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SDN Touchpoint Vol. 6 No.

2 –
Better Outcomes
Outcomes by
by Design
Design
Main Takeaways

CONTENT SUMMARY
Capture User Experiences As they happen�
Using smartphones to gain user insights
Humanising Healthcare through hands, heads and hearts
Using Patient Insights to design future health solutions
Collaborating with patients through online communities.
Exciting Times to be in healthcare
Service Design work-out on innovation in healthcare
Health Matters: Reframing Design in Community Health Interventions
5% Design Action’: Cancer Screening Service Innovation in Taiwan
Interview: Geke van Dijk and Bas Raijmakers
Better outcomes by design

CAPTURE USER EXPERIENCES AS THEY HAPPEN�
Using smartphones to gain user insights
For more information please refer to pages 17-18 of this PDF.

75 %
Smartphone and tablet
penetration has risen to
seventy-five percent in
developed countries, paving the
way for mobile research to
become a serious alternative to
some more traditional methods.

Smartphones allow us to capture
data that is both real-time richer
in content, bringing us closer to
the moments when and where
experiences actually happen.

Whilst mobile research
participants won't give long,
drawn-out responses, it is
possible to keep 'checking in'
and to capture feelings and
behavior over a period of time –
weeks, for example – as opposed
to more traditional research,
which relies on spending an
hour or two with a respondent,
or an evening at most.

” I get the feeling that they’re not always crystal clear on what that means.Humanising Healthcare through HH AANNDDSS E EAADDSS EARTS EARTS For more information please refer to page 19 of this PDF. records in a CRM system. And while lots of healthcare companies are talking about “humanising the healthcare experience. They are people. HEAD HEART HAND Patients aren’t just lines in a spreadsheet. Kerry Bodine . or the list of ailments in their medical records.

But of course. Hands: by using wearable body monitors that track everything from miles walked and calories burned to the quantity and quality of a person’s sleep and so on. Specifically. I’m educated. Heads: Healthcare providers should aim to make every single patient (and payer) interaction as easy as possible. a U. health service providers need to connect with their patients.To develop meaningful relationships and improve medical outcomes.” Hearts: Medical providers need to understand their customers’ underlying emotional drivers — both on the aggregate and individual levels — and make sure that the patient experience is aligned appropriately. the real challenge now comes in developing useful services that will allow us to improve our health by taking full advantage of our quantified selves. how to file a claim…” Being the young entrepreneur that he is. and design. understandable. “I opened my insurance bill one day and I realized that I had absolutely no idea what it meant.S. they need to touch them at their hands. HH AANNDDSS EEAADDSS EARTS EARTS . His goal was to “make it simple. heads & hearts as follows: For more information please refer to page 19 of this PDF. transparent. and relatable primarily through technology. Josh decided to create a new type of health insurance company — from scratch. I run a growing business. data. To make health-related wearables a reality. and I didn’t know what my benefits were with doctors or hospitals I had in my network. companies have had to overcome significant technical challenges like shrinking sensors and extending battery life. Good case: Josh Kushner. founder of venture capital firm Thrive Capital shared his frustration with the health insurance space during a recent interview on CNBC’s Squawk Box. cable news program.

Collaborating with patients through online communities. Raise public awareness: Patients are not ‘armed’ to educate their broader circle of friends and acquaintances about their condition and its impact. feel better supported socially and more empowered �Articulate their status and talk to others. Three potential routes for UCB to facilitatepatient communication: People with a chronic condition are increasingly taking active control of their health. For more information please refer to pages 20-21 of this PDF. sharing information about treatments and finding great support in their interaction with fellow patients. Trigger communication planning: The ‘excuse’ for not engaging in the conversation about their condition is often the ‘lack of opportunity’ or that they never ‘planned’ to talk about it.� . Chronic patients participating in online communities become more knowledgeable.USING PATIENT INSIGHTS TO DESIGN FUTURE HEALTH SOLUTIONS. Patients risk becoming isolated if they fail to be understood by their peers and loved ones.

chronic diseases will cost the world $47 trillion in treatments and lost wages by 2030. it also brings more risk than working with existing process parameters because whole-service innovations are more complex and likely to question existing organizational boundaries. they can seek to think differently about the way they deliver their services using available resources and design fundamentally different service innovations. At a time when healthcare finances are so constrained whilst demands are increasing. The World Economic Forum estimated that.EXCITING TIMES TO BE IN HEALTHCARE For more information please refer to page 22 of this PDF. unless current trends reverse. Healthcare providers seem to face clear choices: they can work towards containing healthcare spending by restricting services. But not only is this harder to do. . there is a realization and understanding that existing healthcare systems will not deliver what the future requires. or to challenge current healthcare management. or request often-overworked staff to work even harder. of course. Alternatively. the need to design more effective solutions is self evident. Across the world.

healthcare leaders and entrepreneurs are starting to see a landscape full of opportunities by focusing on some emerging healthcare themes: Empowered patients: Equipped with more knowledge about their conditions and lifestyles. Rather than viewing future predictions as overwhelming obstacles.EXCITING TIMES TO BE IN HEALTHCARE For more information please refer to page 22 of this PDF. ensuring that patient records and treatment plans are readily accessible and cutting down internal inefficiencies. . New tools and incentives are being designed to improve decision making about personal healthcare and treatment options by promoting more proactive models of health and by helping people better track and understand their day-to-day behaviors. New services are emerging to help empower patients with technology and to provide access to social communities and peer-to-peer advice before visiting a professional. patients and staff. citizens are starting to take a key role in determining when they interact with the healthcare system and how their care is delivered. Nudging behaviors: More joined-up care: Digital platforms have evolved to facilitate communication between doctors.

or to question a given expert diagnosis. Take patients seriously. For instance. . Taking patients seriously entails helping them to better understand the complexity of their situation. patients can decide for themselves what they find most important and want to pay for. An increasing number of people now turn to the internet first to look up their symptoms and then decide whether or not to consult a specialist.SERVICE DESIGN WORK-OUT ON INNOVATION IN HEALTHCARE For more information please refer to page 23 of this PDF. by making the costs of care more transparent. Sharing personal experiences between patients who have similar diseases would enable the exchange of tips and tricks and help them to cope better with a disease. and giving patients the opportunity to better compare different care providers.

at the same time. The big challenge for healthcare is to become more efficient and. If hospitals differentiate their service level to specific target groups. BILL Shifting the mindset of medical staff from ‘patients’ to ‘consumers’ is needed for the high quality care the medical professional should aim for. while the hospital would be able to manage their revenues and margins more effectively. This would give the healthcare consumer more freedom of choice. . Cutting costs does not necessarily have to lead to a lower level of service or a decline in the patient experience. improve the patient experience.SERVICE DESIGN WORK-OUT ON INNOVATION IN HEALTHCARE For more information please refer to page 23 of this PDF.

and an improved experience at the same time. PATIENT One way of improving the service level without extra costs would be to better align specialists. a smoother care process. for instance. so that they better know what to expect. This could lead to both an improved experience for the patient and a smoother internal process. which could lead to less stress. based on a more integrated patient approach. involve previous patients as volunteer ‘experience experts’ to better prepare the new patients. This would create a better flow and experience during their healthcare process. The new patients would get more attention than currently. PATIENT EXPERT Hospitals could.SERVICE DESIGN WORK-OUT ON INNOVATION IN HEALTHCARE For more information please refer to page 23 of this PDF. . Patients could also be given better information and guidance beforehand.

. obesity s e t e b a i d !! t n e l e c ex Individuals with chronic health problems – obesity.” exposing the insufficiency of our own understanding of what health means to this group. When designing health interventions. the patient’s voice should be part of the design development.HEALTH MATTERS: REFRAMING DESIGN IN COMMUNITY HEALTH INTERVENTIONS For more information please refer to pages 24-26 of this PDF. diabetes. problems with mobility – would often rate their health as “very good” or even “excellent.

Taiwan has begun the provision of free-of-charge screenings for oral cancer. In fact. colorectal cancer and cervical cancer. the number of global cancer patients will rise by as much as fifty-seven percent. .5% DESIGN ACTION: CANCER SCREENING SERVICE INNOVATION IN TAIWAN For more information please refer to pages 27-29 of this PDF. including the feeling that they were too healthy. 13 8.2 The World Health Organization has predicted that in the next two decades.2 million to 13 million per year. too embarrassed or too old to get one. breast cancer. more than fifty percent of cancers could be prevented or diagnosed earlier if people led healthy lifestyles and received regular cancer screenings 5% Design Action was able to determine reasons behind people’s decisions not to get cancer screenings. too busy. Deaths caused by cancer will also rise from 8. To increase the cure rate and reduce the cost of cancer treatment.

.Interview: Geke van Dijk and Bas Raijmakers For more information please refer to page 30 of this PDF. It needs longer partnerships that result in change on an organizational level. or if you want to develop a service in a traditional product-oriented company. organizational change is needed and that won’t be achieved with a single project. When you aim to change how governments engage with citizens and other stakeholders in policy development. .’’ .

BETTER OUTCOMES BY DESIGN “The physician should not treat the disease but the patient who is suffering from it” Maimonides (12th century scholar and physician) Translating the human-centered nature of service design into a patient-centered focus for healthcare and wellbeing is happening worldwide. .

REFERENCES .

smartphone and tablet penetration has risen to seventy-five percent in developed countries.Capture User Experiences as They Happen Using smartphones to gain user insights The advent of mobile research provides radical new opportunities in the field of user research. This combination of users’ active and passive feedback (data and metadata. audio. reflecting the diversity of the user’s life. in this particular case. While some organisations have been active in the field of mobile research for several years. at any time. photos. • Metadata: smartphones automaticallyprovide us with valuable metadata such as time. The nature of smartphones means that they are currently best suited for capturing bite-sized responses. we have found that our mobile research platform. how they were using them.g. The research was prepared using the Contextmapptm dashboard. With studies like this we usually invite between fifteen and thirty people. and the overall context in which they used them. In pursuit of this. • Customer journey research Let people map their experiences and gain direct insight into their needs throughout the customer journey. Mobile research advantages: offers several • Whenever. but we find that this ‘sweet spot’ allows enough insight to bring some robustness. for people to join. discover how they experience a brand’s touchpoints. which relies on spending an hour or two with a respondent. wherever: users wake up and go to bed with their smartphones giving us constant access to their daily lives. allowing a leaner and more dynamic process — the learning comes faster. we built a landing page and asked. or as a stand-alone explorative study to capture behaviour over extended periods (e. • Rich data: smartphones allow us to collect all kinds of data like video. consuming media or installing a digital television set. instead of extensive. Depending on the type . drawn-out responses. However. why they preferred these. detailed feedback: users are not likely to engage for more than a few minutes at a time. These assignments consist of a set of questions: open. However. a group of people were asked to participate in a mobile diary study. via Philips’ Twitter account. multiple image (e. The question is: where does its application harness the best results? To date. duration and GPS locations. Get a detailed impression of their lives using photo and video. • Real-time monitoring: progress is monitored in real-time. bringing us closer to the moments when and where experiences actually happen. • In-situ data collection: capturing the defining (true) moments as they happen.While mobile research is still in its infancy. it is possible to keep ‘checking in’and to capture feelings and behaviour over a period of time — weeks. multiple choice. the course of a week) and uncover the ebb and flow of user needs. which led to forty-five completed diaries. Whilst mobile researchparticipants won’t give long. instead of hazy memories after the fact. audio or video tasks. Contextmapptm. • Explorative product and service research Zoom in on people while they are preparing a meal. • Mobile diary studies Use it as a sensitiser. It is not a hard and fast rule. paving the way for mobile research to become a serious alternative to some more traditional methods. A practical look at ContextmappTM The work that we have done for Philips Kitchen Appliances nicely brings to life the benefits of using mobile technology. Smartphones allow us to capture data that is both real-time richer in content. The goal of the research was to find out which kitchen appliances people were using: which ones they liked best. anywhere they go. quotes and images. without beginning to be overwhelmed by the volume of data. all the while saving time by not having to actually be with the respondent. respectively) blurs the traditional line between qualitative and quantitative data. it is still not being implemented across the mainstream. for example — as opposed to more traditional research. new functionalities will open up new opportunities and applications in the future. yields excellent results in the following three types of user research. Our dashboard enables one to easily setup research projects by creating several assignments.g. over the course of a week. or an evening at most. a set of emoticons) or ratings/sliers and photo.

Make it fun! Using visuals. we have learned a lot and keep learning more every day. whether or not the person cut the vegetables themselves. In other. integration of ‘iBeacons’. Altogether. Visualise results Use the rich data that you have gathered. 3. And improving. like ‘blender’ or ‘irritating’ The research Philips conducted helped them to create a segmentation based on cooking behaviour and pinpointed particular needs and problems. as well as the statement to be reviewed. Results were uploaded immediately. Iterate. we posed suggestions like: ‘Take a picture of the ingredients of your meal’ and asked them questionssuch as: ‘What kitchen appliances do you like best and why?’ Automated push notifications helped respondents remember to complete assignments at the right moment. And we haven’t even mentioned wearables. here are six research principles: simple guidelines that help you set-up your project. Ask ambiguous questions Ambiguous questions allow your participants to fill in the assignment as they see fit. or ‘Visualise Data’. As soon as the first participants finished. such as Google Glass. which can be made in any format. And learning. and so on. then iterate again. where we don’t think of people as simply consumers. We’re interested in getting in touch with other agencies that want to share or gain experience with mobile research. See who is on track and help slower respondents if needed. It helps you during analysis to understand needs and Robbert-Jan van Oeveren . ‘I’m cooking pasta’. Improve and test Always conduct the research upfront yourself. 5. but as collaborators in the design process. allowing both us and the client to have real-time monitoring of progress. As soon as the project was live. should you be interested in doing so. where all results are plotted. And although we’re not fully there yet. where a lot of (technical) innovation is still to be expected. the hunt for interesting insights started! The online dashboard gives two options: ‘Export Data’. This way. 2. You’ll find that some questions and assignments are best asked differently. Participants could choose the order of assignment in the way that suited them best. you will get the answers that really matter to them. gamification elements and a light tone of voice helps to enhance the experience and thus engagement of the participants: creating a place where they can be creative helps to get more out of them. we have conducted many similar projects and. co-research and automatic data processing and visualisation. automatic face and image recognition. users were asked to complete assignments on their smartphones. We have built our mobile tool with that philosophy at its centre. Questions are chosen and the results are visualised for all participants. This is far better than a cultural-probe exercise being completed just before the actual interview takes place. smart usage of push notifications and timely reminders can help people remember to participate in a way that is also convenient for them.of assignment being created. The team from Philips was particularly excited about the richness of the data. learned a great deal. mobile research is an area in rapid development. We got answers to questions we didn’t ask!” Six mobile research principles Along with Phillips. which results in a downloadable Excel and folder with media files. We’re entering an exciting new time. as we have sometimes experienced using traditional methods. we could set a particular order of assignments or it could be a set of repeatable assignments. projects. per segment. which we call ‘experience storyboards’. which offers three choices: • A chronological timeline. 1. the kitchen they were preparing it in. because they can literally see what is going on. Monitor progress behaviour. more linear. allowing for self-reporting. but to also be able to see what kind of pasta it was. It is a visual representation of the journey of the participant. enabling a dive deep into one person’s story • A selection of results. it inspires during ideation and concept development and it convinces clients. 4. enabling one to find all results that contain a certain keyword. smart algorithms. In the case of Philips. Think about text mining. 6. which makes it easy to compare differences between participants • Search for results. Based on our experiences. as opposed to steering their answers in a certain direction. As the client said: “It was good to not only get the answer. Fit around the user’s life Try to anticipate and understand how the research fits into the life of the user. And improving. types of question can be chosen. in doing so.

so businessto. and relatable primarily through technology. (Don’t worry. we all have things that we’re trying to do when we visit a particular provider — like fixing a chipped tooth. Kerry’s Take At its essence. In 2004.) Hands With four long fingers and nifty opposable thumbs. and memory recall. number of kids. an online quoting tool that enables prospective customers to fill in their marital status. heads. the real challenge now comes in developing useful services that will allow us to improve our health by taking full advantage of our quantified selves. and entire imaging rooms into a pirate ships. understandable. and hearts? Kerry Bodine . They are people. health service providers need to connect with their patients. and coral reefs. As healthcare consumers. The heart is our metaphorical emotional core. and design. Heads Hearts The head is the seat of our cognitive faculties and information processing functions like perception. a host of companies like Jawbone (which acquired BodyMedia last year).S. how to file a claim…” Being the young entrepreneur that he is.’ GE Healthcare created its Adventure Series. we’ve had limited ability to continuously monitor what’s happening in our bodies. And don’t forget that we bring our emotions with us when we go to work. a U. they need to touch them at three key body parts. Today. a New York City-based startup with more than 40. clear billing information that’s aggregated per visit.Humanising Healthcare through HH AANNDDSS E EAADDSS EARTS EARTS The following should not be news to you. This is obvious when we’re looking at a patient who’s going through chemotherapy or a woman who’s giving birth to her first son — but it’s equally true when we’re just trying to eat a healthy take-out meal or join a gym. This doesn’t require a physical exam. MRI machines. heads. our hands help us do things. and. transparent. data. Specifically. So keep them with you as you’re working today and ask: Will this decision or action connect us with our customers’ hands. And although we might try to deny this. records in a CRM system. and it won’t be awkward at all. To develop meaningful relationships and improve medical outcomes. or the list ofailments in their medical records. Andwhile lots of healthcare companies are talking about ‘humanising the healthcare experience. cable news program. Similarly. It’s our heads that help us navigate health insurance websites and fill out intake forms at the doctor’s office.” The result is Oscar. income. filling a prescription. recognition. Wearable body monitors represent a major advancement in this area. founder of venture capital firm Thrive Capital shared his frustration with the health insurance space during a recent interview on CNBC’s Squawk Box. jungles.business healthcare companies aren’t off the hook in this area! Medical providers need to understand their customers’ underlying emotional drivers — both on the aggregate and individual levels — and make sure that the patient experience is aligned appropriately. it’s impossible to disconnect our functional needs from our emotional ones. a Facebook-like timeline of the subscriber’s medical history. But the three H’s of customer anatomy are equally valuable for any service designer in any industry. and Fitbit market wearable devices that track everything from miles walked and calories burned to the quantity and quality of a person’s sleep. and I didn’t know what my benefits were with doctors or hospitals I had in my network. Healthcare providers should aim to make every single patient (and payer) interaction as easy as possible. Josh decided to create a new type of health insurance company — from scratch. companies have had to overcome significant technical challenges like shrinking sensors and extending battery life. I run a growing business. ‘humanising the healthcare experience’ means remembering that patients are human — and connecting with patients’ hands. of course. Nike. Up until recently. or filing an insurance claim. The Oscar website includes a robust provider search that includes physician fees and patient reviews. But of course. but it’s sometimes easy to forget: Patients aren’t just lines ina spreadsheet. Healthcare companies help us accomplish these goals (or perhaps you prefer to call them ‘tasks’ or ‘jobs to be done’) by developing useful services and getting them into our hands. I’m educated. and zip code in a quick and easy Mad Libs format. Josh Kushner. These experiences shouldn’t make our heads hurt.’ I get the feeling that they’re not always crystal clear on what that means. I worked for BodyMedia. To help children’s medical imaging go from ‘terrifying to terrific.000 physicians in its network. the maker of one of the first wearable body monitors on the market. a set of decals that turns CT scanners. To make health-related wearables a reality. His goal was to “make it simple. my own dentist in San Francisco has placed flat screen monitors on the ceiling and plays comedy shows during exams to help patients of all ages refocus their attention and reduce their anxiety about their dental procedures. “I opened my insurance bill one day and I realised that I had absolutely no idea what it meant. and hearts is a critical step towards this goal.

causing physical and emotional distress. created a research community for patients diagnosed with a chronic condition. leaving them at times feeling powerless. The objectives of the community were to • connect participants from all over the country on an online closed platform • enable participation in a flexible asynchronous way to maximally accommodate patients’ abilities and • allow participants to share their stories and exchange tips and tricks in an inspiring learning environment The community research project started with ‘patient immersion’. to ideate about potential patient communication support services for the future. A three-week online research community was the backbone of this patient research project. Why is it relevant to service design? This study illustrates the huge potential of patient collaboration for the health industry to co-create relevant patient chronic condition. The goal was to identify opportunities for patient solutions that help them improve their ability to communicate about their illness to their loved ones and others who they socialise with. a biopharmaceutical company focused on chronic diseases. the participants were invited to connect with peers who were suffering from the same research is merely the starting point in tackling a big problem for patients dealing with a chronic disease. a one-week online ethnographic multimedia module where patients shared their personal stories with the moderator in a private forum. it can inspire the health industry to take patient-support services forward. In the last week. rather than empowered. But while large numbers of patients connect with distant fellow sufferers via online communities. as patients struggle to express themselves in both disease areas. This gradual approach helped patients to open up to the moderator and to each other. patients have more information than ever before about their diseases and treatment options. Carl Vandeloo from UCB explains: “It was very interesting to allow patients with epilepsy and RA to communicate with each other. which has 16 million visits each month.Using Patient Insights to Design Future Health Solutions Collaborating with patients through online communities The challenges of living with a chronic disease Today. they often have a harder time communicating about their disease in their immediate environment: with family. The problem is that many symptoms — such as fatigue and depression — and their impact are hard to explain. This was a great way to group the UCB teams of different areas to think about solutions serving more than one patient group. In the second week.uk. Empowering patients in an online community We invited fifty US participants with chronic health conditions. Living with a chronic illness. Think about the wealth of data on the online community PatientsLikeMe.” . where more than 220. To overcome communication challenges in relation to these ‘significant others’ and to avoid social isolation. friends.000 conditions and Patient.552 posts and 367 photos and video testimonials.co. the community approach helped to bring new insight to the table and bring down the ‘silo thinking’ of the different departments involved within the organisation. for example rheuma toid arthritis (RA). Those close to them do not always seem to understand them as well as fellow patients do. InSites Consulting and UCB. People with a chronic condition are increasingly taking active control of their health. can take its toll on the patients’ wellbeing and personal relationships. Patients struggle to communi- cate these less-tangible problems to the people closest to them. resulting in 2. neighbours or colleagues. we invited all participants together (across therapy areas) for the patient brainstorm discussions. Patient empowerment is one of the main trends in today’s digitalised healthcare landscape.000 patients share their stories about over 2. to discuss common grounds and shared needs in an online discussion forum. Furthermore. sharing information about treatments and finding great support in their interaction with fellow patients. more specifically RA (62%) and epilepsy (38%).

” — RA patient . Three potential routes for UCB to facilitate patient communication: Raise awareness Trigger planning Support expresion These 3 routes could help patients better reflect on their feeling. The ‘excuse’ for not engaging in the conversation about their condition is often the ‘lack of opportunity’ or that they never ‘planned’ to talk about it. “My husband said to me.’ He was so right. First of all. The second route is to trigger communication planning about their condition with their significant others.. The first and most important route according to patients is to raise public awareness.needs. ‘Honey. First of all. chronic patients participating in online communities become more knowledgeable.Three roads towards improved communication The research confirmed that patients risk becoming isolated if they fail to be understood by their peers and loved ones. refrigerator mood magnets are a tool that can enable patients to express their status. articulate their status and talk to others. feel better supported socially and more empowered. While this services. I love you. both in terms of how they are feeling and for rating the physical burden. but if you don’t tell me how you’re feeling how am I supposed to know how I can help you? I can’t read your mind. A systematic self-reflection by the patient can be of great help. the results present new opportunities for health care providers such as UCB to improve the patient experience. The third route is to support patient expression. They would experience it less as a stigma and would not need to explain things that are self evident. Patients participating in the research brought up three potential routes for UCB to facilitate patient communication.. I had to trust him enough to confide in him when I expected him to be there to support me. the results present new opportunities for health care providers such as UCB to improve the patient experience. Patients who have a difficult time expressing their thoughts and feelings about their disease should have tools that facilitate communication. for caregivers and for patients living with a chronic disease. Patients do not even realise that their significant others others cannot read minds and that they need to integrate routines for discussion into their lives. The community members made us realise that many patients are in need of simple status expression aids. such as a diary to keep one’s finger on the pulse of one’s status and current services. Patients would benefit greatly from the public having an increased knowledge about their condition. Second. Anouk Willems Magali Geens . feel better supported socially and more empowered. avoiding frustration or even isolation. Examples of how to raise public awareness include more general public campaigns about their condition or simple instruction sheets explaining to ‘outsiders’ which critical incidents may occur. chronic patients participating in online communities become more knowledgeable. Patients are not ‘armed’ to educate their broader circle of friends and acquaintances about their condition and its impact. particularly when they need practical support or emotional relief. For example. Second. for caregivers and for patients living with a chronic disease. It stimulates talking about the condition.

citizens are starting to take a key role in determining when they interact with the healthcare system and how their care is delivered.wef rum. Alternatively. Healthcare providers seem to face clear choices: they can work towards containing healthcare spending by restricting services. where healthcare is seen as an ongoing conversation between people.uk/healthcarer adicals 3 http://www. While the economic realities of current healthcare models tell a different story. This presents an exciting new paradigm and framework for designers to work within too. the need to design more effective solutions is self evident. Across the globe. we can see early adopters acknowledging some of the emerging healthcare themes and creating alternative services that have the potential to make the wider system more resourceful. The NHS Hack Day5 aims to understand some alternative models for procurement within health technology and brings together healthcare and technology professionals to improve NHS IT. Online consultations are designed to resolve health concerns quickly and conveniently. it also brings more risk than working with existing process parameters because whole-service innovations are more complex and likely to question existing organisational boundaries. patients and staff. interpret blood tests remotely.nahs.com/publishing/futu re-of-health-2014 4 https://www. Rather than viewing future predictions as overwhelming obstacles. It gives patients anytime access to their medical records and to doctors who may be located across the world.com 1 Julia Schaeper .1 At a time when healthcare finances areso constrained whilst demands are increasing. Patients Know Best6 lets patients and clinicians easily access medical records that would typically be trapped in siloed IT systems. for instance. New feedback loops often encourage users to make small behavioural changes over time. lifestyle.uk and https://changeday.com 7 https://sherpaa. and can. patients and the public to collaboratively improve health and care. or request often-overworked staff to work even harder. Nu dging behaviours New tools and incentives are being designed to improve decision making about personal healthcare and treatment options by promoting more proactive models of health and by helping people better track and understand their day-to-day behaviours. or to challenge current healthcare management. is a scary prospect for some. The World Economic Forum estimated that. social platforms and data systems to streamline the way information is spread across organisations to deliver a more personal and consistent model of care. ensuring that patient records and treatment plans are readily accessible and cutting down internal inefficiencies. of course. It is reported that more than 7 million people visit the site each month. wellness and social tools are also being developed for the healthcare industry. patients will be better prepared to communicate with their doctors during consultations to ensure optimal health outcomes and treatment plans. a multitude of health. New services are emerging to help empower patients with technology and to provide access to social communities and peer-to-peer advice before visiting a professional.psfk. The NHS responded by creating its own ‘Change Day’ and School for Health and Care Radicals.com 6 http://www.nhs. we are starting to see compelling signs of change against some of the unsettling healthcare challenges. they can seek to think differently about the way they deliver their services using available resources and design fundamentally different service innovations. in this context we are presented with a great chance to help healthcare leaders create and embrace new service innovations and develop services that are poised to improve health outcomes in the long run. As a result. But not only is this harder to do. Secure online platforms are offering new ways for doctors to share research and advice about conditions that fall outside of their expertise. while analytics tools interpret patient data to support diagnosis. Early outcomes show healthier citizens less reliant on public resources. boost benefits and to expand coverage to more employees. More joined-up care Healthcare providers are starting to use new technologies. healthcare leaders and entrepreneurs are starting to see a landscape full of opportunities by focusing on some emerging healthcare themes:3 Empowered patients Equipped with more knowledge about their conditions and lifestyles. As designers. This. Digital platforms have evolved to facilitate communication between doctors.Exciting Times to be in Healthcare Across the world.000 doctors.healthtap.patientsknowbest.2 Despite slow governance processes. And yet. let’s face it. rather than something that happens when someone falls ill References http://www. two frontlineled movements designed to inspire and mobilise staff. trading questions and answers with a pool of about 46. whilst companies' healthcare spending is analysed to suggest ways to save money. we know that simply removing unwanted variation and non value-added activities from existing healthcare processes won’t deliver the more significant quality and productivity gains we need. Mobile technologies provide deeper insights and individualised coaching to activate users around wellness and exercise. chronic diseases will cost the world $ 47 trillion in treatments and lost wages by 2030. unless current trends reverse. Sherpaa7 provides patients and businesses with 24/7 access to doctors over the internet to stem rising healthcare costs and to provide more personalised patient care. there is a realisation and understanding that existing healthcare systems will not deliverwhat the future requires.com 5 http://nhshackday.org /news/non-communicablediseasescost-47-trilion-2030-new-study-relea sedtoday 2 http://changeday. The Healthtap4 start-up offers an online service that lets you instantly connect with a clinician via the net and ask personalised touchpoint 6-2 51 better outcomes by design medical questions to help diagnose common conditions professionally and quickly.

Related to this is the idea of the ‘quantified self’: by developing a better understanding of your own body and behaviour. service designers should thus also look for aspects that will help hospitals be the best or first in something. Service designers should help them to show the added value of service design. but who might if they knew better what it was and what they may get. In many sectors. based on a more integrated patient approach. a smoother care process. it will have a stronger impact when they tell the story. and why. What type of information would be most useful to provide to patients? Sharing personal experiences between patients who have similar diseases would enable the exchange of tips and tricks and help them to cope better with a disease. they rely on this type of evidence. so that they better know what to expect. at the same time. Conclusion In a plenary wrap-up to the session. Taking patients seriously also entails helping them to better understand the complexity of their situation. the Dutch chapter of the Service Design Network organised the 6th Service Design Work-out. could be useful for prevention purposes. The informal setting enables the members from the network to mingle and share their thoughts. Hospitals could. for instance. The big challenge for healthcare is to become more efficient and.Service Design Work-out on Innovation in Health Care In April 2014. it seems more effective to explain that service design is actually valuable in a complementary way. Make sure the ambassadors can tell the story. Attention should also be given to actively creating opportunities to measure the success of the service design project from the start. providing high quality information on what is good. The new patients would get more attention than currently. This could lead to both an improved experience for the patient and a smoother internal process. by making the costs of care more transparent. Julia Schaeper . is very important. Another way of improving the service level without extra costs would be to better align specialists. Around thirty participants from various backgrounds came together to discuss the added value service design can bring to the healthcare sector. but it might also be a new type of key performance indicator (KPI). how does a five-star restaurant innovate? Building up a portfolio of best practices from projects in other organisations and sectors is also a useful way to convince stakeholders in management. We tend to focus on ‘unusual suspects’ for service design. meaning those organisations that currently do not yet hire service designers for projects. and indicating the different ways one can interact with them. Also. Shifting the mindset of medical staff from ‘patients’ to ‘consumers’ is needed for the high quality care the medical professional should aim for. thereby lowering the threshold of experimenting with it. we shared the results from the various group discussion and reflected with Jiska how this could contribute to her daily work in the UMC. efficiency control and experimentation are equally important to safeguard continuity and innovation. For instance. This would create a better flowand experience during their healthcare process. The objective of the Service Design Work-outs is to offer an opportunity for people working in service organisations to present some of the issues they face in their work and ask the service design community to think along with them. This evidence from parallel fields gains ambassadors in the organisation permission to experiment on pilot projects and to demonstrate their value. A service design approach can support this. For instance. How can service design thrive in a health care sector that is dominated by a focus on eff iciency and measuring effects? Instead of opposing the efficiency and evidence-focused management approach. Creating visual evidence from all stages in the project to illustrate how service design contributes to real change. In health care. The group questioned if this ‘airline-type of service segmentation approach’ could be translated to healthcare. and an improved experience at the same time. while safeguarding sensitivity to ethical issues. patient routines have gradually changed. How to better support increasingly demanding care consumers? While adecade ago it was still obvious to first turn to a specialist in case of medical problems. Could hospitals differentiate their service level to specific target groups? This would give the healthcare consumer more freedom of choice. patients can decide for themselves what they find most important and want to pay for. As a result. The session kicked off with a presentation by Jiska de Wit. or to question a given expert diagnosis. How to deal with this trend? And how can this be turned into an advantage for better services? Taking the patient seriously is at the core of answering this trend.” She also seemed very fired up by the last discussion and indicated that it would really help if service designers were able to find a way to the connect the ‘efficiency and measuring’ culture of hospitals. Patients could also be given better information and guidance beforehand. and giving patients the opportunity to better compare different care providers. and specially in academic hospitals. behaviour change can be triggered in a positive way. it seems that being the best in class or the first to do something. This issue should be addressed early to be able to integrate ways to measure the value of the results. the participants worked in groups on tackling the three questions below. innovation manager at the UMC (Utrecht Medical Center). the interaction with the medical professional has changed. Further thought should also be given on how to use this trend as an advantage. As the management team does not have the direct experience on the ground. These references show how service design contributes to effective change and innovation. After a brief Q&A. while the hospital would be able to manage their revenues and margins more effectively.These ambassadors can be found on any level in the organisation.ist. Can a hospital improve its service level despite the need to cut costs? The first remark made here was that cutting costs does not necessarily have to lead to a lower level of service or a decline in the patient experience. In return. She discussed the trends and issues the care sector currently faces. This could be increased customer satisfaction. An increasing number of people now turn to the internet first to look up their symptoms and then decide whether or not to consult a special. involve previous patients as volunteer ‘experience experts’ to better prepare the new patients. which could lead to less stress. They are willing to try things out and showcase the results to their colleagues. improve the patient experience. for instance by identifying different type of patients. It would definitely help service designers to develop a useful metaphor to explain the value of service design in terms that resonate with management aspirations. She mentioned that the discussions really inspired her: “…it was good to be amongst service designers again. This article summarises some of the outcomes of these discussions. this data for research purposes can be very interesting for the medical professionals.

aims Often.) The study revealed that the traditional methods of collecting qualitative information in health assessment were inadequate for comprehensive health measurement in underserved urban populations. How might we make these measures meaningful to people to motivate them to improve their health? What other measures are relevant to health perceptions and how might we learn what they are? From a service design course came an interdisciplinary partnership In 2012. yet incomplete. we applied service design methods such as a customer journey map1 and personas2 that provided Garden on the Go® leadership with a comprehensive description of the people who use their service. The FSPH partners. Working together: designers. and expand their On-the-Go model to other programs that . Instead of pursuing a conventional survey method. etc. Herron will be responsible for disseminating study findings back to the communities involved. The findings of our study aim to improve understanding of the culture of our target population — Garden on the Go® customers — with regard to their perceptions of health and what they perceive to be a healthy diet. What does health mean to YOU? The objective of Health Matters is to identify new. Additionally. the patient’s voice should be part of the design development. but shared. producedelivery program provides fresh. based on their community based research practice in the public health context. Garden on the Go® conducted a health assessment survey with the Richard M. worse yet. Herron has served as the primary research conveners and has taken the lead in developing research methods. if you think you’re healthy when you actually aren’t. the programs are not as effective as they could be or. abstracts and manuscripts to disseminate findings to the academic community. gathering data and data analysis. you won’t pay attention to your health. The IU Health Garden on the Go® aims to gain a better understanding of what fruits and vegetables would be attractive to their customers as well as how to assist them in the selection. each project partner has defined a specific goal. blood pressure. At the completion of the study. Fairbanks School of Public Health the previous year to see if and how the program impacted health through various biometric measures (weight. the study is concluding its data collection phase. will discuss the challenges and roles of designers in integrating their disciplinary practice into health care interventions. affordable vegetables and fruit to Indianapolis neighbourhoods in need. Garden on the Go® and the researchers from FSPH saw the potential of service design methods to help better understand their population and proposed to develop a collaborative research project between the Herron School of Art and Design. problems with mobility — would often rate their health as “very good” or even “excellent. Garden on the Go® leadership from IU Health and scientists from the Fairbanks School of Public Health (FSPH) at Indiana University initiated the Health Matters study. The team noted that individuals with chronic health problems — obesity. When designing health interventions. They are also interested to know how they might improve their service overall. design researchers from the Herron School of Art and Design. and provided limited information.Health Matters: Service Design in Community Health Interventions Garden on the Go® is an obesity-prevention effort initiated by Indiana University Health. public health scholars. specifically focusing on an interdisciplinary academic research process. understandings of the people they are trying to serve. Under this overall study objective. have provided consultation and assistance in aligning service design practice with academic research process and protocols. This paper. and presentation of fresh fruit and vegetables as part of a healthy diet for their families and themselves. we developed a project in the course entitled ‘People Centred Service Experience Design” in which we partnered with Garden on the Go® to conduct a customer survey to learn about customers and their needs. As of June 2014.” exposing the insufficiency of our own understanding of what health means to this group. and service providers Since the project launched in 2013. Health Matters aims to understand how individuals in underserved urban communities define health in order to make health interventions more relevant to community health perceptions. We know that health perceptions affect self-care: in other words. health promotion intervention programs are developed and implemented for target populations by public health professionals who possess validated. They will also collaborate with the design researchers in preparing the reports. people-centred definitions of health. IU Health has provided logistical support and access to Garden on the Go® customers. In 2013. Three different. IU Health will assist in sharing the research fin ings with the community when the project is completed. This year-round. may be rejected out of hand. Biometric readings such as weight and blood pressure are clinical measurements that don’t reflect people’s perception of being healthy from individual perspectives. diabetes. mobile. Having seen our participatory approach to customer research. preparation. Fairbanks School of Public Health and IU Health.3 When this inclusion does not happen.

we design researchers had only a vague notion about what data analysis entailed in public health. via an onlineeducational module) are not permitted to interact with study participants or potential study participants. The IRB process is valuable for design researchers for considering the ethical aspects of research in design work. While they are not certified academic researchers. but structured. food and lifestyle and participate in informal. Designers who wish to work in partnership with academics will increasingly find it necessary to develop a disciplinary understanding of design research that encompasses the process of inquiry beyond the collection of data. relevant and patient-centred measures for health. A cohesive approach to data analysis across data types was necessary. The institutional review board (IRB) — also known as an independent ethics committee or ethical review board — receives research proposals involving human subjects and reviews and monitors biomedical and behavioural studies to protect the safety and rights of participants. and to address how we can integrate our disciplinary practice into health care interventions as equal collaborators with research partners. misrepresentation of study processes and potential forcoercion at any point in the study are among the issues that can cross the boundaries of respect and trust and ultimately undermine the validity of the findings. Recruitment: building the team Recruiting participants for research projects is frequently difficult. journal entries and discussions. what is the disciplinary language related to research processes and what are the methods to achieve the goal? Although this study was developed based on a shared view of the novelty and value of design research in data collection. We need to define our own disciplinary position. Current IRB review is designed for specific disciplines such as medical or social science research and is not optimally designed for design research practice. measures for health. The project is currently concluding the data collection stage and we expect to reach the dissemination stage in the fall of 2014. in alignment with currentresearch agendas seeking patient centred outcomes. This stage provided opportunities for us to reflect on the differences between public health and service design in data analysis and to further articulate the methodological aspects of design research. The vocabulary and overall framework of the IRB approval process emphasises ethical codes of medical research. voice and group discussion as methods for data collection. While data analysis in public health is executed by individual researchers (generall speaking) using a theoretical framework that feeds new knowledge back to the discipline. What we learned: design researchers who wish to use interdisciplinary collaboration as a venue and means for validation. It also addresses coercion. IRB approval is required for all such research undertaken at the University. once participants are secured. in alignment with current research agendas seeking patient centred outcomes. recruitment. Questions of recruitment bias (manipulated selection of research participants). The shift into an academically rigorous research practice entails a steep learning curve for design researchers in order to navigate the review system from submission to approval. inequities in power and social status and other potential psychological impacts. For instance. Our partners’ openness to learn alternative approaches in data analysis enabled usto lead the process of analysis. connecting patients and healthcare providers/ researchers by co-designing for healthcare outcomes. The service design researchers at the Herron School of Art and Design aim to establish a collaborative research model by providing relevant design methodology for rich data collection and deep analysis. and those who wish to disseminate the impacts of design to the public need to become familiar with the IRB in order to engage at a level on par with specialists in other fields. service designers externalise the analytical phase and facilitate collective analysis including all stakeholders who share an understanding of the defined population. Pre-research: An articulation of ethical practice in research Academic research goes through a pre-research phase in order to ensure that studies are ethically sound.would be relevant to their customers. data collection. follow-up discussions with the research team. The Richard M. Additionally. Participants take photos of their daily lives relating to health. analysis and dissemin tion. research design. time consuming and inefficient. Fairbanks School of Public Health aims to develop new. it is time for design to define its code of ethics from a disciplinary perspective. connecting patients and healthcare providers/ researchers by co-designing for healthcare outcomes. Our research process consists of six stages: pre-research. to integrate it into institutional mechanisms for research such as IRB and to educate designers about established research standards outside of commercial practice. As design research becomes more integrated into interdisciplinary research. These combined methods generate three types of data: photographs. What we learned: current literature in design research tends to focus on methodology and tool making. we invited the Garden on the Go® counter staff and a community liaison for data analysis. including those relating to invasive procedures (such as drawing blood) and full disclosure of research methods. we used photo. Research design: what is beyond methods and tools? In developing interdisciplinary research projects — specifically when establishing a new project — there are a few things that require mutual understanding from project partners: what are the common goals of the research endeavour. The service design researchers at the Herron School of Art and Design aim to establish a collaborative research model by providing relevant design methodology for rich data collection and deep analysis. they possess an intimate knowledge and the most profound understanding of the audience through their frequent interactions. particularly because of the mix of disciplines within our team. there is often a problem with adhering to the . In this study. Design research in academic partnerships: new territory for designers The main purpose of this article is to share our experiences and challenges as designers in interdisciplinary academic research settings. Those who do not receive certification (typically.

Interactions outside of labs enabled us to build relationships with the participants. Grant Grant # UL1TR001108 from the National Institutes of Health.. http://www. Health Matters was funded in part with support from the Indiana Clinical and Translational Sciences Institute funded. Bridget Hawryluk. M. Design research methods yield rich. From recruitment to data collection at discussion sessions. Ashley Bailey. used community meeting time for discussion groups and we were able to leave boxes for camera pick-up on site in office spaces. Develop Innovative Ideas. National Centre for Advancing Translational Sciences. it is a key learning outcome for public health. Fairbanks School of Public Health. Our next steps include codifying our methodology within public health research. J.org/research-wesupport/ research-methodology-standards/ 1 Youngbok Hong Acknowledgments This paper would not have been possible without the generous contributions Helen Sanematsu . (2012) Universal Methods of Design. The Patient Centred Outcomes Research Institute Methodology Report. of the following people: Lisa Cole and Kaliah Ligon. in a more protective role aligned with the princi- ples for ethical treatment of human subjects as regulated by the IRB.research process: participants drop out or fail to comply to research protocols.This is service design thinking : basics-tools--cases. the School of Public Health provided a theoretical and discursive home for the study. Tysha Sellers. contextualised data for service design (applicable to Garden on the Go® as they expand their menu of services) and. for improved understanding of underserved populations.. (2010). Niki Girls and Lynn Rodgers. Herron School of Art and Design.pcori. & Schneider. as designers. Brian Crain. every touchpoint in engaging with research participants was carefully designed in order to optimise their experience. Helth talks What you’re eating? . and Nick Walters. Indiana University Health. and with an ultimate aim of institutionalising design research as a legitimate complement to existing data collection methods for patient-centred research. Richard M. Martin B. Our process was made efficient by the clear definition of each of our roles: our association with Garden on the Go® provided institutional support that helped with recruitment. the work is a cutting-edge example of community-engaged research in health. our partnership has raised the profile of all three groups in community health circles through community presentations. (2013). Health Matters was at an advantage in relation to study recruitment: we consulted with our partners at the IU Health outreach team and selected four of the active Garden on the Go® stops as our research sites and began working with community leaders at each stop to coordinate days for recruitment. Clinical and Translational Sciences Award. Valerie Moore. contextualising our data as new findings in a field unfamiliar with design research and design provided patient-centred methods. Our approach in designing the participants’ experience was complementary to our partners’ expertise in the area of health research. Mass: Rockport Publishers 3 PCORI Methodology Committee. camera pick-up and discussion. On the academic end. Conclusions Our work with IU Health/Garden on the Go® and the Fairbanks School of Public Health demonstrated the potential for simultaneous interdisciplinary collaboration in both the public realm and the academy. we aimed at optimisation by identifying and connecting the touchpoints involved in the research process. 2 Lidwell W. in effect. Terrell Zollinger and Cindy Lewis. In the process of our research. The attention that we paid to the participant experience in the data collection process prioritised the person rather than the data and. Edna Martin Christian Centre. to have a better understanding of the organisational cultures and to adjust our research plan accordingly. currently a broadly supported area of health research in the United States. Indianapolis Housing Agency.Concord Neighbourhood Centre. Andrea Haydon. and Design Effective Solutions. Amsterdam: BIS Publishers. put us. Our communication with the leadership at each of the sites was key: we were introduced at community and resident meetings. 100 Ways to Research Complex Problems. Data Collection: Designing an experience of engagement Framing the participant’s experience from a service design point of view. References Stickdorn.. Gloucester.

2 million to 13 million per year. including government departments. but the number of people who have taken up this opportunity has been low thus far. In fact. Second. medical and public health personnel may not be able to implement such ideas. this article aims to share a public health service innovation in Taiwan — an innovative and sustainable design for a cancer screening service — through which we hope to discover how organisations engage in learning and co-creation with their stakeholders. On top of users’ needs and feelings. Taiwan has begun the provision of free-of-charge screenings for oral cancer. placing a great burden on the shoulders of health and welfare policies. including those who get regular cancer screenings. and relevant non-profit organisations. and everyone has the ‘right’ to get cancer screenings. which has made it a tough nut to crack in terms of effective service design. breast cancer. The National Health Insurance program is a compulsory service in Taiwan.83 billion on cancer-related treatment a year. a non-profit design platform initiated by Taiwanese designers in the . Because of this. which accounts for twenty-seven percent of the total budget of the National Health Insurance system. but most people do not realise that such screenings are also somewhat of an ‘obligation’. demanding that physicians with authority to take into account the needs of their patients and their families or persuading hospitals with enormous profits to introduce service design is a task of tremendous difficulty. one Taiwanese person is diagnosed with cancer every five minutes and forty seconds. 5% Design Action: innovation in cancer screening services ‘Social innovation relies not so much on ideas of design as practical design action’. In addition. public services do not face frequent external competition and the pressure to continuously innovate and make breakthroughs.‘5% Design Action’: Cancer Screening Service Innovation in Taiwan Designers have consistently encountered obstacles when trying to introduce innovative ideas into public health services. the validity and legitimacy of the service provider are essential parts of service design. Such adherence is a major obstacle standing in the way of innovation: for example. medical institutions. On average. An even more astonishing fact is that the Taiwanese government spends U S $1. and the cancer screening service serves as a good example of this in three ways: Process and concepts of 5% Design Action Public health service is a complex and highly specialised discipline. despite the good intentions behind the program. The additional medical costs caused by late diagnosis are shared by society as a whole. The World Health Organisation1 has predicted that in the next two decades. Most public health service personnel offer only one standard option. the number of global cancer patients will rise by as much as fifty-seven percent. a certain level of social cost may be inherent in public health service. Service innovation: a weak spot in cancer screening First. Deaths caused by cancer will also rise from 8. Unlike general privately owned business. To increase the cure rate and reduce the cost of cancer treatment. This strange form of social inequality needs to be changed by incorporating an innovative model into cancer screening services. Third. Cancer has been at the lead of the top ten causes of death in Taiwanfor thirty years running. resulting in unnecessary increases in social and medical costs and. Making use of an open and innovative structure. holistic innovative experience cannot be implemented unless these stakeholders are effectively incorporated therein. innovative ideas simply based on user orientation seem to be incompatible with the inherent specialisation and authoritativeness of cancer screening services and. more than fifty percent of cancers could be prevented or diagnosed earlier if people led healthy lifestyles and received regular cancer screenings. public health services are resistant to innovation. colorectal cancer and cervical cancer. The profes- sionalism and authoritativeness that have been established in the health discipline result in people’s firm adherence to specific services. Taiwan’s cancer screening service involves a wide range of stakeholders. Such is the principle behind 5% Design Action. therefore. just like the Ford Model T.

Share In the last stage. 5% Design Action recruited volunteer designers with an interest in this theme: a total of eighty volunteer designers were willing to participate in this project. Through these initial results. 5% Design Action plays a critical role as being a platform that invites designers and other professionals from a range of fields to pitch in five percent of their free time. the primary goal was to identify problems and focus on producing practicable results that satisfied the needs and conditions of service providers. The exploration results were discussednby the connected organisations as 5% Design Action sent representatives to the screening sites to observe and interview the people there. the platform’s research team started to collect and analyse secondary data. in the past. interactive design. 5% Design Action divided the eighty volunteer designers that they had recruited into twelve groups. After six months of discussion.spring of 2013. and the platform’s first project was titled ‘Innovating in Screening Services and Cancer Prevention’. but rather for the co-learning and co-creating ‘process. breast cancer. ‘Share’. Therefore. they can join 5% Design Action with the main service providers and stakeholders to provide their knowledge and professional skills in designing new solutions to societal issues or challenges. family and neighbours. 5% Design Action was able to determine reasons behind people’s decisions not to get cancer screenings. the research team continues to exploit the result. Many details and minor modifications still remain to be worked out through discussions with executive departments. and 3. 5% Design Action yielded results that were not specifically targeted at the design of the cancer screening service. Transfer 5. including: 1. 5% Design Action wanted the participation of designers with an ambition for social innovation. Service design inspired 5% Design Action to visualise the needs of ordinary people and service personnel to guide co-learning. colorectal cancer andncervical cancer. including the feeling that they were too healthy. and is aiming to continuously innovate in various service procedures. Recruit 3. with areas of expertise spanning graphic design. At this stage. establishing brand images that related to the citizens’ lifestyle and promoting cancer screening service through networks of friends. even though they are passionate about social issues. While the guest designers have returned to their work. Co-Create 4. Moreover. too embarrassed or too old to get one. The course of this project has also been made into a documentary2. 5% Design Action made the next step forming a cooperative connection with various organisations. there are few opportunities for many designers to participate in the service development process. service design and fields related to public health. 5% Design Action developed ten concrete-innovative concept designs. However. as a cooperation between designers from a variety of fields and related participating institutions. Non-profit organisations (four cancer prevention foundations). This goal was achieved through discussion between organisations and experts who had been working in this field. the objective of this project was agreed upon: to improve the overall cancerscreening experience and increase people’s screening acceptance and participation rates. Transfer Near the end of this project. invite relevant stakeholders to take part in in-depth interviews and to construct a network of cooperation. and agreeing upon the objective. It also helped in identifying the core problems in the complicated context of a service system. 5% Design Action is preparing to launch four new services in the third quarter of 2014. At this stage. product design. Co-create In the third stage. The project consisted of five stages: 1. clarifying the problems. in an effort to systematically accumulate and transfer knowledge or to create new values . Target 2. such as visualising the cancer screening process to reduce people’s fear of it. the objective of 5% Design Action is to uncover potential innovation opportunities and solutions. a series of discussions were conducted in the form of workshops and online platforms to develop innovative design concepts and service models. Each group worked individually in exploringnservice gaps and innovation opportunities pertainingnto oral cancer. 2. too busy. Government institutions (Health Promotion Administration and Department of Health of the Taipei City Government). Share Target From the very beginning of this project. Executive departments (Taipei City Hospital and twelve health service centres in Taipei City). Recruit After discussing with the stakeholders. Centred around service design. To cut straight to the core of the problems involved. As a result. At the end of this stage.

With the toolkit and the results of this project. The premiere was a huge success. & Kramer. (2011). Complex social innovation should not be confined to a closed system of thoughts involving only one area or unit. CA: Jossey-Bass The average tenure of a public health nurse in Taiwan who performs cancer screenings is 2. The networked nonprofit: Connecting with social media to drive change. It even produced ‘innovative ideas cards’ to accumulate knowledge and continue encouraging the output of inno- References 1 Chen-Fu Yang Chih-Shiang Wu Shu-Shiuan Ho Tung-Jung Sung . The crucial role played by nonstakeholders Innovation is far from a new thing to both the organisations and the personnel involved in cancer screening: the problem is that competition and dependent relationships within the ecosystem have led to a lack of communication and cooperation. They believed that. B. surprisingly. This high turnover has obstructed the passing on of experience. more people will be able take part in service innovation in cancer screening. In addition. practicable solutions can be co-created. free agents will be regarded as necessary promoters of social innovation and design through crowdsourcing. In addition. as well as the demands and perspectives of users and of executive departments. 5% Design Action has summarised its research findings. in the social networking era. as developed by Kanter and Fine (2010). co-learning and co-creating Empathising with users may be important for good service design. attracting social and media attention. 9(1). 5% Design Action developed a design thinking toolkit for training healthcare personnel.. This is similar to the concept of the “free agent”. Given the results and findings of this project.in the future built on the existing foundation. (2010). In response. increased these organisations’ willingness to cooperate. the designers of 5% Design Action engaged this problem from the angle of the non-stakeholder: they provided assistance to these responsible organisations in implementing feasible innovations. learning and action are the only solution for applying comprehensive thought and innovation to a service system.7 years. by which attractive. 2 Kanter. vative ideas in a systematic way. 5% Design Action also organised a premiere and a conference built around the project documentary. design can be introduced to more healthcare areas. 36-41. but designers and service providers must respect each other’s professions and attempt to communicate from each other’s perspective. accumulating and re-creating knowledge Kania. San Francisco. Moreover. provided as a reference for others working on the practical side of service design: Co-seeing.. To accumulate results for long-lasting participation. This approach. and the phrase ‘innovation in cancer screening services and cancer prevention’ was adopted to convey to healthcare experts the value of service design. A. With the experience and knowledge acquired from this project. this project was invited to share its results and findings at the 2013 National Cancer Prevention Conference. In 2013. in which more resources were expected to be provided for 5% Design Action in the future. J. Organisations would rather be described as being ‘responsible’ than invest effort in finding ways to improve the service experience and increase screening test-partic- ipation rates. 5% Design Action expects executive departments to get acquainted with the ideas behind the methods and values of service design and to gain innovative energy from inside their organisations. ‘Collective impact’. a documentary was made about this project. Stanford Social Innovation Review. This faintly echoes the “collective impact” proposed by Kania and Kramer (2011). for the purpose of educational training. and thepremiere and events established an interdisciplinary platform of dialogue. Recording. Furthermore. A superior service design involves a long dialectical process. Interdisciplinary observation (of demands and problems). & Fine. Discussion and conclusions 5% Design Action has been developing service innovations for cancer screening and other healthcare issues. inviting people from important organisations related to cancer. M. as well as constructing a channel for communication between cancer screening service providers. we have come to the following conclusions. thereby co-creating more innovative solutions and opening up more valuable opportunities.

STBY is a truly Anglo-dutch company. There has been a huge growth in the involvement of practitioners in this field since then. There has been an strong uptake in industry (among both agencies and client organisations) as well as in education and government. Who makes up that group. These different perspectives come naturally with the two locations we work in. you both took part in the the first of the SDN’s GlobalConferences. So there was never an expansion from one country to the other. to share knowledge and sometimes offer a different perspective. we discussed this year to maybe to transform the Dutch network into a chapter within the international network. we immediately started in both London and Amsterdam. After a few years of happily co-existing next to the international SDN. Back in 2008. and not just modest with your research ambitions. It has also been integrated in pioneering innovation programs between industry and academia. The two studios virtually operate as one. such as health care. Design research is your area of expertise. but also the multinational and multicultural team we have. It makes more sense now the field is growing so much and also consolidating internationally. telecom. utilities. and the rest of the team also has a lot of contact with each other. and were already spending much of our time in London. and what activities have you carried out? In the summer of 2008 we initiated the Dutch service design network as a result of an inspiring meet up between the four agencies who were at that time pionering under the banner of service design. That puts you in a good position to look back on the growth of service design in Holland in the years since then. and hospitality. you have to be modest with your ambitions for the service you are creating. Projects simply don’t achieve enough lasting or systemic change and the issues that are addressed are often too big or ‘wicked’ to be solved in a single project. This way of thinking and doing also removes the time and budget limitations: if you have little time and budget for a service design project. workshops. or if you want to develop a service in a traditional product-oriented company. such as talks. Our perspectives and local knowledge are even much more diverse with Reach. The main challenge at the moment in all these settings is to move from projects to partnerships. with projects sometimes happening across the two locations. How do you handle this way of working. transport. One of our first activities was to support SDN with organising the international service design conference in Amsterdam. STBY’s partner network for global design research currently comprising 11 companies around the globe. so for us as directors it really made sense to establish ourselves in both countries. their Anglo-dutch company STBY. To do proper service design you need to do proper design research. It does not make sense to do one without the other. and it’s an area that I believe is sometimes overlooked by service design practitioners. especially if they face time or budget limitations? The most important advice is to not see design research as separate from service design. etc. It is an integral part and cannot be separated from the rest. discussions.Interview: Geke van Dijk and Bas Raijmakers In this issue. always with locally based teams. such as the CRISP programme (2011-2015) where 60 organisations from academia and industry collaborate to create knowledge about designing Product Service Systems. drinks. organisational change is needed and that won’t be achieved with a single project. It needs longer partnerships that result in change on an organisational level. editor Jesse Grimes interviews Geke van Dijk and Bas Raijmakers and learns about their involvement in service design networks. we spend about 50% of our time in each studio. We saw equal opportunities in in both countries. Geke van Dijk Bas Raijmakers . and what challenges remain for Dutch service design practitioners? In 2008 only a relatively small group of people in The Netherlands were aware of service design. When you aim to change how governments engage with citizens and other stakeholders in policy development. with currently five nationalities. Since then we have organised more than 50 local events. There has been the (independent) ‘Service Design Netwerk Nederland’ established for many years. and design research. What are the developments you’ve seen. For global companies we do design research in several countries simultaneously. As the directors. The initial meet up was actually triggered by clients who told us that it was crazy that we did not know each other yet. It is a nice mix of enthusiast professionals. and what prompted this expansion? When we founded STBY 10 years ago. So we had a drink and decided to organise shared activities for a wider community. STBY operates both in the UK and Holland. in Amsterdam. What recommendations would you make to Touchpoint readers on how to incorporate research into their projects. two countries where service design is at its most established. By now service design has firmly spread across many different sectors. We have now extended the core group of organisers with extra people for industry and academia.

THANK YOU! .