New Grammar : Moment of Mediation
BackStory :
We’ve been thinking about how to intervene BigSystems ( healthcare, education, society or even large companies ) through design since 26th September 2013.
( I’ll talk more about intervening vs. disrupting a big system in a separate post )
The design challenge given to me and my colleagues was to rethink the patient experience by our former CTO who had personal experience in arguably, one of the finest hospitals in the world. I quote :
“ ..the whole experience is so primitive, so dumb, and so inhuman, that there is no doubt that we are still living in the dark ages when it comes to healthcare. Sitting there in the middle of the night, staring at dead walls, white lights, the inhuman atmosphere, .. we *have* to rethink the experience of the patients.”
10+ deep interviews later, my colleague Neelam and I were looking at 13 separate journeys and 60 situations that we could start with. We seemed to have hit a geyser. See them here.
Very quickly, it became clear that any one of these situations and moments could be an offering by itself. And we could go back and find more. We had a problem of plenty.
The question became : how do we approach this list ? One at a time, over a lifetime ? The question resolved to : what was our intention in doing this ? to increment the status quo or alter the status quo ?
Our intention was and is to re-think and not re-fine. This meant we needed to step back and think about the how before we stepped forward into the where. Simply taking potshots at a BigSystem didn’t make sense.
Stepping Back & Opening Up :
Big Systems are much too for a David and Goliath approach. In my naive view, treating a BigSystem as “The Enemy” is both inefficient and de-energising . As a designer, I was looking for an empathetic value system that did not require me to alienate the members of the BigSystem yet could change its course — hopefully radically. I found it in Aikido.
“O-Sensei was frequently heard to say. ‘Aiki is not a technique to fight with or defeat an enemy. It is the way to harmonize the world and make humanity one family.”
― Linda Holiday
So our thesis became : It is possible to intervene and change the direction of a Big System, without having to break it up. Provided you can blend with where their energy is today and bring them back into balance, and not force your energy on them.
( I‘ll talk more about 4 Conceptual Shifts to intervene a Big System in a separate post )
It also became clear, that the real value was not the situations we were discovering — we could find many more — but the frames we were using for thinking about the problem. These frames were making it possible for us to have meaningful discussions internally on how to intervene healthcare.
This eventually became a complete approach with its unique coherent grammar for intervening BigSystems.
It was quite clear at this stage that we needed to open this up and invite help in. Lots of it. We were inspired by the idea of murmuration of starlings.
So we thought: what if we made these frames explicit, then others could use it to discover situations for themselves. If we could agree on the how, everyone could decide the where according to their own interest.
So, this is my attempt to share these frames, one frame at a time. It stands on the shoulder of giants, and we hope it lets you see a little further than before.
Moment of Mediation
BigSystems aggregate power and disempower the beneficiary. You can feel it as you enter a hospital, for example. You are numbered, all signs of being different are removed, the usual personal boundaries eliminated. Beneficiaries feel like a cog in the wheel. This simply the nature of the beast. Or more accurately, an outcome of the mental model the actors in the system are carrying. For healthcare this is felt by the patient or caregiver. In education it is felt by the student. In society it is felt by the citizen vis-a-vis the government.
As we see it : Dis-Empowerment of its beneficiaries is at the heart of the problem with BigSystems.
This power differential comes to the surface most sharply in situations where the interests of the beneficiary and the system collide.
For example,
You’ve just been told that they found “something” in your mammogram. You need empathy and help in working through the fear that accompanies that information. The System, needs to simply transmit that information and move on to what to do next .
These situations are experienced as moments of helplessness or powerlessness by the beneficiary. This is what they remember when they look back.
Confessions: I’m a systems thinking buff and believe that systems of two are inherently unstable, and systems of three are inherently stable.
For example,
Two members arguing (i.e. oscillating out of bounds) need a third member to restore balance. In a situation of mild imbalance, this person may be a friend. In extreme cases, a lawyer.
Restoring the balance of power in the moment, then needs a third entity. Given that BigSystems are also closed systems, software seemed like a perfect fit. It’s intrinsic nature is to mediate experiences and most importantly you can carry it with you into these situations.
Mediation can, quite literally, be at hand, all the time.
—
mediate
verb |ˈmēdēˌāt|
1 [ no obj. ] intervene between people in a dispute in order to bring about an agreement or reconciliation: Wilson attempted to mediate between the powers to end the war.
—
Given how extreme the power imbalance is today, it seems almost certain to me that that all software mediation will need the power of communities to restore balance.
If you knew 1 million people had your back, would you feel differently ?
So we gave this moment where the interest of the beneficiary and the BigSystem collide a term : the Moment of Mediation.
It is the exact moment of unmediated interaction between the beneficiary and the Big System, which leaves the beneficiary feeling helpless or powerless.
The sentences in red in the deck are these moments. We’ve heard more than one person say that any one of these could be a startup unto itself. But we I believe it will take more than just a few startups. It will need all the startups, speaking the same language, even as they go after different parts of a dysfunctional BigSystem.
Intervening BigSystems, then resolves to taking the journey through the eyes of the beneficiary and zooming into situations where s.he felt helpless or powerless. Zoom in again to find the exact Moment(s) of Mediation. For example,
I’m admitting my Dad who had a decade long history of cancer. The doctor at hospital looks at me and asks : “ tell me your father’s medical history”.
I experience immediate stress. I have a file full of tests, reports, drug side effects, pre-existing conditions. Where do I start ? And what if I miss telling him something vital ? What if my father has to suffer the consequences of my carelessness ?
True Story. Here is how I mediated the moment that that time. I can imagine having a technology mediated experience which addresses my basic question — did I miss anything — would have completely transformed how I felt about that moment.
( obviously I’m all for sharing personal medical records)
Testing it
The first test of this approach was in social situations.
Society, after all is a Big System
Could we discover moments of mediation in a complex social situation ?
BangalorePlays :
With a help of a few good friends from the Global Shapers, and a core high-octane, we conceptualised, designed and executed BangalorePlays a day long, inter-disciplinary event aiming to make the city safer for women.
For the situation that I facilitated, involving a young woman who was harassed by bystanders and eventually the cops in Bangalore, we found 13 moments of mediation. The discovery process worked beautifully ! The ideation process however sucked, and needed a huge effort of synthesis on my part and more time than we gave it. This still needs work — more on this in a separate post.
Here’s a report card :
Healthcare Cohort @ D.Labs, ISB :
We are now testing the approach along with our friends at D.Labs on their first healthcare cohort. The initial acceptance has been exciting to see. Every single startup in the cohort found it useful and made the right kind of noises. Even the one’s a year into their product, after some initial resistance.
Encouragingly, even friends in pre-sales and customers at a recent design thinking workshop took to it immediately. And Jess, thanks — your feedback gave me the validation I needed to take it further.
Other Applications
A good test for new grammar is whether it creates new meaning in an old situation. I’m seeing this is the case. I recently installed LinkedIn Connected and I love it. This is the notification I received on the way to work this morning.
With this grammar, this becomes the moment of mediation :
“ I’m running late for my meeting and didn’t have time to check who’s attending. Why can’t you help me know just enough about the attendees so I don’t enter cold ? ”
Essentially you could re-design any experience by thinking about the moments of mediation ( where does your consumer feel helpless or powerless in her experience today ) and determining what is the nature of intervention required.
In systems terms — each moment is a tiny balancing loop, which restores balance to that moment.
I needn’t say this : service design is a natural complement to this language.
Jobs-To-Be-Done
This also compares favourably with the jobs-to-be-done formulation by Clayton Christensen. In essence, the need of the person at the Moment of Mediation is the job-to-be-done. Since the person can have different needs at different moments, the same product may have to meet two different needs at these moments— giving rise to the now famous milkshake story.
In additional the grammar gives a first clue as to what you should do apart from what you should offer : empower your consumer and bring him back to balance. This in effect makes the designer responsible for the well being of the consumer.
Standing on the Shoulders of Giants
I could only get this far because of the amazing work done by the guys at designingcx.com. Check them out. They’re awesome. Their version of journey mapping & service design and their simple, precise language is the one I use and find useful. I highly recommend it. It’s their notion of “moments that matter” was the basis for my thinking.
In Summary :
A Moment of Mediation builds on the notion of “moments that matter” but looks at it thru a few very specific lenses.
First — We takes the position that people experience any offering in moments and not in a continuum. Whether a product or service, for your consumer it is an experience which is, well — experienced in moments.
Second — We believe that what people want most deeply, is to be in Balance.
This leads us to the inference that when faced with a BigSystem that dis-empowers us, Balance is achieved by restoring the Balance power to the person, in the moment, without alienating the actors of the BigSystem.
In essence, its Aikido applied to BigSystems. And makes us, the designer responsible not just for the offering, but for Balance : restoring wellbeing back to the consumer without destroying the actors in the BigSystem.
Easy to say, hard to do. What I cannot account for is emergent behaviour and unintended consequences of an intervention. It is likely we run into the constraints of Christensen’s Disruption Theory which in effect states that destruction of the BigSystem is inevitable. This something that we’re hoping figure out as we go down this path.
Happy to hear your comments, critique or advice.
Next
Now that you’ve found the moment, what next ?
Restore Balance. Change the Script.
