Watch CFI external advisory council members Tim Brown and Larry Keeley discuss the challenge of transformative change (YouTube version for slow connection).
Mayo Clinic: Design Thinking in Health Care
In the early 2000s, Mayo Clinic physician Nicholas LaRusso began asking himself a question: if we can test new drugs in clinical trials, can we also test new kinds of doctor-patient interactions?
Although over the last 50 years there had been enormous advances in diagnosing and treating disease, the systems of delivering health care had changed little. In fact, new tests, treatments, and procedures meant that the health care experience had become increasingly complex for provider and patient alike.
But what if there were better ways to provide care? As LaRusso reasoned, “New technology, new diagnostic tests, and new therapeutics will be most effective if we can improve the ways we deliver these enormous advances to patients.”
LaRusso had heard that design firms like IDEO were offering consulting services in the area of human factors design, and he wondered if their work might be applicable in the health care setting. Mayo had a history of innovation in care delivery, starting with the invention of the patient medical record in the early 20th century, and the clinic was always looking for ways to improve both patient outcomes and the health care experience.
In 2002, in consultation with IDEO, LaRusso and colleague Dr. Michael Brennan opened a skunkworks outpatient lab called SPARC, where physicians and designers could test hypotheses about ways in which providers and patients interact. They dealt with a number of challenges: recruiting busy physicians to a new and untested type of research, crossing the cultural divide between physicians and designers, doing experimentation with real patients, and gaining institutional support for their unusual endeavor.
Within six years, the lab had grown from a small venture to an enterprise-wide Center for Innovation, a dedicated research institute that studies the processes of health care provision, from the initial phone call, to the clinic visit, to the diagnosis and treatment of the problem, to follow-up and preventive care.
In 2010, the CFI was a respected internal consultancy of Mayo Clinic. It had five platforms that encompassed various kinds of service redesign, and it had grown from two full-time employees to 32. It had undertaken projects to reorganize the work flows in a practice, test new strategies for patient education, use technology to improve physician consultations, and redesign the traditional exam room.
At the same time, CFI designers and physicians acknowledged that the innovations they had developed were small, and they spoke of the goal of "transformational" change. But in 2010 there were questions about how the CFI would achieve its stated aspirations. What would a major change in health care delivery look like? How should the CFI's impact be measured? Were the center's structure and processes appropriate for transformational change?