healthcare

The Power of the Fringe: Why Ecology Research Should Include Auxiliary Actors for Truly Powerful Results

by CAMILLO DE VIVANCO and GAYATRI SHETTY, ReD Associates Through years of research and work for the healthcare industry, we’ve come to experience the power of the auxiliary actors. The industry often overemphasizes the classic dyad of patient and primary health care provider, missing actors on the periphery who have frequent touch points with patients and frequently play a larger role in delivering care to patients than the actual healthcare professionals. Take, for example, Benjamin, a health technician we observed for a full day in Paris. Benjamin spends his days driving from home to home, delivering in-home medical equipment to patients, as well as checking in on those who have notified his company of problems with the equipment they have been given. On average, Benjamin visits anywhere between 5 and 15 patients in a day, depending on the tasks he is assigned. Benjamin, like many technicians we observed in our ethnographic fieldwork, consistently moves beyond his remit – spending significant amounts of time training...

The Inhuman Condition: How Research Unlocked New Perspectives on Psoriasis and Began to Change how it’s Understood and Treated

SARAH KELLEHER Truth Consulting Case Study—This case study highlights the value of exploring the reality of having and treating psoriasis. Its aim is uncovering why it is that, despite treatments being available that offer transformative results, people with psoriasis can continue to live in isolation and with feelings of shame. If clear skin alone isn't enough, what is it that can help create a sense of well-being? Even undertaking a piece of work like this represented a significant step forward for the pharmaceutical industry where, historically, investing in this kind of deep patient insight work hasn't been common and where getting buy-in to the outputs is far from certain. How can sight lines be created and developed, particularly from physicians to patients? Explored in this case study are not only the ethnographic and other methodologies used, but also: some of the challenges in bringing together this encompassing piece of work; the strategies and efforts made to ensure that core audiences engaged with the research;...

Taking Sides in E-cigarette Research

RACHELLE ANNECHINO Critical Public Health Research Group, Prevention Research Center TAMAR ANTIN Critical Public Health Research Group, Prevention Research Center In the last ten years, an eclectic mix of electronic nicotine delivery products (‘e-cigarettes’) and practices have proliferated in the US with little restriction, producing a vast array of vaping mechanisms, flavors, and styles. At the same time, anti-tobacco movements have targeted e-cigarettes as a threat to public health and advocated for restricting e-cigarettes in much the same way as conventional cigarettes. While anti-vaping proponents associated with public health movements have typically regarded e-cigarettes as primarily harmful products that should be suppressed, vaping advocates regard e-cigarettes as harm reduction products that should be readily accessible to smokers. Distrust between these two warring “sides” animates the controversy over e-cigarettes. In our role as researchers conducting a qualitative study on e-cigarette use, we encountered...

Ethnography Is the Path-Maker to Better Care: Paving the Way to a Patient-centric Healthcare Model

CIARA GREEN Experientia LAURA POLAZZI Experientia ERIN O’LOUGHLIN Experientia VITTORIA TRAVERSO Experientia This paper presents a clear and flexible model for understanding the concept of patient-centricity. This model emerged from our own ethnographic work in healthcare contexts, and was tested and strengthened with a literature review and interviews with experts and thought leaders in the healthcare industry. Our model posits that patient-centric care should be Personalized, Hassle-free, Active, Collective and Transparent (PHACT). Hospitals, payers, clinicians, Pharma and MedTech divisions (among others) can use these pillars as a guide to drive their transition to patient-centricity. The underpinning principle for the PHACT model is that ethnographic inquiry is the necessary path-maker for each stakeholder to understand the best ways to implement and maintain these five pillars of patient-centric care in their particular healthcare context....

Finding a Voice in Opiate Addiction: Identifying the Role of Caregivers in the Recovery Process for VIVITROL

GAVIN JOHNSTON InTouch Solutions Case Study—Opiate addiction is a significant public health crisis. In the past year, it has become a hot topic at all levels, including the political realm ahead of the presidential election. Triggers, treatment options and restrictions, the criminal justice system, and costs to society are all part of the discussion but the cultural milieu in which addiction occurs is poorly understood. This was a significant problem for our client, the maker of a monthly injectable that inhibits the ability of an addict to get high. Our client, basing their marketing strategy entirely on quantitative data, realized that they needed to get a deeper understanding of addiction and the roles caregivers, friends, and family play in the treatment and recovery cycle. Our team convinced our client, who was inherently nervous about executing qualitative work, that in order to create a meaningful marketing plan, they needed to understand the complexities at a deeper level than data could provide. Working with the client...

Strategy as an Unfolding Network of Associations

TOM HOY Stripe Partners TOM ROWLEY Stripe Partners Cast Study—This case explores a business strategy development project run by Stripe Partners for a London-based online healthcare company, Dr Ed. The first part lays out the details of the process: an intense four-day ethnographic research programme called the ‘Studio’ involving the Dr Ed senior management team. The second half reflects on the outcomes of the process one year on through a series of management interviews, and evaluates the contribution the Studio made in relation to the new business strategy. The evidence from the case suggests that the concept of strategy can be reappraised. From strategy as a static set of choices made at a specific point in time to strategy as an unfolding network of people, shared experiences and artefacts that is constantly being remade. The primary benefit of the Studio approach is its capacity to initiate, align and catalyse a ‘strategy network’. Studios are effective because they combine ethnographic encounters with collective problem...

‘It’s Not Just about the Patient’: A ‘360° Feedback’ Ethnography of Chronic Care Knowledge Generation

JYOTIRMAYA MAHAPATRA Xerox Research Centre India, Bengaluru NIMMI RANGASWAMY Xerox Research Centre India, Bengaluru SAJAL NAGWANSHI Xerox Research Centre India, Bengaluru The paper attempts to offer a method to consistently monitor and capture a data eco-system in the everyday of a patient-caregiver relationship. We offer an account of the capture and intermeshing of different types and quality of data sources and their gainful deflection into a methodological protocol for ethnographic engagements. We call this the ‘360° feedback’ ethnography and elaborate its underlying methodological process in this paper. Building on the live feedback obtained from various stakeholder activities in a care ecosystem, we propose how a 360° feedback can enrich regenerative knowledge....

“Hey, the water cooler sent you a joke!”: ‘Smart’, Pervasive and Persuasive Ethnography

by NIMMI RANGASWAMY, SAURABH SRIVASTAVA, TEJASVIN SRINIVASAN & PRIYANKA SHARMA (Xerox Research Centre, Bengaluru, India) Article 6 in the series Data, Design and Civics: Ethnographic Perspectives How must we conjure up smart spaces? ‘Smart city’ has become an over-indulged urban metaphor, whipping up an apparition of dispersed, highly networked and interconnected socio-economic, infrastructural and communication nodes. The smart city narrative seems to dwell on the idea of cites as ‘receptacles for technology’—and qualitative transformations are brought about by the application of technologies. Even after decades of research to the contrary, we still tell ourselves stories about the inevitable march of technology and its deterministic effect on culture and behavior. But aren’t cities also places that give birth to technologies? As researchers we are drawn to the miraculous nature of technology to sense, track and quantify not only human use of infrastructure but also the human ‘self’. We are working to...

From Inspiring Change to Directing Change: How Ethnographic Praxis Can Move Beyond Research

CAROLYN HOU ReD AssociatesMADS HOLME ReD Associates This paper reflects on the evolving nature of ethnographic praxis in industry and argues that we must move beyond research and towards strategy in order to elevate our praxis, and to deliver real impact and value for our clients. Although this conversation is not new for the EPIC community, there has been a lack of models and examples – even in its tenth year – for how to do so. Taking a project with a medical device company that manufacturers voice prostheses for laryngectomees as a case study, we show how a team of social scientists used “Sensemaking” to determine a new commercial direction for innovation and to design a five-year portfolio strategy for our client. In doing so, we illustrate how our praxis can do more than deliver research insights or design, but also act as the core foundation that defines business processes and strategy....

Enriching Ethnography in Marginalized Communities with Surrealist Techniques

ANDREA JUDICE Núcleo de Multimídia e Internet, University of Brasilia, Brazil MARCELO JUDICE Núcleo de Multimídia e Internet, University of Brasilia, Brazil ILPO KOSKINEN School of Design, The Hong Kong Polytechnic University, Hong Kong This paper describes two projects, Vila Rosario and Vila Mimosa, two pieces of ethnographic research that aimed at improving public health in poor corners of Rio de Janeiro, Brazil. The research sought to improve public health in these two marginalized communities in Rio de Janeiro. The main objective of the paper is to explain how Surrealist techniques can be applied to enrich ethnographic fieldwork. The broader question of the paper is the tension between these imaginative techniques work with fieldwork, a tension that goes back to the disciplinary differences between design and the social sciences....

BarnRaise: IIT Institute of Design Creates Systemic, Transdisciplinary Collaborative Models

by ROXANNE KNAPP, IIT Institute of Design The Institute of Design (ID) at the Illinois Institute of Technology is building thought leadership and practice around using design to innovate for humanity’s most pressing, confounding issues. The world faces daunting global challenges—complex, fast-changing, and unpredictable problems—that design strategy is uniquely poised to address. Our students explore how the practice of design is evolving in response to large-scale economic, social, and technical changes. Our faculty teach methods and frameworks that support an emerging kind of design, one in which designers coordinate relationships between systems and foster conditions in which ecologies can grow. For over a decade, ID graduate students curated the Design Research Conference, which brought together a growing community of design professionals advancing the role of design research in innovation. Then in 2014, a group of students saw an opportunity to re-envision the event, aligning it with the changing role of design and two...

Voices, not data points: building connections between clients and informants to create impact

by MARIA CURY, ReD Associates Camila sat down on her faded pink sofa, unwrapped the bandage around her calf, and showed me a violet wound, some of the skin crusty and some of it wet. Her daughter Cecilia sat on the edge of a chair in the corner, filling gaps in the story – “remember we tried a gel that inflamed your skin,” “the pharmacy down the street never gives us enough gauze.” At ReD Associates, we often work with big healthcare companies who seek more patient-centric approaches to product design, and our insights have implications on product, packaging, and patient-compliance. This project aimed to make wound care products relevant to more people by understanding how patients care for chronic wounds in emerging markets. Camila, a sixty-four year-old Brazilian patient with a venous leg ulcer, was doing everything wrong. She risked infection by putting olive oil over her calf (“I know I’m not supposed to, but it’s the only thing that takes away my pain pain pain”); she used dry gauze with wisps that stuck...