. We now understand how daily habits impact the development and treatment of many (if not all) conditions. Decentralizing the focus and responsibility of one provider, and instead leaning on a team of providers and new team-players who can approach all challenges in a holistic and systematic manner, can result in better outcomes with fewer unforeseen consequences. For example, if treatment for arthritis affects a woman’s treatment for endometriosis, there has to be a way to compromise without harming the patient, or at least focusing on her preferences and motivations.

6. From cure to care:

• The old aphorism “to cure sometimes, to relieve often, to comfort always,” attributed to Dr. Edward Trudeau, is probably the most comprehensive care politic ever uttered. Focusing on caring rather than curing means that even when there’s no cure, care can still be provided in the best and most efficient ways. Especially because the patient’s preferences, motivations, frustrations, and limitations are the ones that define what to do, and how to do it.

So, where do we start?

What’s most ironic about the healthcare landscape is that the healthcare system is not to be blamed. Well, not entirely. A few years back I met Lauren Taylor, co-author of The American Healthcare Paradox at a Transform conference at the Mayo Clinic. She put it so eloquently: “We conceive of health quite narrowly. We think of it primarily as an output of healthcare services and medical care.” It isn’t. Health is a result of a combination of factors.

It is clear that changes need to happen systematically in order for health to be considered holistically, and to decrease healthcare expenditures considerably. And, dare I say, to get us to the point where some of the costs related to healthcare can be redirected.

Either way, change is coming, and healthcare systems need to adapt. I see how the financial industry is hitting every curve ball with fintechs addressing people’s needs in a way traditional bureaucratic institutions couldn’t before. And I see how even banks are struggling to change and keep up with the new mindset of innovation. All these make me wonder, what will be the driver for change in the healthcare system? Will it be an economic crisis?

That’s where design can play a major role: Is healthcare complexity a global challenge, or a design opportunity? Or both?