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Design Thinking Research into Integrated Care at Calvary Health Care
Telstra Silverlining Project
Dr Jeffrey Tobias Julian Kezelman e: [email protected] e: [email protected] p: 0401 890 071 p: 0430 058 069
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Design Thinking | Lean Startup | Open Innovation
“The provision of effective, efficient and coordinated healthcare that addresses a person’s phyiscal & mental healthcare needs, in partnership with the person, their family and carers, across different care domains”
Defining Integrated Care
• Supported by immediate & effective communication, processes and technology
• Requires coordination between clinicians, services, patients and their carers
Mark Doran, National CEO of Calvary, argues there are three phases on the journey to integrated care:
Journey to Integrated Care
• Connected care (system-centric care) • Co-ordinated care (clinician-centric care) • Integrated care (patient-centric care)
1) Understand communication issues in integrated care from clinical perspective
2) Understand how problems prevent optimum care outcomes for patients
3) Observe integrated care in real time to develop insights and solutions
4) Develop solutions to solve real problems in a meaningful and insightful way
5) Apply design thinking to research development of integrated care solutions
Objectives of Silverlining
Quotes from Project Launch Event “The days of big
technology companies saying
we have the answer are gone”
“What is the key form of
communications between hospitals &
GPs?”… “Fax!”
[To achieve integrated care]… “eat the elephant one bite at a time”
“The risk of not changing is so great that we must take the risk towards change”
When Integrated Care Fails
Project Stakeholder Motivations
Highest quality of integrated care
Design thinking model for integrated care
From carrier to solutions provider
Traditional Solution Development Cycle
Define Design Develop Deploy Drink
Design Thinking in Silverlining
ENGAGE
Observe clinicians, recorded in notes, video & audio
Distil insights from data to define unmet needs & problems to be solved
Workshops to brainstorm some solutions
Storyboard best solutions to problems
Ongoing
Diverse group of Calvary clinicians, service providers & administrators
Areas Participating
• Emergency
• ICU
• Palliative Care
• Medical Ward
• General Practice
• Community Care
• Aged Care
Our trained observational
researchers spent time with each of the participating
areas of integrated care
The observers documented daily
routines, observing their experiences in
coordinating care across care settings and boundaries
Observations
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Workshop One – Extracting Unbiased Needs and Insights
INSIGHTS • Fragmented system brought together by sheer will power of team (Personal smartphones) • Huge potential to use video conference/social media to connect, to educate, to support, including clinical,
emotional and spiritual perspective • Patients in palliative and terminal phase present in all care settings and there is little support for clinicians/
patients/families outside of palliative service • Require information sharing on medication management et al between acute/aged care and palliative care • A different approach needed to address large geographic region and limited resources • Lack of communication technology • System not geared for transition of care from Hospice –to home – to hospice. Who does the continuity of care
remain with? • Not geared up for mobility and visiting patients – communication/gps/access to internet/email/notes/safety
NEEDS • Universal medical record access – aggregated view of clinical and non clinical needs • Point of contact data entry • Ability to deliver telecare/telehelth and tele-coordination • Communication for all of the family • Streamlining assessment criteria and dissemination of to relevant funding bodies • Access to modern technology to support mobility • Palliative care principles embedded in training for all clinical disciplines • Need for advocate role to co-ordinate services and represent the interests of the individual
PALLIATIVE CARE
Workshop 2: Structured Brainstorming
I hope, in my last stage of life, that my extended care team and family has access to resources that
enable them to know what to do, and when
Time to Implement
6-‐12 Months
Redefine PalliaEve Care
Connec&ng the Eco-‐system
SOLUTION
Issue No, sorry! They won’t!
1. Complete in-building coverage 2. Context based, rich portable patient records 3. Multi-platform, multi-device integrated
messaging 4. Dynamic, multidisciplinary scheduling solution 5. Closed community social media
Five solutions
Delivered an MVP - ‘Huddle spot’
§ Legacy systems seriously obstruct innovation and integrated care
§ Technology procurement process is broken § Challenge of delivering care while innovating § True integrated care is going to be a very long journey § Clinicians crave technology more now than ever before § Integrated care is multi-faceted – including the need for
policy change
Clinical Learnings from SilverLining
Patient-centric design thinking research is next big opportunity
§ Design Thinking an exceptionally valuable process § Jumping to the solution to be avoided at all costs until the
time is right § Using impartial observers vital § Solutions based on fact rather than opinion § Process gains huge buy-in from stakeholders § Process needs careful scripting and monitoring – with
exceptionally valuable outcomes
Process Learnings from SilverLining
Patient-centric design thinking research is next big opportunity
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Dr Jeffrey Tobias Julian Kezelman e: [email protected] e: [email protected] p: 0401 890 071 p: 0430 058 069
20
Design Thinking | Lean Startup | Open Innovation
