Service Design in Healthcare: our top 5 takeaways from the PULS conference

Seeing health and healthcare through patients' eyes is crucial when developing new services. Adopting an outside-in approach has a proven record of increasing efficiency, and of course improving the patient's experience of the healthcare services themselves.

On June 1st 2017 Livework and Netlife Research hosted a new conference in Oslo where user involvement, service design and digitalisation in healthcare were central themes: PULS (Norwegian for pulse.)
We gathered people who are interested and engaged in healthcare, and invited a panel of expert speakers from around the world. They shared concrete examples of real-world healthcare cases and practical knowledge on how to improve and innovate healthcare to meet the challenges that face us.
Here are 5 of the main takeaways from the day.

1. Citizens are the untapped resource in innovating healthcare

There was a clear trend during the conference that healthcare models are slowly shifting their focus from a productive system” to productive citizens”. A trend that stops seeing patients as passive recipients of services in favour of providing them with products and services that empower them to take part in their own healthcare. Services that enable citizens to play the role of both consumer’ and producer’.

The Norwegian Health system will collapse if we don’t rethink healthcare. Productive citizens are part of the solution.

Lavrans Løvlie , Livework Studio

For example, Marnie Meylor De Mooij demonstrated the value of this approach when presenting the project Improving the pre-natal patient experience. By providing pregnant women with the right tools, leveraging technology and re-designing the model of care, women became active participants in their own pregnancy. Average appointments went down dramatically from 12-14 to 3-4 per person, enabling a better experience that saved time and money for all concerned.

Patients are chronically underestimated as key participants in making healthcare better and more efficient

Marnie Meylor de Mooij , Mayo Clinic
The potential lies not only in medicine, technology and delivering treatment more effectively, but in engaging citizens in their own healthcare. 
Read more about the project here:
Lavrans Lovlie, Livework studio

2. The Power of Storytelling

The value of storytelling was emphasised throughout the day, by anthropologists, nurses and designers, as well as directors, professors, and marketing professionals. Using storytelling as a tool allows people to stop focusing on their roles as healthcare professionals and switch focus to the needs of their patients. It’s something that can unite people. This makes storytelling a central approach in transforming systems, because it helps to flatten hierarchies and unlock creativity.

Capture stories and communicate them back

Siri Bett , IBM Watson

The examples at PULS ranged from using storytelling to communicate peoples needs to executives and other important decision makers by creating an exhibition, to using stories to communicate a shared vision of what needs to be changed, before moving on to solutions. 

A shared space where people who disagree can gather, helping to articulate the vision and the case for change.

Aviv Katz , Innovation Unit

A storytelling exhibit to share insight with those not involved from Siri Bett, IBM Watson

Storytelling is a powerful and effective way to engender empathy and create a shared understanding, provide direction and build a case for what needs to be done.

3. Technology can’t replace warm hands. See it as the enabler, not the driver.

Another clear take away during the conference was that, technology—when used wisely—can enhance the patient experience, improve efficiency, promote autonomy, personalise information and enable new value propositions. But in order to achieve this we must start with understanding peoples’ needs and behaviours and not just solely from the perspective of their care and treatment program.
For example, a service developed by Oslo University Hospital and Netlife was co-created with and for patients with psychosis, allowing the individual to take responsibility for and manage parts of their own treatment. The technical solution enables the patient and therapist to put together and maintain the best possible plan, which includes sleep monitoring, documenting medication and cognitive or physical therapy.

We need a more user-friendly e-health service in Norway my car has a better digital experience than I do

Nina Ulstein , Direktoratet For e-helse
We also heard that written content is another important aspect often overlooked in development processes where technology is dominant. Although this can be avoided by setting-up a test panel of people with first-hand-experience to give feedback and shape content, tone of voice and language. The key here was to facilitate a process in which patients created and validated content for other patients who were in the same boat.
In summary, starting with empathy and a plan to involve staff and patients throughout the process helps us to deliver better services and humanise technology whilst taking full advantage of it.
Sune Knudsen, Danish Design Center

4. Bridge the gap: Show don’t tell

PULS clearly demonstrated how service design has become people’s ammunition” to help rethink and envision the future of health and healthcare. Our tools are simple, yet powerful because they allows us to gain insight into what motivates people, and even help people make better choices for themselves and for society. Many of the principles found in design are now combined with new fields, such as Behavioural Economics. This lies in the intersection between psychology and economics and studies how small changes, referred to as nudges, have proven to be highly successful, as well as affordable. 

Good solutions are often about getting back to human basics. Easy to say, difficult to do. That’s why design is needed.

Sune Knudsen , Danish Design Center

Another happy moment at PULS is that non-designers are increasingly engaged in participatory research to experience and feel the living experience of others” in order to inform decisions. This solves the problem of getting over the door step in hospitals to gain insight about peoples needs. Caroline Chaffin, a former nurse who is now a service designer at Livework, is the living proof of this trend and shared her transition from working in the hospital battlefield, to supporting front-line staff wanting to innovate. 

99 % of the time we are not the people whom we are designing for

Erica Gibson , Telenor

In order to convince those in charge, we must show not tell.  This was demonstrated by the Danish Design Centre who used shipping containers to build future scenarios in healthcare which they transported to the construction site of a new hospital to influence decision makers. We can’t build a healthcare system that will last for the next 50 years, if we don’t even know what the next 10 years will look like.

5. I’m more than just a patient!

Our final take away—that was also featured in many of the talks—identified the importance of designing for more than just the users’ or the patients’ perspective. After all, health and healthcare is such an all encompassing part of our lives. We therefore also need to see and understand the full human perspective.

I have an appointment once a week, but my life is what happens to me in between.

A patient , Oslo University Hospital 

A great example of this mindset was illustrated by students from the Oslo School of Architecture and Design, Ingrid Fløgstad and Henriette Sagvolden’s with their project Reframing sexual health”. A service design approach was adopted to move public health services out of the clinic and into people’s everyday life. By weaving the service offering into the fabric of people’s everyday activities and lives they managed to increase awareness and trigger engagement. For example, free contraception was made available at bars and clubs.

Can sexual health initiatives learn from everyday social interactions

Ingrid Fløgstad & Henriette Sagvolden , Students from the Oslo School of Architecture and Design
Thanks to all this year’s speakers and attendees. We are delighted to see that 86% of the participants would like to attend PULS 2018 and look forward to seeing you then!
To find out more, visit:

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