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GfK Healthcare | April 2010 | |
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A “New Way” of Thinking About Change  Freshly returned from an excellent – and excellently attended – PMRG meeting in Orlando a few weeks ago, I am still awash in positivity about one of the keynote presentations. Dan Heath, author of Switch: How to Change Things When Change Is Hard, kicked off the session with an impeccably well- reasoned and entertainingly presented offering that summarized in one hour the major takeaways from his book. This summary, moreover, was a clear and cogent rendition of a theme I have been beating on for some time. That is, we have left behind the eras of invention and persuasion, and are entering the era of design. Hopefully I will do Dan’s important examples justice as I summarize them below, since I believe they provide us with important guidance as to how we should go about making some of the “massive changes,” to use designer Bruce Mau’s terminology, that the health care industry, health care itself, will need to make in years to come. Throughout his presentation, Dan used the metaphor of a man sitting atop, and driving, an elephant. While the elephant was clearly of significantly greater mass, the human could, through appropriate guidance, both keep it under control and provide it with direction. Extrapolating one step further, Dan seemed to clearly indicate that things which appear to be difficult can actually be accomplished rather easily if one knows what one is doing. Apropos to the crowd at hand, which happened to be convened the week that the health care reform bill was passed, it was clear that many things would have to change, many old habits would have to be set aside and many new ones learned as the thousands of pages of the bill rolled out over the next several years. Historically, the way to accomplish this would be to inform and persuade. A classic example was the recent advertising campaign directed at the U.S. population, and funded at great public expense (commercials during the Super Bowl don’t come cheap!), in an effort to get us all to complete and return the U.S. Census forms. While this attempted persuasion was going on, it has been interesting and somewhat disturbing to note, much ado was being made on television about the fact that the word “Negro” was included among the racial buckets into which respondents could put themselves, as were separate categories for Hispanic, Puerto Rican, etc. Many of the people I have seen interviewed on this topic were both offended by the use of the anachronistic term for African American and confused as to where they should place themselves categorically. What if they were dark of skin, born in Puerto Rico and spoke Spanish, for example? In many of the redirections of the elephant that will have to be made as a result of both health care reform and the necessity to make health care more efficient and effective, Dan pointed out that we have a choice. Either we can mount expensive, confusing and, like the U.S. Census example outlined above, potentially offensive communications programs, or we can design systems that make it natural and straightforward for health care stakeholders to follow the path we would have them pursue. Several humorous, but meaningful, examples were offered in this regard. What if, for example, there were a large number of novice drivers on the road, and we wanted to get them to drive in straight lines down the road. Dan showed a large highway with multiple cars, and pointed out that one approach we could take is to mount an expensive campaign to educate and convince each of these drivers to drive in a straight line so other drivers could anticipate their movements. His next slide showed the same road with white lines painted on it, accompanied by the observation that by the use of this simple design trick, a considerable amount of rhetoric and expense in public relations communications could be saved. The white lines, as any fool could literally see, not only made it clear to drivers that they were to proceed in a straight line, but also made it easy for them to do so. In brief, a simple element of good design forestalled the need for a promotional campaign. The second example Dan used, and that I will paraphrase below, is a bit scatological, for which I apologize. It makes its point so well, however, that I need to include it. More specifically, it seems as though they were having trouble with the men’s bathrooms in Amsterdam. To put it bluntly, men were urinating as much around the urinals as they were in them. In old think, the appropriate response to this rather health-hazardous and disgusting situation would have been to put up signs urging cleanliness, perhaps have announcements being quietly made over a public address system, etc. But in the age of design, a better idea was put into place. Quite simply, the authorities etched a small, very realistic housefly into the optimal spot in each urinal where a direct hit would be least likely to yield a messy splash. Men being men, and without anyone saying a word, the users of the urinals could not resist the natural tendency to use the fly as a target. Problem solved! In brief, Dan’s presentation succinctly and brilliantly supported a point I have been writing and speaking about for some months now. With the information overload of words that overwhelms each of us daily, simply throwing more words at people will not get done what needs to be done in terms of informing, persuading, motivating, etc. Rather, we are increasingly going to have to depend on good design, in health care and across our life space, to get people to do what we want them to do. As at least one pundit has observed, “Advertising dollars are the fine that you have to pay for bad design.” Design, when done well, not only communicates the information we want it to communicate; it communicates a message and creates a positive experience that will reinforce the behavior and yield a satisfied client. Here’s a final example not from Dan’s presentation but from my own experience in health care. Patients admitted to a suburban hospital for a routine procedure, like a colonoscopy, are still often transported into the procedure room on a gurney, as they have been for hundreds of years. Lying flat on one’s back, metal sides in place so one doesn’t roll off, counting acoustical tiles in the ceiling as you are rolled to your destination hardly creates the sensation that “everything is going to be alright.” Check in to the extremely well- designed new medical building at the Hospital of the University of Pennsylvania, however, and one finds oneself transported in a semireclined position in a rolling chair reminiscent of a first- class seat on a fancy international airline. Much more comforting than a gurney? You bet! Likely to lead to better outcomes? We’re starting to look at that now. I’m with Dan. As we move deeper into 2010 and beyond, watch for communication and facilitation through excellence in thoughtful, user friendly design to replace a barrage of words, to be more effective and efficient and to create messages and experiences that yield better outcomes and, eventually, a better and more sustainable world.  Richard B. Vanderveer, Ph.D. CEO, GfK Healthcare   |