Designing innovative new approaches to patient care

13 May 2016

At the Mayo Clinic, Inspirefest 2016 speaker Lorna M. Ross uses design perspectives to benefit clinical practices.

Why do some patients feel comfortable undergoing dialysis at home, but others insist on coming to the hospital?

The answer isn’t always obvious, but, thanks to fresh eyes on the problem, a team at the Mayo Clinic led by Irish design strategist Lorna M. Ross was able to point to factors that helped or hindered home-based dialysis.

“We spent time with the patients, shadowing and getting to know them, and we heard a lot of stories,” said Ross, who has been working at the US clinic for around seven years. “It is like field work, and from this we get insights into the choices they are making. These insights are not always the ones they articulate to their physician.”

The ‘field work’ for Project RED found that if patients had home situations where dialysis was normalised and the family accepted rather than feared the procedure then things went more smoothly, rather than if the patient felt vulnerable or threatened by having the procedure at home.

The result? A whole new set of tools to identify patients with the capacity to perform dialysis at home. “It has really shifted how they segment their patients,” she said. “They don’t just look at the person clinically and say just because we think you are healthy enough to have dialysis at home we are going to encourage you to do it – we understand you have to have the whole scenario to support that.”

Patient at the centre

The dialysis conundrum is just one of many issues benefiting from a new perspective thanks to the Mayo Clinic Center for Innovation, which uses design principles to put more of a focus on the user – in this case, the patient.

“The bank, retail and hospitality sectors know that if you understand customers you can anticipate what they need and be much more pro-active about planning,” Ross explained. “But healthcare is not really there yet.”

That’s starting to change at Mayo, thanks in part to Ross’ experience as a designer. From Blackrock in Dublin, she studied fashion and textiles at the National College of Art and Design in Dublin and started a business straight after college. Then she moved to London to study industrial and computer-related design at the Royal College of Art. “That pivoted me into the area of research,” she said, recalling her particular emphasis on wearables, including designing a ‘phone glove’ that won acclaim.

Ross moved to the US and worked for the Interval Research Corporation (a blue-skies research organisation and think tank spearheaded by Microsoft co-founder Paul Allen), Motorola and the MIT Media Lab.

At Interval, Ross worked with physicists, material scientists and engineers and found the ‘everything is possible’ culture inspiring. “That is the kind of environment people thrive in,” she said. “So, now, when building teams, I try and think about how do you create the same kind of passion, how do you empower people to be really enthusiastic and committed to what they are doing.”

Healthcare beckons

While visiting a colleague in England, Ross sat in on a meeting about issues in the NHS and tuned into the potential for design to improve healthcare. “The [healthcare] system is so complex, there are so many moving parts – healthcare became my thing,” she said.

Now at Mayo, she and her team look at healthcare delivery through a design lens, reframing problems in new ways.  “We talk about the ‘problem as stated’ and the ‘problem as understood’ as being different things,” she explained. “We acknowledge a problem is experienced – maybe patients are behaving a certain way – but this is not the root cause, this is a symptom of something else. So we reframe how we are articulating the problem.”

Projects at the Center for Innovation have included research to support wellness among caregivers of people with dementia, designing rooms to improve the experience of consultations and a phlebotomy chair to put young patients at ease when giving blood samples.

The timing can play an important role too – and the Center looks to participate when people are building new spaces or renovating. “If you are making adjustments, it is a good time to work with us because we can then make sure when you are making revisions you can optimise for patient experience,” she said.

In a less bricks-and-mortar sense, one of the biggest issues to deal with in US healthcare is the change in payment models – this is an area that needs thought, according to Ross. “The economics are changing in terms of how people are being compensated, and the entire practice model feeds into those outcomes,” she said. “How do you then adapt really ingrained, culturally-embedded practice models because you are moving the end point?”

Inspirefest is Silicon Republic’s international event connecting sci-tech professionals passionate about the future of STEM. Join us again from 30 June to 2 July 2016 for fresh perspectives on leadership, innovation and diversity. Book your tickets now.

Dr Claire O’Connell is a scientist-turned-writer with a PhD in cell biology and a master’s in science communication