Research & Design Strategy

Healthcare service design: Five failure modes to avoid

When it comes to designing patient services for health care, we have the best intentions.

But sometimes we get in our own way when it comes to creating good design. Here’s a few failure modes to watch out for…

1. Mapping only the clinical journey. A patient’s health and wellbeing are comprised of so much more than symptoms. Don’t forget the financial burden. It’s different for every patient and can change significantly throughout a patient’s journey – how she starts is not necessarily how she will be at different points throughout or at the end. Treatment costs change throughout the journey and the patient’s income (or the caregiver’s income) changes, too, as work is missed and benefit status changes. To illustrate how much financial toxicity worries Americans, a recent study by Amino and Ipsos found that Americans are just as worried about a medical bill they can’t afford as they are with being diagnosed with a serious illness.

For example, a cancer patient may have great commercial coverage, but may lose it if she needs to file for disability or has to stop working. Or caregivers/family members may have to miss work or stop working to take care of the patient, contributing to more financial stress. Financial assistance foundations can lose funding. After surviving diagnosis and treatment, a third of cancer survivors experience financial hardship that can put their physical and mental health at risk, according to a 2016 study published in CANCER.

In recent years, as treatment costs continue to escalate, financial toxicity is increasingly considered an adverse event of cancer care. The pain extends beyond cancer patients to all consumers of health care. The average family premium has risen nearly 20 percent in the last five years, according to the Kaiser Family Foundation. Between 2005 and 2015, out-of-pocket costs such as deductibles, co-pays and co-insurance, have risen 66 percent, which was more than twice the rate of wage growth during that period, according to Kaiser. When we neglect the financial journey of patients, we ignore a significant factor that could greatly impact quality of life.

2. Neglecting to invite legal to the meeting. Legal always gets a bad rap. We tend to think of them as the department of “no.” I’ve planned plenty of workshops or milestone meetings and when I ask clients who we can invite from legal, I often get a look like I have three heads! There’s an assumption that having legal in the room will stifle innovation. But what I often see is worse than that – a team spends several rounds ideating without legal and then when ideas are presented, they are shot down. Co-creating with legal earlier helps surface some very important design criteria that we can use to inspire rather than stifle innovation.

We not only need to put ourselves in others’ shoes, but we must recognize all the shoes there are in a patient’s journey.

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