Experts say that good design is invisible. Yet, whether we notice it or not, design is all around us.
When walking through the local grocery store, the location of various items is fairly standardized; for example, baked goods are typically found near the entrance (the smell of bread stimulates our appetite, and hungry shoppers buy more). Similarly, when trying to modify the personal settings of an app or website, most of us would look for our picture or maybe an icon of a head and shoulders, often in the top right corner of the screen (consistency with technology makes it easier to achieve our goals). These designs are not accidental but instead are an intentional part of the experience.
The U.S. healthcare system is so complicated that many authors would refer to it with air quotes around the word system. The way many of us experience care delivery is much less like an organized, well-planned structure and more like a hodgepodge of workflows, rules, and random groups that somehow try to keep us healthy or, if needed, return us to health. While we’ve gotten to the status quo due to various decisions, or lack thereof, to improve healthcare, we need to apply the principles of human-centered design both purposefully and thoughtfully. To that end, I’ve co-authored a book that offers up practical advice to healthcare leaders called “Designing for Health: The Human-Centered Approach.”
The lack of intentional design shows. For example, the implementation of electronic health records systems (EHRs) several decades ago sometimes resulted in unintended inefficiencies as well as physician and nurse unhappiness, highlighting the need for better-designed clinician interfaces and workflows. Similarly, roles in healthcare have often been molded by the pressures of the moment rather than by a thoughtful analysis of needs and capabilities (e.g., the lack of meaningful team-based care in many clinics and hospitals forces impractical and unnecessary work on physicians). This ad-hoc approach can lead to suboptimal patient care, inefficient use of resources, and an overall strain on the healthcare ecosystem.
This call for intentionality in healthcare design is not just about refining existing systems but about reimagining them. Intentional design involves a proactive, human-centered approach that anticipates and addresses the needs of all stakeholders: patients, clinicians, and payers. This methodology requires a deep understanding of the intricacies of U.S. healthcare delivery, coupled with innovative thinking that challenges the status quo while acknowledging the world in which we live.
To shift towards intentional design, healthcare organizations should embrace a culture of innovation and continuous improvement. This involves investing in user experience experts and human factors engineers, fostering cross-disciplinary collaborations, and adopting an iterative design approach. It also means prioritizing user feedback and continuous evolution to ensure that the solutions deliver the desired experience and business outcomes.
This move towards human-centered design isn’t just for large, sophisticated healthcare systems, and it need not be overly complicated. A key tenet in the process should be simply making it easy to do the right thing. If clinical leadership wants physicians to practice evidence-based medicine, then the informatics teams must incorporate specific recommendations into order sets with defaults set in accordance with the evidence for most patients. Another principle should be to — are you sitting down? — get rid of stupid stuff. Merely asking your staff to identify workflows, technologies, or even paper forms that perhaps made sense when they were developed but no longer serve a purpose can be a big win for the organization. Of course, follow-up and transparency are essential: If there is a reason that a particular EHR question is important, it’s crucial to get that information to the employee who made the suggestion.
The journey to intentional design in healthcare is not just desirable but imperative. By embracing intentionality, healthcare systems can move beyond the limitations of serendipitous, dated, or fractional designs to create solutions that are both effective and sustainable. This shift requires a concerted effort from all stakeholders, a commitment to innovation, and a willingness to challenge conventional wisdom. The commitment to strategically achieving success means ensuring that the healthcare industry not only meets the needs of today but is also prepared for the latent challenges of tomorrow.