healthcare

Defining Social Determinants for Resilient Health

Kurt Ward speaking on stage at EPIC2022
Keynote Speaker: KURT WARD, Philips Healthcare Kurt Ward is a Senior Design Director at Philips Healthcare who is responsible for strategic alliances and collaborations across businesses and partners to stimulate, inspire and explore new value spaces and innovation opportunities. He is based at Philips in the Netherlands and has led global design teams for over twenty years. He was previously the Director of research at Westwood One/CBS networks in New York. Kurt’s work focuses on redefining social determinants for resilient health. To design sustainable and adaptable health systems in the future, how can we reframe our understanding of humanity’s relationship with ourselves and the natural world? Throughout his 22 years at Philips Design, he has constantly honed his skills and developed design thinking across many areas of the company. From Philips’ brand identity to helping to craft its mission and vision. From managing customer event experiences across Europe to the concept development and creative direction...

The Giving Caregivers: Resilience as a Double-Edged Sword in the Context of Healthcare

Juliana Saldarriaga speaking on stage at EPIC2022
JULIANA SALDARRIAGA A Piece of Pie In this paper we challenge an assumption about caregivers of chronic patients that we’ve repeatedly encountered in our ethnographic fieldwork: that of the inherently and permanently resilient caregiver, or a person that, driven by feelings of affection for the chronic patient, will remain strong regardless of the challenges posed by the healthcare system or the disease itself. We describe three deeply rooted beliefs that explain why this assumption is still widespread within healthcare systems: the belief in caregiving as female calling, or the fact that women are assumed to have not just a biological advantage, but an interest in caregiving, the belief in individuality, or the fact that individuals are thought to have a preexisting and inalterable identity, and the belief in the pathological origin of mental illness, or the fact that we tend to ignore structural causes and social determinants of mental and emotional distress. We provide theoretical and practical evidence to support each belief...

Amplifying Resilient Communities: Identifying Resilient Community Practices to Better Inform Health System Design

Diagram called "Strands of Health." Six strands of different colors are wound together, then unravel. The strands are labled: Environmental Health; Social Health; Physical Health; Emotional Health; Financial Health; Spiritual Health
ROMIT RAJ Quicksand Design Studio BABITHA GEORGE Quicksand Design Studio CRISTIN MARONA Matchboxology REBECCA WEST Ipsos ANABEL GOMEZ Independent Technical Advisor TRACY PILAR JOHNSON The Bill & Melinda Gates Foundation ADITYA PRAKASH Quicksand Design Studio SUNNY SHARMA Ipsos AYUSHI BIYANI Quicksand Design Studio MRITTIKA BARUA James P Grant School of Public health, BRAC University CAL BRUNS Matchboxology Globally, the COVID-19 pandemic has been an inflection point, bringing heightened awareness around the preparedness and resilience of public health systems in dealing with severe shocks. While the pandemic has accentuated the existing weakness in public health systems, for many, especially those belonging to marginalized sections of society, seeking healthcare has always been fraught with severe challenges and frictions. This paper presents the findings from a two-year design research project conducted in South Africa and Bangladesh, which studied the challenges faced by health seekers, especially those...

Hysterical Health: Building Ethnographic Expertise for More Equitable Innovation

An EPIC Talk with LUCY NEILAND, DEANA KOTIGA & ANGUS GRANT, Ipsos November 11, 8–9:30am US Pacific Time (16:00–17:30 GMT) Free for EPIC Members Ethnographers challenge the centuries-long legacy of myth and misinformation about women’s bodies that continues to shape innovation. A centuries-long legacy of myth and misinformation about women’s bodies continues to shape society…

Designing Virtual Primary Care: Desire or Dread? How Structural Forces Shape the Anticipation of Futures

MARIE MIKA GRH+DOD* ARVIND VENKATARAMANI SonicRim The COVID-19 pandemic changed many healthcare companies' priorities and dramatically accelerated the drive towards increasingly virtual health care. Grand Rounds Health*, a healthcare startup, decided the time is now to launch its virtual primary care offering. It was assumed that a rural, lower-socioeconomic population would be more eager for, and best served by, virtual primary care, given their greater geographic distance from clinicians and other assumed access deficits. However, ethnographic research revealed that it was the urban, higher-socioeconomic population who both reported far more favorable experiences with remote care and more eager anticipation of virtual primary care. This is partly due to different technological experiences and ecosystems, but more directly due to differing trust in and agency with institutionalized health care. Ultimately, this case study reminds researchers that our experiences are shaped and limited by our social positions, and that we cannot...

Investigating a Gestational Care Facility: An Ethnographic Exploration of Bio-technological Possibilities through a Retro-speculative Lens

OSHIN SIAO BHATT Design Academy Eindhoven PechaKucha Presentation: This story outlines the use of a fictional ethnography to delve into the theme of human-technology interface, with assisted reproduction as its focus. Drawing from my ethnographic experiences around reproductive technologies and clinical spaces at large, the narrative imagines a world where technologies that assist in processes of conception and birthing have become increasingly inventive as well as readily available. The story, drawing on both existing as well as retrospeculative techniques, studies, and theoretical concepts, explores the notion of a child-to-be as symbolic of the idea of birthing futures. The speculative ethnography of a clinical facility centered around assisted reproduction, in an alternative present, dives into the ‘promissory’ role played by reproductive technologies and substances, while questioning normative notions of ‘desired futures’. With its focus on technological innovations and their relationship to ever-evolving socio-cultural...

How Ethnographic Methods Make APIs More Usable

abstract design
by LIBBY KAUFER and MARIA VIDART-DELGADO, Ad Hoc LLC Ethnographic methods that center systems-thinking, how knowledge is constructed, and how knowledge is shared among communities are the best approach for developing collective digital products like APIs. Application Programming Interfaces, commonly known as APIs, connect the front-end interfaces we see when we navigate the internet (like websites and apps) to the back-end systems, or databases, that store information. APIs enable people to carry out transactions online, like purchasing goods, booking flights, or applying for government benefits. While they are invisible to end-users, APIs are crucially important to developers and to the way many websites, programs, and applications function. Like codebases and databases, APIs are objects consumed collectively and collaboratively by teams of developers who work together to integrate front-end to back-end systems, run tests, and monitor and troubleshoot integration issues. In the context of APIs, typical UX research methods...

Harnessing Empathy To Scale A Healthtech Startup During The COVID-19 Pandemic: A Case Study Of myICUvoice, A Communication Tool Designed For Critical Care

NADYA POHRAN University of Cambridge & SympTech Ltd TIMOTHY BAKER SympTech Ltd SIMON PULMAN-JONES Emergence Now AMY WEATHERUP AJM Enterprises This case study explores the scaling experience of an early-stage healthtech startup company called myICUvoice. During the Covid-19 pandemic, myICUvoice rapidly scaled from a single intensive care environment to being widely used nationally (UK) as well as globally. We explore why and how so many volunteers were motivated to donate their time and expertise to help scale this early stage startup. Specifically, we examine the roles that empathy played throughout the scaling process. There are three distinct types of empathy that we have identified in our story: em-pathos, empathetic understanding, and mass-empathy. These each had a distinct role in driving the startup forward. Importantly, we note that human-centered design (which often focuses almost exclusively on achieving empathetic understanding) will immensely benefit from considering the multiple types, and multi-faceted...

Who Cares Where?: A Pivotal Ethnographic Study for Italian Hospital Homecare

ISABEL FARINA Experientia srl ELENA MESSINA Experientia srl MICHELE VISCIOLA Experientia srl ELENA GUIDORZI Experientia srl CHIARA AGAMENNONE Experientia srl DARIA CANTU’ Experientia srl The case study presented is an in-depth view on the project “Casa nel Parco” (translated as “the House in the Park”), a three-year, European-funded project (ERDF Funds 2014-2020) in the Italian region of Piedmont that involves 4 hospitals, 2 large companies, 14 small-medium enterprises, 2 universities, and 2 private research centers. The goal is to research and innovate hospital-homecare services for elderly and ALS patients, as well as their caregivers, through the implementation of e-health solutions. The uniqueness of our case study lays on the fact that our ethnographic work was pivotal in shifting the narrative of closed hospital ecosystems (Goffman 1961); where those outside of the hospital environment are not viewed as credible or essential sources for improving the care system. In this...

Architecture Can Heal: Spatial Literacy to Protect COVID-19 Healthcare Workers

MICHAEL DOLINGER Mount Sinai Kravis Children's Hospital ASHLEY MARSH MASS Design Group In April 2020, a study of The Mount Sinai Hospital in New York City was conducted to better understand the challenge of adapting idealized infection control design guides to site-specific conditions during a pandemic. The study aimed to capture quick interventions that are working, offer a new hypothesis and framework to guide future design interventions, and share lessons to assist other medical facilities as they pursue their own necessary spatial adaptations moving forward. Three units repurposed for COVID-19 were studied. Using action cameras and cloud-based videoconferencing, clinicians helped designers remotely peer in real time to active COVID-19 units, create “heatmap” annotations of perceived risk by frontline clinicians, and conduct interviews with decision makers. The COVID-19 pandemic has challenged health care systems around the world to provide safe and effective care. Leveraging spatial design, architecture, and design...

Caregiver/Family Agency: Rebuilding Confidence, Play, Familiarity, and Passion in a Healthcare System

ADAHEID L. MESTAD HGA AMIN MOJTAHEDI HGA During recovery and transition to the ‘new normal’, the loss of agency for patients and families of patients who go through a major health disruptor such as transplant, cancer, or cardio-vascular disease can be profound. Considering this, how can acute care hospitals help solve for caregivers’ loss of agency? And what does the physicality of such effort in the confines of a hospital building look like? The goal of this case study is to (1) demonstrate how ethnographic thinking and design research can help a medical center understand the needs, values, rituals, and agency of a patients and their families; (2) show socio-spatial solutions that can support the transition to the patient’s and family’s new normal. The ethnographic study showed that the patients and families who go through a major health disruptor struggle with the loss of agency in various ways. While loss of agency can be obtuse, four themes emerged as contributing factors to the overall sense of loss: (1) loss...

Getting from Vision to Reality: How Ethnography and Prototyping Can Solve Late-Stage Design Challenges

BRADY SIH Kaiser Permanente HILLARY CAREY Winnow Research MICHAEL C. LIN Kaiser Permanente Cast Study—In 2014, Kaiser Permanente began implementing a next-generation medical office model that reimagines the outpatient care experience, combining new architecture, workflow, and technology to create a more convenient experience for patients and a connected, efficient experience for staff and care teams. As the first next-gen facilities were being built, challenges emerged as teams across a variety of disciplines attempted to translate the model's vision into reality. Teams were making design and operational decisions in parallel, without the ability to see how their decisions impacted the overall user experience. To resolve these challenges, our innovation team at Kaiser Permanente used a hybrid make-and-observe method of prototyping and ethnography. Employing a co-creation mindset (Bødker and Grønbaek 1991), we engaged staff and patients to help us bring the future state of these next-gen clinics to life in a minimally viable way....

The Transformative Power of Singular Stories: Making the Case for Qualitative Evidence in Healthcare Contexts in Colombia

JULIANA CARDONA A Piece of Pie JULIANA SALDARRIAGA A Piece of Pie MARIA FERNANDA ESTUPIÑAN A Piece of Pie PAULA GAMBOA A Piece of Pie Case Study—In this case study we describe how we collaborated with a Colombian healthcare provider company and enabled its decision makers to understand the power of stories and other types of qualitative evidence in healthcare contexts. The stories became a tool for recognizing singularities in a complex, massive system, where individuals were constantly reduced to social security numbers. We describe the qualitative methods implemented, such as in-depth interviews, projective techniques, shadowings and observations, explain the difficulty in explaining the value of our qualitative evidence and mention some of the lessons learned throughout the project. We also discuss the project’s outcomes, such as understanding the difference between user perception and user experience, the impotance of healthcare providers to go beyond healthcare and using stories as input for measuring quality of the service....

Eye Tracking in Medical Ethnography: Evaluating Evidence for Perception, Action, and Collaboration in Healthcare Professions

LARRY S. MCGRATH Design Science Consulting, Inc. Using eye tracking in ethnographic research poses numerous theoretical and practical challenges. How might devices originally intended to record individuals' vision of two-dimensional planes be useful in interpersonal contexts with dynamic visual interfaces? What would the technology reveal about collegial environments in which different levels of knowledge and expertise come together and inform decision-making processes? Why would pupil movement show us anything that conventional ethnographic methods could not? In this paper, I argue that these challenges are not intractable. When tailored to specific questions about perception, action, and collaboration, eye trackers can reveal behaviors that elude ethnographers' gaze. In so doing, the devices enrich the observational and interview-based methods already employed in ethnographic studies of workplace dynamics. Hospitals are a fruitful context in which to test the value of eye-tracking evidence. Healthcare professionals look, interpret,...