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Mapping a Path to Better Health Care

"If our maps are wrong, our judgments will be wrong.” —Eamonn Kelly, author of Powerful Times: Rising to the Challenge of Our Uncertain World

design mind on GOOD is a series exploring the power of design by the editors of design mind magazine.

What’s wrong with health care? That's a big question with lots of answers: There are cost wars between insurance companies and drug manufacturers; malpractice suits and expensive technology causing doctors to raise rates; greedy and negligent providers; misaligned patient behaviors and expectations—the list goes on. I'm going to focus on the last item on that list: patient perspectives. I want you to gain insight into how you engage with the health-care system by providing you, the reader, with a design tool for capturing and mapping your own experience. It's time to stop thinking like a sick patient and more like a consumer.

The Problem Space

One of the misconceptions we have about health care is that when we access this system, we think we are engaging with institutions similar to governments or religions. We expect it to operate with common constitutions, principles, and value systems. But this is not how insurers, manufacturers, and some providers view the system. They see it as a marketplace or an industry in which patients are a factor in profit. As businesses, they have done little to convey that it is a consumer system that can offer unique benefits (and responsibilities) if you realize how it operates.

Many of us view health care as a right that should be democratically controlled and regulated by and for the people. Others see it as another free market system. No matter the economic structures of the system, all the actors involved define the quality, effectiveness, and sustainability of the system.

So to inform this system, we need to move from the mental model of “sick patient” to “consumer of health products and services.” In order to do that, we must understand our patient (consumer) responsibility of self-reporting. Dr. Ethan Basch, an oncologist who treats men with prostate cancer, suggest that “doctors, researchers, drug makers and regulators pay more attention to patients’ firsthand reports of their symptoms while they take medicines, because their information could help to guide treatment and research, and uncover safety problems.” Dr. Basch is currently working on a way for patients to become better at self-reporting by providing a vocabulary and protocol for self-reporting symptoms to the providers.

The idea here is that patients are more informed and are able to provide doctors and drug companies with useful self-reported data, making drugs safer and the system more efficient.

The Design Action

I want to build on this idea of self-reporting and take it one step further by providing you with a way to capture and map the experience of your health-care journey, focusing specifically on the (hopefully annual) trip to the doctor’s office. You can use the journey map as a tool to do so.

A consumer-journey map is a tool used by designer to understand the experience of consumers and users in the purchase and use of a product or service. It’s a liner map (with a start and end point) meant to capture the key moments in a particular experience. For instance, the journey someone takes while buying a car or a computer. What are their motivations? What do they need? What is being communicated to them? What was the purchase and use of the product like?

Instead of a designer making one about you, I want you to make your own.

Step 1: A few weeks before your appointment download and print out the two documents above. Keep them in a handy place (along with a pen) until the visit.

Step 2: On the day of your appointment take these documents with you. At the beginning of your appointment share the papers with your doctor. Explain to him/her how they made you feel and what you learned from it. Use this as a chance to get their perspective on your role as a consumer of health care.

Step 3: Send it back to us along with a note about the outcomes. We will do a follow up post in a few months showing some of your results. All results will be anonymous of course!

The goal of the journey maps is to help you see your patterns over time and prompt a better conversation with your provider and or insurer. The journey map helps to orchestrate the many fragmented touch points of our health care in one “aha“ moment. It can also provide a shared framework, that we can used as a society, for discussing the experience of being a health-care consumer.

I hope you decide to give it a try. When you are finished email a digital photo or scan of the document to

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