Co-creation is the way to introduce user needs and emotions in a product or service. It is the key point that makes a user experience become good or bad. This is especially true in the health area, where patient co-creation and innovation find one of their broadest fields for application.
Internet has changed already years ago the patient-doctor relationship for the better. As in any other aspect of life, people that need a service –health in this case- search first intensively on the web, build an own opinion and look for peer opinions and experiences. The difference between us as internet user searching for any commercial product or service and us as users searching for health is that health is life and gets therefore a special value.
For this reason, patient communities tend to be more stable and show more cohesion than, for instance, sport communities. This is why we speak about e-patient, as communities with a shared and vital interest.
Patient retention and social networks
Public and private medical organizations have realized the huge potential of e-patient communities. In private health, an active patient engagement in service co-design and co-creation of spaces and protocols (patient experience) helps to make of hospitals more friendly places, mainly oriented towards patients’ needs and emotions, which leads to a greater patient rotation (retention of patients as customers) as well as recommendations; direct or over social networks, communities and forums.
This is the case of Rainbow University Hospital. With over 125 years of history, it is considered as one of the best American children hospitals. One of the identified problems by the hospital was the anxiety parents of injured or ill children had when arriving to admission. In an American hospital, during admission the patient has to be clinically evaluated, the insurance questions solved (or no intervention will happen) and a lot of extra marketing information is poured on the patient (parking discounts, where to eat, visit rules).
A child’s admission is not the right moment to overload parents with logistic or commercial information. Rainbow Hospital worked with The Beryl Institute, a consulting firm specialized in patient experience in involving parents and hospital employees in order to solve the problem. The process ended with a new service, where former parents that worked as Volunteer Ambassadors in order to inform new parents on everything that is not urgent, but could be important. They address parents once they have a more calmed moment after admission stress; their job is not so much to offer information, but to inquire with a short conversation what the real secondary needs of parents are (food, parking, overnight rules) and try to give them solutions out from the hospital’s offer in a moment when parents are more relaxed. The case can be read in this link.
As can be observed it is perhaps a minor service. The goal is to reduce parental stress, while not giving up the idea of transmitting commercial information. In other words, avoid the rejection caused by a message that at the end means: “give your money”, in a moment, when parents are involved in what really matters: their child’s health. What matters about this example is how working with patients and staff, a negative experience has been turned into a positive one.
User journey and protocols
In a more modest field, currently we are working intensively on various aspects of a fertility clinic. Without a direct patient driven co-creation, the work with doctors and assistants using interviews and workshops is leading towards what is known as “user journey” (in this case, patient’s journey). A patient experience map from the point the patient gets to know the clinic by doctor referral or internet to the point the treatment ends. Starting with an empathy map build together with patient assistants as a first step towards a service mentality, we work now in every single patient-clinic interaction. Currently we analyze the way doctors conduct consultations, the information they transmit, their listening abilities, if they are correctly understood by patients…
Patient co-creation in public health
In public health, patient co-creation has clearly helped to reduce health care costs, becoming thus more effective and efficient for the citizen. This is the case of Camden Sexual Health Center. The design was done involving actual and potential users. They helped to design the center interior architecture and also the way the service had to be delivered and promoted. You can find more information at this link.
It is not about building more hospitals and reducing waiting lists: the diabetes example
The biggest cost reduction in health is obtained when no service is needed. Especially because our European health care system was designed to treat infections, serious illness (like cancer) and sudden body failures (heart attack). But today, the biggest health cost comes from chronic diseases. For this reason, tendencies in healthcare are going towards proactive rather than even preventive medicine. For this reason, the challenge is not to build more hospitals and optimize processes in order to reduce waiting lists. It is about understanding what patients can do in order to change their lifestyles and prevent chronic diseases. Exactly the contrary what Spanish national and local health authorities did until the crisis. And the opposite of what they are doing now: cutting services without changing habits.
Here is where patient communities with support of public health make sense and can create experiences that change health habits. A good example is the Bolton Diabetes Network .
Every 4th Briton has Diabetes. Although Bolton is recognized as one of the UKs best Diabetes services, the hospital estimates that 80% of the patients do not manage correctly the health habits that have impact on their sickness. After an ethnographic and co-creation work with patients and with the support of Kent county, Activemob was created. A mob is a small patient group of mutual support. They are linked via internet and start activities they can share. Kent County helps for instance with children care, so that time is left for healthy activities. A shared activity can be to walk the dog. This way, members can find this kind of activities that allow a natural grouping by interests and to develop a motivation for participating; a motivation that is reinforced of course a system of incentives and rewards. The program has been so successful, that Kent County is developing a Social Entreprise out of it.
Emotions are important
Marketing departments Stress that emotions are of paramount importance in the moment of truth of purchase. In the medical field they are a key factor; not only from the commercial point of view. Every health issue is at least linked to anxiety. And if it is serious with fear, emotions attached to death, guilt and stigmata appear always. Co-designing medical services necessarily means to take into account this emotional complexity.
Returning to the fertility clinic, we draw over the user journey a parallel map of emotions that appear in every interaction, so that we can foresee what can happen and how to manage it. For example, fertility patients show great anxiety about the development of inseminated embryos. And they expect the doctors to inform them on this evolution. But embryos are alive and rarely do they develop by consulting patient’s and doctor’s agendas. In these days of tension, no information produces anxiety they might express itself with anger or whipping. Being conscious about these emotions and when they appear, communication strategies are being improved, including intermediate calls to the patients by assistants, than can give provisional data until the doctor calls and close this silence gap.
Open innovation and patient driven innovation
Include patient’s knowledge into clinical studies is a growing trend. Initially it was not well seen due to the scientific strictness clinical research demands. These are projects that need strict and closed methodologies, designed by competent and trained professionals. What space is here left for patients? We will try to answer this question in post soon to come.