Design Future Now: Episode 4
Design Future Now: Episode 4
Design Future Now: Episode 4
By Lee-Sean Huang January 27, 2020

Design Future Now: Episode 4

Kim Erwin on Healthcare Delivery Design

Design is about systems modeling and aligning the human beings that go to work every day and want to do a great job and making it easier to do the right thing. And I find that telling stories of design, small, powerful stories can cut through a lot of the abstraction that words bring to the situation.

 

Lee-Sean: You are listening to Design Future Now, a podcast about designing the future and the future of design. I’m your host, Lee-Sean Huang, design education manager at AIGA, the professional association for design. 

We are continuing our conversations around the theme of healthcare as an area of interest and potential career paths for designers. 

In our previous episode, in case you missed it, I interviewed Miya Osaki and Tina Park about their design practice. They run a studio called Diagram, where they help healthcare organizations design for behaviors and transform patient experiences. Miya and Tina also teach at the School of Visual Arts, and they have their own podcast called Yah No, where they share their experience as design entrepreneurs working in healthcare.  

But back to this episode, our guest this episode, who you heard earlier, is another designer and educator working in the healthcare space. She’ll introduce herself and we’ll jump right in.

Kim: My name is Kim Erwin. I am a co-director for the Institute for Healthcare Delivery Design, which is located at the University of Illinois in Chicago. I'm also a research professor at the School of Design at UIC as well and spent 10 years in a full teaching load and teaching capacity at the IIT Institute of Design before leaving and moving into healthcare.

Lee-Sean: Kim, welcome to Design Future Now and thank you so much for being here. To kick things off, why does design in healthcare matter? What brought you to healthcare as a designer?

Kim: I can't imagine a field that is more human-centered than healthcare. And the professionals who are drawn to healthcare: the doctors, the nurses, the administrators, the policymakers, the pharmacists, the medical techs, you know, these are people who love and are trained in components of it. They have a deep expertise. 

I think what they feel unprepared for are the challenges of dealing with a system that is measuring them not on the care they're delivering from a patient's point of view, but from a quality point of view, and a billability point of view. 

And what designers can bring to that is a perfect complement. So these people with deep expertise in a technology, in a set of diagnostics, in a knowledge base, and design comes in and says, “we know how to translate that to the human context of care.” We can improve the situation for frontline clinicians. We can improve the situation for patients. We can bring human-centered thinking to a very fundamentally human-centered field that if you asked most people in it don't feel is very human-centered.

Lee-Sean: As a designer myself with no background in healthcare at all, except maybe for being a patient, or being the friend or family member of somebody who’s had to use the healthcare system, I find it really intimidating going into a space with so much deep expertise, specialized jargon, all sorts of gadgets and devices that I totally don’t understand in these complex systems. 

So my question is, besides just diving in and learning about the subject matter, what are some things designers can do or should know to prepare themselves for a career in healthcare?

Kim: I think for designers to prepare themselves for healthcare, there are a number of things that need to come together for them. One is that you have to be curious about the domain of healthcare. The naive mind of the designer, which sometimes can be really helpful in disciplines or industries that need a new idea about how to connect to their customer base. That's not very helpful in healthcare. 

You really need to understand all the invisible forces: the policies, the payment systems, the performance measures that doctors and healthcare systems are held to. Those are all invisible, and so you can go in and watch a patient and provider interact and not understand all the invisible forces that are creating that context. So you have to be curious about the business models. You have to be curious about the policies and the procedures. And if you're not willing to be curious about all these forms of expertise, it's probably not the field for you.

You also need to know that you are designing for a multisystem, a system of nested systems. And designing for a multisystem means that you need to be able to manage complexity. You need to know how to do systems modeling. You need to understand the interconnectedness of all the different components that you might be thinking about changing and how would changes in one area will cascade into others. 

You also need to know how to manage stakeholders. Healthcare is a very human-centered, stakeholder-intensive environment. And so, I think designers who are excited about new ideas and even complex new ideas, have to be just as excited about the people you’re asking to implement them and to engage those people early on, not after your idea is done. They need to be part of designing your idea.  

So, in addition to developing your skills at concepts and developing concepts, you need to develop skills about handling humans and engaging people and making them feel valued and bringing them in and not believing that you are going to save them, that you are a complementor to a great, diverse set of expertise. And learn how to navigate that and create leadership through that. 

Lee-Sean: So, on the other side of things, how do you communicate the value of design and what designers do in healthcare spaces to folks like doctors and hospital administrators, who might have their own conceptions (or misconceptions) about what design is and what we actually do?

Kim: How can we communicate the value of designers to all these administrators and doctors is a great question. I'm still working on it. I will say that, of course, the conception of designers is that we make beautiful things. So I often start there. I say, “you know, I don't make teapots. I don't make fashion. There are people who do that and I buy their products, but that's not what I do.” 

And I start explaining, that design is about systems modeling and aligning the human beings that go to work every day and want to do a great job and making it easier to do the right thing. And then I often tell a story and I find that telling stories of design, small, powerful stories can cut through a lot of the abstraction that words bring to the situation. Giving them examples is helpful. 

And the other thing is. I have the great fortune of having a great space. I have 7,500 square feet, for my institute. And what I do as best as I can and as often as I can, is I bring people into my domain, and I show them and showing people work and showing how the teams are working and looking at the full scale imagery we have, they start to understand the worldview is very different than the one that they have adapted to. 

And I think that most people who are leading that world, even if they love their job, they don't really believe they're working in a system that is working for anyone. So when they see our space or they hear our stories, I think they feel the optimism that design as a field brings to a very tired and burned-out field like healthcare.

Lee-Sean: Now we are coming upon what I call jokingly my life and death questions. First life. What’s giving you life right now? What’s inspiring you to get out of bed and go to work in the morning?

Kim: What inspires me every day, I have to say, you know, I've been around the block a few times. I've been working for decades. I am inspired by the healthcare providers that I work with. I have never seen such a group of talented mission oriented people in a mission that, by the way, design very much mirrors that idea of giving a quality experience to everyone.

As somebody who has done systems design, it's painful to watch broken systems. You just look at the consequences of the pile up of bad decision making on the frontline clinicians and the patients that they serve. And I find and draw great inspiration from people who come to work every day and use systems that are really not optimized in any way to support them, and in fact, quite the opposite and still come to work and still managed to deliver great patient care, despite not having even basic supports, that feed their spirit or create efficiency. And so I think they're heroes.

I am honored to come in and figure out how to make a small modifications. I don't care if it's a drop down menu in the EHR, which was one of my great achievements of 2018 was getting a dropdown menu installed, to facilitate patient transfer. 

Lee-Sean: Acronym explanation: EHR stands for “electronic health record.” 

Kim: These are things that have a scale effect. Small things have a scale effective medicine. you can make one small modification and they can affect. Thousands and thousands of people going forward. And that to me is inspiring.

Lee-Sean: And final question: Death. What myth would you dispel about design? What misconception would you kill off?   

Kim: I don't know that I want to dispel issues in medicine about design. I feel like designers need to earn their place at the table. So I would like to spell dispel some issues for designers, which is, designers are not the hero of the story. And I think that design's mission and passion for work can sometimes bring a zeal that is, a little tone deaf to, like I said, these enormous amount of heroics that people every day do in healthcare.

So you're just one more hero in the scene, and understanding your role and being attentive. And listening carefully for the opportunities to facilitate and bridge these worlds, is something that designers, I would encourage them to tread carefully and not walk in with this mission oriented idea that they are going to save healthcare.

Healthcare doesn't need saving from any one person that needs all of us to save it. So we have to work in collaboration. And I think the other is the idea that the problem for designers is thinking that they have identified a problem, no one else's identified. That is not my experience. My experience in healthcare is everyone knows exactly what the problem is.

They live it every day. They're not unclear on the issue. I don't think design's contribution here is identifying the problem. Design's contribution is stepping back and saying, “how do we make it better and easier to do the right thing here” and thinking in these systems solutions and then helping advocate for them.

Because it's not that people don't want to change. It's very difficult.

Lee-Sean: Kim Erwin, thank you so much for joining us and sharing your work with us, for the insights, for the inspiration. 

And thank you listeners for tuning in. We are experimenting with different episode lengths and show formats, and planning our guests for future episodes. We would love to hear your feedback. You can email us at podcast@aiga.org or leave us a voicemail on our podcast page at anchor.fm/designfuturenow. Your message could end up on a future episode of Design Future Now. 

If you are listening on Apple Podcasts, please give us a rating and a review, it helps like minded listeners find our show. Or subscribe to Design Future Now on your podcast platform of choice. You can also find us, DesignFutureNow on Instagram, Twitter, and Facebook.   

Design Future Now production of AIGA, the professional association for design. We hope to see you at the AIGA Design Conference in Pittsburgh, Pennsylvania, March 30 to April 1, 2020.  

Special thanks to John Snowden, who helped with recording this episode and to Meredith Davis and Randa Hadi who hosted us at NC State University where we recorded our interview with Kim Erwin. 

And once again, I’m your host, Lee-Sean Huang. Until next time on Design Future Now! 



 

 

 

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