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Using Human-Centered Design Thinking to Improve Healthcare

Using Human-Centered Design Thinking to Improve Healthcare

At its foundation, healthcare quality improvement is a process of systematically improving care to better meet the needs of patients. Similarly, the concept of human-centered design thinking asks us to put people at the center of processes meant to address problems and improve outcomes. Although people have leveraged the concept of design to develop innovative solutions for centuries, “human-centered design thinking” is a relatively new approach in healthcare settings that is gaining in popularity.

One leader in this space is IDEO, a global design and innovation company; they launched a series of resources and toolkits to implement design thinking into tangible projects and emphasized the mindset behind the theory—the notion that how one thinks about design directly affects the impact of the solution. Through their design kit, IDEO suggests a three-step guide to cultivate a practical and repeatable approach to arriving at innovative solutions: inspiration, ideation, and implementation. IDEO urges professionals to connect with the population they wish to serve to ensure a project’s goals align with the needs of the intended community, and then to generate tangible ideas and solutions to address identified issues. This connection to a specific community puts the individuals they are designing for in the spotlight.

As the use of human-centered design thinking continues to grow, innovators continue to generate different visualizations of the process. Similar to IDEO’s three steps, another popular approach has been the Design Council’s double diamond model. Created to convey the process of design to designers and non-designers alike, this model (Figure 1) highlights a balance between big-picture thinking and detail-oriented refinements while translating ideas into action. This double diamond model was the guiding framework for the development of the Michigan Cardiac Rehabilitation network (MiCR) NewBeat materials – a partnership effort between MVC, BMC2, and HBOM (Figure 2). Strategically understanding the perspectives and needs of patients after undergoing a major cardiovascular event was pivotal to the success of the project.

Figure 1.

Figure 2.

Leading the NewBeat project was Larrea Young, who works as a multimedia and human-centered design project manager at MCT2D and HBOM. In reflecting back on the success of the cardiac rehab NewBeat project, she said, “One of the first questions we ask people when we talk about design is, what does it mean to design? People’s answers often focus on aesthetics; design makes things pretty or more accessible. While aesthetics is an important aspect of design, it is only one small part. We define design as envisioning and building a preferred future. This is the essence of the human-centered design process, an approach that examines challenges through lenses of aesthetics, culture, society, technology, and economics to define what something should be. In this process, we gain a deep understanding of people’s lived experiences, challenge conventional norms, and pilot innovative solutions. In the realm of healthcare, this process helps us build solutions that contribute holistically to the health and well-being of our providers and patients.”

Further evidence of the value of design thinking can be found in the quality improvement projects that placed critical importance on understanding the population they wished to serve. Many of these also have a heightened focus on patient-centered in the context of social drivers of health. Taking this into account, a number of healthcare initiatives are now incorporating a design thinking framework to ensure the circumstances, needs, and desires of patient populations are understood; and the results are promising.

In another recent study published in JAMA Network, Dr. Alex Peahl and colleagues wanted to determine how prenatal care could be redesigned to improve access and quality for Black pregnant people with low income. Utilizing human-centered design thinking, they interviewed 19 patients and 19 healthcare workers at prenatal care clinics in Detroit, Michigan, focusing on the first two phases of IDEO’s process: inspiration and ideation. In conducting this series of personalized interviews, Dr. Peahl and colleagues not only collected data to prove that current care failed to meet patient needs, but they also gathered ideas from the patient population of ways to redesign prenatal care for pregnant people in the community. By placing the individuals affected by the redesign at the center of a project, the team ensured the solutions they developed would lead to improved outcomes and experiences (Figure 3).

Figure 3.

Recently, Dr. Alex Peahl, MD, MSc, Assistant Professor in Obstetrics and Gynecology at the University of Michigan, led the MVC Coordinating Center through a workshop on design thinking. Dr. Peahl outlined its principles, provided personal and professional examples from her work, and facilitated a space for MVC teammates to collaborate and practice design thinking with one another.

As the MVC Coordinating Center looks ahead, design thinking will be incorporated more frequently to improve the quality and impact of MVC offerings. If your team has successfully adopted human-centered design thinking or other patient-centered frameworks that can be shared with peers across the state, please contact MVC.

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HBOM Resources Help CQIs, Providers Reduce Smoking

HBOM Resources Help CQIs, Providers Reduce Smoking

Today, the leading preventable cause of death, disease, and disability in the United States is tobacco use. National studies show that 70% of smokers want to quit, but in Michigan only about 15% receive treatment. This critical gap is the current focus of one of the newest population health Collaborative Quality Initiatives (CQIs) in the Blue Cross Blue Shield of Michigan (BCBSM) Value Partnerships portfolio. The Healthy Behavior Optimization for Michigan (HBOM) CQI aims to ensure that all smokers who are interested in quitting receive the support and resources they need to be successful.

HBOM’s mission is to make “the healthy choice the easy choice,” which is accomplished in this case by providing tobacco cessation support throughout the state of Michigan through value-based reimbursement (VBR). In 2022, nine CQIs committed to working with HBOM to provide targeted, just-in-time tobacco cessation support to seize on their “teachable moment.” This approach draws on evidence-based behavior change strategies that leverage unique shifts in patient motivation around major health events, when they may find new motivation to commit to positive health behaviors like smoking cessation.

HBOM works with hospitals, clinics, and care teams across the state of Michigan through its partner CQIs to promote healthy behaviors among patients. They also provide partner CQIs and their respective members with the infrastructure and metrics to measure the impact of these changes. Although HBOM is primarily concerned with three health behaviors (smoking cessation, healthy eating, and physical activity), smoking cessation is their current focal point.

HBOM’s smoking cessation tools and resources are available in both paper and electronic formats to ensure equitable access, and are being shared widely at the patient, physician, and organization levels. Clinicians can share these materials with patients to increase access, awareness, and utilization of smoking cessation opportunities. One example includes a “Tap for Support” near-field communication (NFC) badge (see Figure 1) that clinicians and healthcare staff can wear for patients to scan with their phone, providing them with instantaneous online smoking cessation tools and resources.

Figure 1.

Another example is the Tobacco Cessation Box that HBOM tailored to meet the needs of those wishing to quit smoking. In addition to the badges, it includes HBOM’s Quit Smoking Resource Guide Tear Off Pad (see Figure 2), which providers can use as a discussion tool for Nicotine Replacement Therapy options. The box also includes a reference guide containing a high-level overview of tobacco cessation prescription medication options and HBOM’s VBR toolkit.

Figure 2.

When CQIs and their members wish to learn more or provide support beyond the resources mentioned above, they can connect with HBOM to discuss state-wide smoking cessation metrics, best practices, challenges, and collaboration opportunities. The HBOM collaborative meets regularly with participants and partnering CQIs to address challenges and improve population health. The team is also closely connected with the Michigan Tobacco Quitline and resource recommendations delivered by text message for anyone who wishes to quit smoking.

The MVC and HBOM teams have discussed plans to include HBOM resources in future relevant MVC report communications, such as those chronic conditions that are related to tobacco use. In the meantime, hospitals and physicians can request their own tobacco cessation boxes (see Figure 3).

Figure 3.

For more information on HBOM, visit their website.

As the Michigan Value Collaborative (MVC) continues to build its offerings for members, the Coordinating Center is cognizant that many other CQIs also partner with hospitals and providers throughout Michigan. Throughout 2022, MVC will post a series of blogs about some of its peer CQIs to showcase their activities and highlight collaborations with MVC. Please reach out to the MVC Coordinating Center with any suggestions or questions.