by Brandon Schauer
September 25, 2007
As Director of Mayo Clinic Department of Medicine SPARC Innovation Program, Ryan Armbruster and the SPARC team identify solutions that not only advance the patient experience, but also improve health outcomes. Ryan will be presenting at MX East, our experience management conference, taking place October 21-23 in Philadelphia. Brandon Schauer had a chance to speak with him about the SPARC Innovation Program, how it integrates with the larger organization, and the role of emotion in experience.
Brandon Schauer [BS]: What is the SPARC Innovation Program?
Ryan Armbruster [RA]: The Mayo Clinic’s primary value is that the needs of the patient come first. To be effective in the delivery of healthcare and caring services, we really need to have a better understanding of the needs of patients beyond their clinical conditions in order to design the best health care service experience that truly meets their needs.
And that’s exactly where SPARC Innovation Program plays a role. The SPARC program provides the Mayo Clinic with the capability to understand what are all of the unmet needs surrounding the medical condition.
BS: How does SPARC change healthcare delivery?
RA: First, SPARC identifies unmet patient needs through tools such as observational research and ethnographic studies. Then we start to conceptualize solutions, or inform or change solutions to meet those patient needs. We help our partners through understanding how the research insights can be translated into solutions that are going to provide even greater value for our patients.
BS: Can you share a specific example of translating research processes into real-world changes?
RA: The SPARC program has been in full operation for over two years, and during that time we have moved 25 major projects through the these processes. Our solutions focus on the areas of people, process, content, space, and technology. While our projects often focus on understanding unmet patient needs, we just as frequently focus on understanding the needs of staff so we can support their effectiveness in providing the healthcare services.
A recent project focused on increasing the effectiveness of our physicians during visits with patients. We began by observing physicians’ visits with patients, digging deep into how physicians practice medicine. This research resulted in a myriad of different solutions — some about different roles to support physicians in delivering that healthcare, some about different technologies that could possibly support them, some around the actual spaces and facilities.
One specific solution now being implemented is a new care team model that’s being rolled out across the entire Mayo Clinic organization. This model articulates which people are supporting physicians and which tasks they’re performing to optimize the physicians’ role.
Another outcome is the aggressive move by the clinic to upgrade to 24-inch widescreen monitors in every exam room in the clinic. This wider screen can improve physician productivity and effectiveness, but the larger display also enables doctors to better share information with patients.
BS: How does SPARC Innovation Program plan where it’s going to innovate?
RA: The choice of where we allocate our resources to develop innovations is primarily informed by organizational strategies. Our projects help Mayo Clinic better understand those strategic opportunity spaces. SPARC helps conceptualize the objectives and the tactics to accomplish those strategies.
We also might see some opportunities that aren’t incorporated in the strategies, where there might be the ability to have a positive impact on the patient experience or on the staff effectiveness. In these cases we advocate for related projects, or maybe even conduct those projects, in an attempt to really influence the organization to move in a certain direction.
BS: Can you walk through an example of a SPARC program project?
RA: A project last year looked at the medication prescription process, and how that influences patients’ adherence to their medication and their medical outcome. We know that in certain situations, a patients’ adherence to those medications is frequently the biggest opportunity space to improve outcomes. One of those situations is in diabetes medications.
When patients start on diabetic medications, they often don’t closely adhere to the prescribed protocol for the medication. In the case of diabetes that creates a particular problem because in order to really start seeing impacts from many of the diabetes medications you have to be on them for a number of months. It’s a huge opportunity to uncover what we as a provider organization might do to really improve those outcomes.
We started the project by looking at how it all starts, questioning how the prescription process works. We observed patients with diabetes going through a physician visit, where they learned about treatment, often for the first time.
Typically the process begins with the physicians breaking the news that you have this condition. In the past the physicians may have said, “These are usually the courses of treatment that are the most effective and this medication is what I recommend for you.” The patients usually nod their head and say, “Thank you. I’ll fill this prescription and start taking these medicines.” This is broad generalization, but well informed through numerous observations at Mayo Clinic and out in the healthcare industry.
We worked in collaboration with another group at Mayo Clinic focused on patient decision-making. Our approach asked, “What if that conversation — that service experience — went a little differently?” We felt there was an opportunity to influence patients’ adherence to their medications and the course of the medications. We looked for ways to incorporate the patients’ values and preferences, helping them get them a better understanding of the medications and make a greater investment in the decision.
Next we prototyped what we call decision cards. The cards listed multiple different types of factors that the patient might be interested in. Over the course of many prototypes, we narrowed the list of cards to six different things, for example, weight loss and weight gain, side effects, or their daily regimen.
Each of these concerns on the decision cards is what’s important when considering different medication options. We profiled the six to eight medication options graphically to show how each stacks up in the different areas of concern.
The conversation is now very different. The physician says, “From these six things, which are the concerns that are most important to you.” The patient will then pick a decision card. Let’s say the patient picks weight loss/weight gain as the first thing to look at. The physician then shows the graphical list of medications, indicating the ones that relate to weight gain or weight loss. The physician then asks, “What’s the next most important concern to you?” And the process continues, eventually ending up in a position where the patient now has a really good understanding of many factors involved with the medication. The patient is much more invested in the decision making process. The result? Preliminary indicator suggest that patients are much more likely to adhere to their medications and therefore there’s a significant impact on their clinical outcomes.
It’s a long story, but it shows how deep research and the development of prototypes can change the nature of how we’re delivering services at Mayo Clinic. It not only changes the patient experience, it also significantly influences health outcomes.
BS: The Mayo Clinic’s foundation is practice, education, and research in medicine, science, and evidence. How has the design-centric SPARC Program been able to take root and grow within the context of a medical organization?
RA: Mayo Clinic is open to the design-centered program because its values are rooted in patient needs. This value of patient coming first is in the hearts and minds of everybody in the organization.
Having a design program to articulate what those needs are and informing better solutions is a logical addition. That’s why design has been applied in the organization to play an important role in informing how our services are created and delivered.
BS: At MX East, you’re speaking on the informative role of emotion in experiences. How did you come across this topic of emotion, and what does it mean to the SPARC Program?
RA: Emotion is such an important element to talk about in relation to designing compelling service experiences. In a healthcare environment, emotion is often at its peak levels, mostly because of the nature of the situation that patients are in when they seek healthcare services. This is particularly true at Mayo Clinic.
What’s interesting in healthcare — as well as any service industry — is how to deal most effectively with the uncertainty of human emotions and human behavior. Emotion is complex. It’s not a rational system. As much as you want to try to design a service or a system that’s reliable and consistent, it won’t be effective if it doesn’t adapt to the many different situations that are present in the complexity of human emotions. But when you successfully design for emotion, it can dramatically influence the outcomes, such as a patients’ health.
Figuring out ways to design services that are adaptable and can flex to meet the unpredictable and rapidly changing emotions that are present — particularly in a healthcare environment like Mayo Clinic — is a remarkable kind of skill set and approach. It’s not just important to the deeply emotional experience of healthcare services, but it can be applied to any type of service. For the most part, services involve interactions between humans, and so they’re always going to be variable. So finding better ways to design services to meet those emotional needs is really critical.
BS: Ryan, thank you. We look forward to your presentation at MX East this October. Brandon Schauer is an experience design director for Adaptive Path. He speaks on, writes about, and practices design as a means to create value. He has a decade of experience developing new user experiences on the Web, desktops, and products. His passion for finding and understanding the unmet needs of customers has led him to diverse environments, from the homes of cancer patients to tunnels beneath Walt Disney World.
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