Mayo Clinic SPARC and IDEO Design Methods: Lessons for design of health care systems in India

Dr Alan K Duncan, Medical Director who heads the SPARC innovation Project at the Mayo Clinic, Rochester, Minnesota has this to say about the IDEO team and their design methods: “…..before I began our work with them I only knew of design as a craft of aesthetics. But I found in the designers three remarkable qualities – not too dissimilar to that of the skilled clinician – empathy, curiosity and positivity. I think this is why design can truly find a meaningful home in health care.” Mayo Clinic, one of the worlds largest health care systems looked to innovate ways to make their systems better but found that they were not equipped to do so easily. This innovation effort is supported by the VHA Health Foundation, USA and I do hope that a similar government supported effort can be launched in India as well to use design to address the health care needs here in India.

Together with IDEO and an in-house team of doctors and designers the SPARC methodology for health care design was developed and tested. The process that was time tested at IDEO over hundreds of highly successful industry projects (see the amazing IDSA-BusinessWeek design innovation awards statistics) was applied to health care sector by the SPARC team to achieve dramatic results in patient satisfaction and quality of service in a sector that was traditionally handled exclusively by medical staff and administrators. The IDEO way included the use of narratives in seeking opportunities for design action which were rapidly prototyped and evaluated through numerous iterations and the results achieved were then communicated with conviction to the entire medical system using design all the way. The approach included the use of processes and skills that could help design, develop and implement the learning directly into the health care system since the SPARC team was strongly coupled and embedded into the service network as an integral part of it and not operating from the outside.

The best traditions of user research have been borrowed by design (see the anthrodesign list on yahoogroups for discussions on this) from the fields of anthropology, psychology and sociology. Using these processes the SPARC team gets into a learning mode by using numerous tools of observation, narration and story telling that helps build a knowledge hierarchy that is both informative as well as sensitive to the deeper needs and feelings of the user groups. The learning curve involves an ask, observe and create cycle that allows one to access tacit knowledge which is not easily accessible to other methods of investigation. Comprehensive records are maintained through the process of interaction and observation with the intent of building models that can be shared and tested through a display of visual information, artifacts and notes. Dealing with health care is a sensitive matter that requires the team to be responsive to issues of access, privacy, care for the human subject as well as the management of the total experience to a high quality of satisfaction.

Collective idea generation using brainstorming is a norm and the IDEO rules for this are as follows:

Be Visual
Wild Ideas are Encouraged
Go for Quantity
Build on the Ideas of Others
Defer Judgment

Prototyping is the next big step. It is used to learn rapidly and to reduce risk of failure and this can be applied to the prototyping of services as well as products. By building these prototypes that team is able to literally see around the corner and experience the future, thus solving many latent needs which can only be recognized by the users once they are shown to them in the form of a prototype. The IDEO motto is… “ to fail often to succeed sooner.”

Form of the innovation and the mode of communication that is adopted is the key for the rapid diffusion of the break-through innovations that are achieved through these participatory and embedded processes in the health care innovation system. Using Everett Rogers’ innovation diffusion model the SPARC team looks at the spread of the innovation to explicate the relative advantage to ensure early adoption, compatibility to ensure fit, complexity to make sure that it makes sense, trialibility so that it can be tried and tested repeatedly and finally observability so the innovation can be seen to be believed in, all of which contribute to the smooth adoption of the innovation across a wide base of user groups.

Mayo Clinic discovered design in their search for an innovation tool and procedure that could be sustained within their own health care system and starting in 2002 in the planning stage the SPARC effort has reached maturity and full staff operation by 2005, leading to a dramatic transformation from within and the assimilation of the process of design as an integral part of the health care delivery system, which is the best way to use design in any case, from the inside. This is what I call putting design inside the health care system and in India we need to do this in as many as 230 sectors of our economy.

I would like to thank my friend Matthew Maleska for bringing this amazing story to my attention. Matt had traveled to India as a Fulbright scholar and studied at NID briefly after graduating from the RISD, Providence. Returning to the USA to join the SPARC team as an in-house design researcher along with a large team of doctors and medical staff at the Mayo Clinic he is finding a meaningful role for himself to use design skills within the health care system. Thank you. This kind of demonstration, if taken seriously by the Government of India and the medical establishment in India and it is adopted here in India as well it could show us the way for putting design inside all 230 other sectors that are in need of innovation today, in an effective manner.

The full presentation and discussions of results can be downloaded from these links below:
PDF file 3.5mb of the SPARC IDEO Method and at this link for more information about the various innovation projects from the VHA Health Foundation

Now "Experientia" has a story on SPARC: putting people first.