Digital Behavior Design (ft. Amy Heymans)

Thanks for tuning to Digital Voices podcast, where we chat digital transformation challenges and opportunities across healthcare and life sciences. And now, your host, Ed Marx.

Hi, welcome to another episode of Digital Voices. So excited to have you join us again. I'm with Amy Hammonds from MadPow. And we're going to talk all about human-centered design and the criticality of design in everything that we do across health and life sciences, which includes the providers and the patients and the payers and retail and tech. And so really excited about that conversation, and it reminds me of one of the best experiences I had in school. So when I got my graduate degree, there was a lot of turmoil happening at my university. And ultimately, the chancellor of the university being really aggravated with 5 specific departments that refused to go back to their natural colleges from which they came from a few years prior, put them all together. And I was on this fast-track 1-year program for my graduate degree. So suddenly I found myself taking classes in apparel design, interior design, fashion merchandising, housing, consumer science. I got 5 master's degrees in 1 year as a result. And I didn't think I'd ever need to use all the design principles I was learning, and I sort of filed them away. But man, now that I'm into my career a little bit and met people like Amy and Mad Powell, I'm realizing just how critical design really is to the overall experience. And so we're going to dig deeper into that a little bit here in the next few minutes. So I love working with Amy. If you haven't heard of Amy or MADpow, you need to look them up. As I mentioned, leaders in design thinking, especially in healthcare and also in finance. And so we're going to talk a bit with Amy about all that. So Amy, welcome to our podcast.

Thank you so much, Ed. I'm really excited.

So Amy, the standard question we ask All of our guests. The first one is your favorite music. So like when you're just chilling, you got some downtime, what kind of music do you listen to?

Oh wow, I have a sort of, um, very varied and diverse music interest. So from hip-hop to belly dancing music to Christian rock to jazz to Sinatra, just depends on the day, depends on the mood.

Yeah, that's nice. I like all of that. So the other question we ask, just so everyone gets a sense about who Amy is, is do you operate by some sort of personal mantra or life message purpose? You know, is there something that your true north?

It's a good question. It's so many things. It's, you know, if I feel like I can make an impact in just one person's life, I will suffer any order of of, um, you know, terrible things. So I'm basically a masochist, and I'll do whatever it takes to, um, to do things that are good and make an impact in this world. But specifically in, in the health arena, um, extremely passionate about improving health outcomes and health experiences and, and doing so in a way that, that also is beneficial to the organizations in the health ecosystem. So that's where I sort of bring that desire for impact into action.

No, that's awesome. And Amy, tell us your story. So did you grow up thinking one day I want to lead Mad Pow, a design firm, or what? How did you get to where you are today?

Yeah, sure. So I was always creative-minded. Loved art in high school. I did a great deal of design, and I wanted to go to art school. And so I went to art school and focused in graphic design and painting, sculpture, but I also took calculus. So, you know, I really loved sort of left-brain analytical thinking, and then, you know, right-brain creative sort of thing. And I left college and started my career in the dot-com boom. And I started doing web design. So I took my graphic design degree, everything I had learned about visual design and graphic arts, and took it to the web, started designing websites and coding. And, you know, quickly learned that it's not just about how things look. If they're beautiful, that matters because people, you know, interpret, okay, I'm using something that's high-end, you know, the better it's designed. But I knew that things needed to be useful and usable as well. And so I started to learn about research and usability testing and become very passionate about ensuring that what I was designing was going to resonate with the target audience, was going to be, was going to be good for them, was going to be beneficial for them. And so that's where I got sort of into user experience and human-centered design, cleaning up the World Wide Web, inventing new digital products, and really looking after, again, the needs of the people served by the digital experiences, but also the business, ensuring that we were not just creating shiny objects gratuitously, but ensuring that they were going to make the business impact that we were hoping for.

Yeah, and that sort of leads me to my next question, and that's why is design so critical? So as you mentioned, some of it is related to the outcomes, and a lot of times people just don't think about design right away. It may not be intuitive to them. So why are some other reasons that design is critical to success for any organization, especially in healthcare, reaching out and being focused on experience?

Well, everybody knows that good design is table stakes, right? We've experienced great experiences as consumers, whether it's Amazon ordering something and then it lands on your doorstep, or, you know, DoorDash, you get your meal to your door in 30 minutes, or you get, or, you know, the iPhone, how easy that is, how well-designed that is. So You know, everybody wants good design, but what we see is that, you know, there isn't consensus in terms of what it takes to get to good design. What kind of team does it take? What does it take? What kind of budget, you know, does it take to get there? But we know that, you know, as I mentioned before about making sure that digital experiences are useful, usable, desirable, an experience somebody has with an organization isn't just about the digital aspects, right? Those digital touchpoints are so important. They need to be seamless, intuitive, streamlined, et cetera. But we need to kind of take a step back and broaden the lens and look at, okay, how does somebody get from point A to point B? How do they weave through the experience? What's the journey? You know, who are they talking with? What are the emails they're getting? Are they going into the physical environment? Are they visiting the hospital? What does that end-to-end interaction look like? And you find that digital is important. It's a thread through everything, but it's not the only piece. We need to look at the policies, the processes, how the organization is constructed, you know, from the inside out to generate these good experiences. What's the culture like, etc.? So I lead MadPow as Chief Experience Officer, and we look after creating awesome digital experiences, but also looking at creating great service experiences, improving the way that organizations understand and react to the needs of the people that they serve. And so that's absolutely, you know, an evolution that we've seen in the industry going past digital into the entire experience and seeking to address the value proposition of the patient, of the consumer, of the clinician. And again, generate results for the organization and real meaning and value in people's lives.

Yeah, Amy, where do you see the most interest coming from when you're talking to the C-suite? So, as you know, with Digital Voices, we're largely chief digital officers across all of health and life sciences. Is it coming from chief digital officers, chief patient experience officers? Who's the typical executive, or if there is a typical executive that really is pushing for great design?

Yeah, sure. You know, it varies from organization to organization. In Pears, if you can imagine, they actually have it pretty, pretty well worked out. I mean, they're still, you know, selling a product that very few people understand, and it's sort of difficult to build a relationship and to build trust with consumers. But from an organizational perspective, there are adequate budgets put into experience design in the digital front. They're sort of understanding journey mapping and service design and service blueprinting and, um, you know, understanding consumer jobs to be done. And that's done typically— there is a design group, and that design group or that experience group sometimes reports into digital, sometimes marketing, and sometimes technology. But in any case, they're, they're well-staffed and well-funded to try to improve member experiences. In life sciences, they're now, you know, marketing has always been present in life sciences. But now, of course, there's digital health, digital therapeutics going beyond the drug, and looking at, okay, how do we support patients throughout every aspect of their journey. And they've started up innovation groups, digital health groups, and they're starting to gain some headway and show the value of applying the rigor of scientific discovery that's applied in drug discovery, applying that same rigor in terms of digital design and service design and experience design. On the health system side, I'm sure you could testify to this. So From an experience perspective, Kaiser and Mayo have service designers. They have folks that are looking at every touchpoint and how do you sort of sort it out and improve experiences digitally. And again, from a service perspective, but, you know, other health systems sort of haven't come up to speed. You know, there may be a random designer here or there looking at improving digital experiences. There is definitely process improvement, but there, there hasn't been this sort of design thinking, human-centered design, um, evolution or ownership inside the organization. Uh, you might have a doctor or a nurse, uh, who's a believer in human-centered design and innovation, but it sort of hasn't taken off. And it's like, okay, we deliver clinical excellence, we save lives. And it's like, yes, absolutely. And, you know, we've invested so much money into EMRs and, and You know, there's stuff on the roadmap for Epic, and it's, it's gonna solve all the problems. But there isn't a group that's looking at, okay, how do we leverage all the resources that we have in place to improve patient and clinician experiences? And how do we, how do we create a culture that is empowered to solve these challenges in the short term incrementally, but also look after future forward, longer term, what kind of organization do we want to be like? What kind of relationships do we want to create? What kind of patient and clinician experiences do we want to— and caregiver experiences do we want to manifest? And so there's a big opportunity moving forward.

Yeah, Amy, you just touched on something too that's really important to remind ourselves that while we typically focus on the patient, and appropriately so, We can't forget the caregiver experience. And we all know prior to the pandemic, you know, there was a lot going on in terms of burnout for caregivers. And with the pandemic, it only— the stress level only got higher. So applying strong design to the caregiver experience is critical as well. So what would you give as—

Yeah, sorry, I was gonna say the patient and clinician experience are interconnected, right? If the patient's having a bad day and comes in, It's going to affect what the clinician experiences and vice versa, right? They're interconnected. And so we're even seeing human-centered design evolve in the direction of relationship-centered design. How do we optimize both together?

Yeah, I like that relationship-centered design. So if I were in the C-suite, or maybe I'm a CEO and I've heard about design, I've heard Amy speak, Attended the big conference, and I'm convinced I need design, but I don't yet have that sort of culture or infrastructure. What might be one or two things that you would suggest that someone who gets it and wants to make change, what are some steps that they might take in order to bring about design thinking in their organization?

Yeah, sure. First, first is a listening tour, right? Listening to patients and clinicians and inspiring that culture of listening and observing amongst all of, all of the executives and leadership so that they really know, not just from a data perspective, not just from a measurement perspective, what's going on, but have a deep understanding from experiences and from talking. qualitative understanding of really the current situation, right? So, that helps us understand more deeply the problem and the opportunities and what's going well, what we have going for us. The other is to make a commitment to constantly include patients and caregivers in the process of decision-making, right? The more that we include and invite to the table of innovation the people who will be affected by the solutions we create, the better we'll be doing. So essentially, an ongoing commitment to designing with patients and caregivers will buy down risk associated with spending a lot of time and money and not seeing the results that we were hoping for. And there's also this notion, you know, the more you sort of build this relationship— and I see executives have epiphanies when they're observing what's really going on and talking with folks. They're like, oh wow, you know. And then, you know, once the eyes are open, you know, you can't, can't close them at that point. So there's sort of this, this awakening. Um, but then you start to see, okay, what, what could we, what could we create together collaboratively, right? Because gone is the ivory tower. We are in a collaborative environment where we collaborate across silos. We collaborate outside of our organization, we collaborate with the people we're serving, right? And then if we can create a little bit of time for creativity and principles-based decision-making so that we're empowering people to make decisions and harness a little bit of creativity in what they do, So that we can start to envision a better way. Because, you know, let's be honest, we have so many problems in health. We really need to figure out what the future might be. And creating a little bit of time and space and leeway for people to explore that, it's going to give them a lot of joy. It's going to give them a lot of meaning. And, you know, especially in health systems and even just the health industry in general, where we're working so hard and burdenment and burnout is an issue. So to create those moments where we can really collaborate and leverage creative minds, that's going to be very helpful. There's all sorts of models, methods, and techniques that can be leveraged. And we could come in, Mad Pow, as a consultancy and teach them to you, whether it's behavior change design or futures thinking toolkit, or even leveraging public health frameworks or design thinking, human-centered design, innovation methodology. There's all these toolkits. We could come in and train you, but Ultimately, it has to be an ongoing cultural commitment to human centricity.

Those are very, very practical steps that anyone can take, so thank you for that. You obviously have been successful doing this a while, and Amy, I was wondering if you might share one or two success stories of some organizations that have undergone such a cultural transformation and embraced design thinking or relationship-centered design and really made a difference in their outcomes? So I know you work across health and life sciences and finance, so any couple examples that you might share?

Yeah, absolutely. My favorite, Ed, is Imagine Care, which was an innovation spun out of Dartmouth-Hitchcock Medical System. And the hypothesis was, how could we bring care outside the walls of the 4 hospitals, outside the 4 walls of the hospital, in the places where people live 24/7? And this is something that started 4 years ago or something like that. You know, prior to the pandemic, any organization that set itself up for working with patients to manage their conditions, in the home pre-pandemic was set up for more success, you know, moving into the pandemic. They were, you know, miles ahead. But this solution, Imagine Care, really brought value-based care to life. It basically had a smartphone device connected to Bluetooth biometric sensing devices, and the patient's, you know, top 5 chronic conditions diabetes, hypertension, COPD, asthma, and even behavioral health pathways could take their measures. There was a digital health coach as well for daily sort of motivation, and they could secure connect to a clinician monitoring this population 24/7. And so, if someone stepped on a scale as a congestive heart failure patient and their weight had spiked, they would get a phone call within 2 minutes of taking that measure. So, it's closed-loop monitoring. And what happened was, in your patients in this solution, they reported feeling like they were no longer alone, somebody had their back, 20% cost reduction in managing this patient population, and 95% satisfaction rating, avoided visits to the to the ER, improved blood pressure, improved health outcomes. And so it really sort of brought to life everything that we knew was possible. And it was just a phenomenal solution that we developed from scratch based on solid research and took all the way into pilot and beyond.

Yeah, that's a great example. You know, as we both would agree, it's just doing the right thing, but it is an example of how design really has very favorable outcomes, you know. So if you're looking at it from an ROI point of view, not only is it the right thing, but you get the outcomes that we just— that you just shared with us. And Amy, I recall, I don't remember the specific client, but I know on the payer side too, you all have introduced some some very positive design thinking capabilities, and as a result, some— I don't know if it was smoking cessation or what the example was, but I know on the payer side too, you've made a huge impact.

Oh yeah, absolutely. So we work with all 5 of the top 5 national payers, as well as over half of the Blues and many regional insurers as well. There's just so much work to be done. And it's on 2 sides of the same coin, right? On one side, you have the fact that the health system is really hard to navigate. It's hard to find the right doctor, make a decision around treatment, understand the costs associated, make an appointment, you know, all these sort of administrative things, quote unquote, associated with, you know, getting your healthcare needs met. So we improve those types of experiences with insurers. We're looking at improving member experiences, helping people understand their plan, How— help them to wayfind, help them to find the best care. And then on the other side, you have health outcomes improvement. So, looking at how do we help people to improve their lifestyle behaviors in the direction of prevention and reducing risk? How do we reverse disease? How do we help people to manage their disease and build towards self-efficacy and condition management? And so, for that, We leverage what we call behavior change design. And so this is the blend of behavior science, motivational psychology, and human-centered design to take an evidence-based approach to design and leverage all the research that has been done and conduct hypotheses, you know, construct hypotheses, test and learn, and basically focus, have a laser focus on improved outcomes. And the important part about that is psychology. There's a lot of knee-jerk reaction in terms of how do we accomplish, how do we help people with medication adherence? How do we help people to change their behaviors? How do we help people to better manage their condition? And people are, you know, human beings are complicated. And we need to understand psychology and integrate what we know about psychology and behavior science into the solutions we're creating, because rewards and incentives and the carrot or the stick, you know, doesn't always work. And there are many, many things that work better. And so, we're helping insurers really do a better job in that regard.

No, that's awesome. So, we talked a little bit of theory. We went And talk practical things. You gave 4 or 5 points of what anyone could do that had an interest in design thinking and bringing that to their organization. Then you shared some excellent examples of the outcomes that others have achieved as a result. Amy, what did we miss? So we just spent 30 minutes talking design and the importance in healthcare, and we probably missed something that might be on your heart to share with us. So I wanted to leave the last— A few seconds with you. Anything that you'd like to share with our audience in closing?

Well, I love that question, Ed, and I'm going to use it in my own podcast. But basically, futures thinking, right? You know, none of us saw the pandemic coming, aside from probably epidemiologists. But, you know, the notion that this black swan event can kind of upend our lifestyles? And what other futures may there be out there, might there be out there? And so, futures thinking is sort of the new design thinking. Okay, and futures thinking offers a toolkit that enables us to analyze various signals and trends happening not just in health, but in other realms and all around the world so that we can start to formulate an idea of what potential futures may exist and consider what we would do. How would we react if we found ourselves in that potential future? We can also look at unanticipated consequences, unintended consequences, and look at, okay, how do our values or ideals, our desire for impact— what happens when we bump those things up against these potential futures? But what I like most about it is that we can envision a preferred future. What does a future look like where we're achieving that virtuous circle between what real people want in their lives and what a business is trying to achieve and create these cycles that lift everybody up? And so through futures thinking, we can start to do that and then figure out, all right, how do we roadmap and get there?

That's awesome. What a great close. Amy, thank you again for being our guest, talking about design. Very intriguing. And I know people can find you at MADPOW. So thank you. Thank you so much, Paul.

This was a lot of fun.

Yeah, yeah, it's good. I love working with you and MADPOW is an amazing organization. So a reminder for those of you who have a question for me, you can now submit your questions via email, in a voice text, send them to our email, which we'll post in the show notes, and we'll answer those live on the next podcast. Thanks everyone, and talk soon.

Hi, this is John Lynn from the Healthcare IT Today podcast. If you like the latest rumors, insights, and happenings in healthcare IT, you'll enjoy hearing my colleague Colin Hung and myself debate and share the latest happenings from the world of healthcare Find the latest episodes or dig into our archive at healthcareittoday.com or search for Healthcare IT Today on your favorite podcast application or YouTube. When it comes to healthcare technology, we love this stuff and we can't wait to have you join in on the discussion of everything health IT.

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