The COVID-19 pandemic has re-shaped not just the healthcare industry, but also the entire patient-practitioner relationship. For a long time, patients have been passive recipients of healthcare, and the ‘user journey’ (if anyone actually thought about it in those terms) went something like this: patient has a problem, patient seeks medical help, practitioner dispenses advice or medication, repeat. There wasn’t much interaction or autonomy from the patient, and innovation mostly went into improving the quality of treatment, rather than the process of seeking it.
This might all be about to change. Thanks to the pandemic, healthcare organisations have been forced to reassess the way they interact with patients, and how patients interact with them. This falls broadly under the umbrella of ‘service design’. Service design is a user-centric discipline that (basically) tries to improve the quality of a particular service, based on users’ individual needs. In other words, service design could make healthcare better. Better for patients, better for practitioners, and better for outcomes.
So how might that look in practice?
“Service Design presents an amazing opportunity to address equity, access and quality of health services provided,” says Kate Okrasinski from MAKE, a design thinking practice based in Hong Kong.
“Service design begins with understanding what someone seeks to achieve and the needs, ambitions, desires and abilities that inform how they will achieve that goal,” Okrasinski says. “In a post-COVID age, service design will help inform what services should be digitised to improve access, equitability and impact of health services.”
In some ways, we’re already seeing the results of this mental shift. Healthcare, although obviously a crucial part of society’s infrastructure, is similar to any other service: it has users, and those users have needs, and the goal of the service should be to meet those needs. In 2021, the Mayo Clinic’s OB Nest prenatal research program trialled this approach with a new, low-risk pregnancy care model.
"In this new model, a low-risk pregnant mother receives at least half her prenatal visits in her home, or her nest," said Yvonne S. Butler Tobah, M.D., a Mayo Clinic obstetrician and OB Nest research program leader. "We're seeking to de-medicalise prenatal care experience elements not needing a medicalised process. We're looking to empower women and offer them more home-based care."
By using online communities, home visits and in-home monitoring, pregnant women in the Mayo study became more active in their own healthcare. Not only did the quality of patient experience improve, the new approach actually reduced strain on the clinic’s resources: at-home patients only needed 3-4 appointments per person, as opposed to 12-14 under the old model.
Prenatal care is just one example of service design in action. During the pandemic, we also saw telehealth become a crucial cog in Australia’s healthcare machine. Between 2020 and 2021, according to the Australian Bureau of Statistics, about a quarter of Australians reported using telehealth to consult with their GP. ABS health statistics spokesperson, Robert Long, added, “In 2020-21, of those who had a telehealth consultation, 83.4 per cent reported that they would use telehealth for a consultation again if it was offered.”
This sort of innovation is particularly important for mental health treatment. In fact, Okrasinski says mental health presents the biggest opportunity in terms of service design: improving patient outcomes by seeing mental health treatment not as a transaction, but more a user journey. “While there is a fascination and excitement for digital services, we are seeing massive innovation happening in the quality, form, and structure of mental health services,” she says.
Okrasinski is quick to point out, however, that ‘service design’ doesn’t necessarily mean simple digitisation. You can’t just throw a health service on Zoom and call it a day. Do that and you risk undermining the “sense of connection and humanity required” in a modern healthcare. “Rather,” Okrasinski says, “the real opportunity lies in reinventing how human services are scaled, supported and distributed. We are seeing emerging start-ups challenge the concept of a clinic, and leaning into holistic patient-centred care models.”
Service design, as applied to healthcare, is really just scratching the surface. What the experts agree on is that, if we’re going to improve the overall health service model, we need to keep a few things in mind. First and foremost is quality of care. Second, we need to involve stakeholders in the creation and ideation of these new service models. That means patients, practitioners, administrators, nurses, support staff, carers, everybody. All perspectives are important, all are valid.
We’re already seeing some strides in this space. For example, the Danish Design Centre, when tackling the concept of future healthcare scenarios, actually built prototypes in shipping containers, and transported those containers to the construction site of a new hospital, to help influence decision-makers and get on-the-ground feedback.
Finally, we need to remember that healthcare carries unique design challenges. It’s not simply a series of product-consumer interactions. It’s all the moments between those interactions. It’s general quality of life, it’s ongoing support, it’s family and friends.
“While still in its infancy, service design is helping build the experience models and business efficiencies required to transcend just treating disease,” Okrasinski says. “Instead, it’s reinforcing health environments, habits and communities.”