The Isles of Healthcare
on June 27, 2009
From modulism
by Claudio Luis Vera
A travelogue from the Isles of Healthcare (part 1)
To this designer, the past couple months have a been a strange trip to the surreal island that is the healthcare industry. While the rest of the world has been shaped by gut-wrenching change, healthcare has been on its own virtual Galapagos, evolving at its own pace.
The world has caught up to this island oasis, bringing with it the Darwinian forces of technology and the market, threatening the industry's very sustainability. It needs to cope quickly -- and embrace survival strategies that have worked for the rest of the world.
Information architecture, not information technology
On the island, "healthcare IT" or HIT is the catchall term for any sort of information flow that happens between patients, clinicians, hospitals and insurers. It's a bit of a misnomer, as it places the emphasis on machines and protocols -- and not on the ways that information is structured and understood by humans.
Information architecture is about mental models, user experience, and usability; it's about making the technology invisible. Much as you don't think about the pistons or spark plugs as you're driving, information architecture affords the user enough abstraction to not have to think of the machinery behind the system.
At best, a focus on information technology would provide proper data flow around the island. A purely IT-driven restructuring would still require another round of innovation to make that data usable by average, non-expert healthcare workers -- as well as patients.
Make applications more democratic
Current systems demand an exaggerated domain knowledge on the part of their users. That's a holdover from the days of the high priests in the lab coats, the ones you'd find in front of a mainframe or sporting a stethoscope. The Web has since opened up that, as different uses in different roles can interact simultaneously with today's Web apps.
Front-end interface tools built on such technologies as AJAX and autocomplete allow the user to look up choices interactively as they're entered. Business logic allows for comparison with other alternatives as in Amazon's "People who purchased X also chose Y". When well-implemented, data visualization allows us to see patterns and correlations we didn't before. Combined, all of these tools can drastically lower the barriers to being effective -- opening up new roles for patients to participate in healthcare.
Imitating competitors is not a best practice
It hasn't done much for the life expectancy of the lemmings and herds of sheep on the island.
Sadly, I've encountered this strategic mistake in countless client engagements, especially when dealing with the Web. Just because competitors A and B choose a given practice or strategy doesn't make it wise. Market research usually exposes this fallacy, even if it's limited to a score of phone interviews with well-chosen stakeholders.
I've particularly found that research is necessary when users and stakeholders see little value in what's being offered (e.g. medical data). While it speaks of a disappointed public, it's also tremendous opportunity to pull ahead competitively.
My shore party is heading back to the ship. I'll post more when I'm back on the island with the naturalists.
(to be continued...)