IS1 Northwell 2022 Presentation by Parsons MS SDM

IS1 STUDIO

Designing the Healthcare of Tomorrow

The team

Maria Alejandra Altet

Shivani Bhansali

Lucia Chen

Ramey Chen

José Pablo Domínguez

Dana Duarte

Radhika Kale

Chrissie Kayode

Meshwa Kshatriya

MJ Kwon

Mikaela Li

Valentina Palacios

Soumil Panwar

Tako Sulakvelidze

Charloe Yu

Claire Zhuang

MS SDM Integrative Studio Spring 2022

Instructors Leah Cabrera Fischer Ankita Roy

We are Researchers Consultants & Strategists Experience & Service Designers Product & UI/UX Designers Branding & Marketing Strategists Visual & Graphic Designers

Contents 01

How we got here

What we found

Opportunities

The path forward

▾ The journey ▾ Insights

▾ Design principles ▾ Opportunity areas ▾ Proposed solutions

▾ Roadmap ▾ Impact

▾ ▾ ▾ ▾

Context Our process Healthcare today Challenge

How we got here

THE CONTEXT

A strategic partnership

The largest integrated healthcare system in New York State commied towards caring for millions of individuals and their families

01 How We Got Here

The number one design school in the U.S. and among the top three globally

THE CONTEXT

Brief from Northwell Northwell partnered with Parsons SDM to look into how they could personalize and digitally transform patient and caregiver experiences while keeping SDOH in mind

01 How We Got Here

OUR PROCESS

An insights driven approach

34 patients

5 insights

59 initial ideas

25 patients

12 caregivers

4 personas

7 prioritized ideas

9 caregivers

7 providers

4 opportunities

4 design principles

7 providers

4 experts

01 How We Got Here

3 experts

HEALTHCARE TODAY IS…

Complex & ambiguous

33%

of U.S. adults went without recommended care, did not see a doctor when sick, or failed to ﬁll a prescription because of costs

24 days

How might Northwell decrease entry barriers and increase accessibility in the healthcare system?

average wait time for a new patient-physician appointment

Source: The Commonwealth Fund, Arista MD 01 How We Got Here

HEALTHCARE TODAY IS…

Missing context

80%

of the factors that inﬂuence our health operate outside hospital walls

$200

average cost of no-shows per patient for health systems

How might Northwell oer care for social determinants of health (SDOH) that prevent patients from staying on top of their health?

Source: County Health Rankings Model, “Prevalence, predictors and economic consequences of no-shows.” BMC health services research 01 How We Got Here

HEALTHCARE TODAY IS…

Lost in translation

3.1m

immigrants in NYC, of which 50% have LEP

23%

of New Yorkers identify with having LEP and associated diiculties

How might Northwell improve the healthcare quality and access amongst patients with Limited English Proﬁciency (LEP)?

Source: MOIA Annual Report 2019 01 How We Got Here

HEALTHCARE TODAY IS…

Not caring for caregivers

23.5%

of New Yorkers reported being a caregiver for family or friends

26%

How might Northwell oer support to patients and caregivers to improve treatment & health care outcomes?

of family caregivers have diiculty in coordinating care for patients

Source: Caregiving in the US 2020 01 How We Got Here

THE CHALLENGE

Reframed problem space How might we create a more holistic, accessible, and inclusive patient experience with a focus on family and caregiving units through the use of digital tools?

01 How We Got Here

What we found

THE JOURNEY

A patient’s healthcare journey ACCESS TO CARE

DELIVERY OF CARE

The initial step of awareness and action towards starting a healthcare journey

When a patient is actually receiving a healthcare service they need

EXTENDED CARE The path to recovery after a patient has been diagnosed and has left the hospital Diagnosis

Recovery

Check up

Get appointment Awareness Trigger

Tests & scans

Identify specialist Commute

Follow up

After care

Follow care

Paperwork

Pay bill

02 What We Found

ACCESS TO CARE

DELIVERY OF CARE

EXTENDED CARE

INSIGHTS

AMBIGUITY BREEDS AVOIDANCE

People have a preconceived notion that the healthcare system is complex and inaccessible, which creates fear in their minds leading to avoidance.

“

So I had a strong migraine and went to the hospital, I made an appointment with a primary doctor, who later directed me to a neurologist and by the time I got my results back my headache was already gone and so were my dollars. Next time I am simply going to CVS. Priya Patient

02 What We Found

___ ▾ ▾ ▾ ▾ ▾ ▾

Perception of complexity Lack of precise and clear information Ambiguous estimates and costs Hard to ﬁgure out what doctors yours need Self-medication Distrust in the system

ACCESS TO CARE

DELIVERY OF CARE

EXTENDED CARE

FAMILIARITY BREEDS COMFORT

“

The needs of patients with LEP are often multi-faceted, ranging from functional translation supports to emotional support, advocacy, and cultural bridging. I was about to deliver Emilio. I didn’t take the translator service because I was worried about the cost and I didn’t want another stranger in the room. As my contractions worsened, I struggled to understand what they were saying. I wished there was someone who could support me in Spanish, but it was too late.

___ ▾ ▾ ▾ ▾ ▾

Lack of empathy & belonging Unaware of eligible services & cost Lack of guidance to anticipate possible problems Service oered at the wrong moment or late Communication gap & language barriers

Soﬁa Patient

02 What We Found

ACCESS TO CARE

DELIVERY OF CARE

EXTENDED CARE

INSIGHTS

TRUST IS FOUNDATIONAL

“

We think about people trusting us and we’re trusted messengers, but we don’t think about how they view trust. This is chronic behavior in health systems, community-based organizations. Everybody’s busy, but we forget to prioritize the people that maer. Lisa

Reaching patients most impacted by SDOH factors requires health systems to build trust in communities that have been historically marginalized / ignored and oer resources in a respectful, digniﬁed way. ___ ▾ ▾ ▾ ▾ ▾

Distrust in the system Unaware of eligible services Misleading guidance Lack of belonging Feels unheard & self-conscious

Health Care Provider

02 What We Found

ACCESS TO CARE

DELIVERY OF CARE

EXTENDED CARE

COORDINATION IS PARAMOUNT

“

Communication, between a patient’s care team of doctors, surgeons, nurses, and caregivers is fragmented and siloed, often leaving the patient or caregiver chasing for answers. While I was suering in pain, my doctor and specialist kept sending me back to each other. I felt like I was running in circles with no answers and real help! When I found a new doctor, I had to get more tests and scans because my old doctors never faxed them to the new one.

___ ▾ ▾ ▾

Siloed communication between doctors Lack of visibility into recovery timeline Limited ownership and control of medical report sharing

Rachel Patient

02 What We Found

ACCESS TO CARE

DELIVERY OF CARE

EXTENDED CARE

INSIGHTS

CARE GOES BEYOND THE HOSPITAL

“

Patients with chronic care situations require extended care outside of the hospital premises, however, symptom management and emergency care are barely catered to outside hospitals. It takes a village to care for an unwell loved one and our family and friends support us by helping. But in certain situations, it breaks my heart to see my wife in pain. Us not knowing how to provide care or what to do to help doesn’t help. Jason

___ ▾ ▾ ▾ ▾

Ambiguous information on care Lack of emergency support & assistance Poor coordination between caregivers and care team Lack of visibility into treatment duration

Caregiver

02 What We Found

THE INSIGHTS

A quick summary 01

Ambiguity breeds avoidance

Familiarity breeds comfort

Trust is foundational

02 What We Found

Coordination is paramount

Care goes beyond the hospital

What resonated with you? What surprised you?

02 What We Found

Opportunities

DESIGN PRINCIPLES

Our north stars Holistic Care

Empathetic Communication

Cultivate Belonging

Cohesive Experience

Care for patients by providing not only functional but also emotional support, in a warm and familiar way that makes them feel at home

Request and deliver information in an empathetic, mindful and digniﬁed manner, making patients feel heard while creating a judgment-free safe space that enables comfort and honesty

Provide inclusive and accessible experiences that cultivate a sense of belonging while keeping in mind patients cultural, social, economic and emotional aspects

Reduce friction by avoiding unnecessary, repetitive actions and proactively share information internally so that every touchpoint with Northwell feels like a seamless continuation of the last one

03 Opportunities

OPPORTUNITIES

Opportunity areas and solutions How might we decrease entry barriers and increase accessibility in the healthcare system?

How might we oer care for patients with social determinants of health (SDOH) that prevent them from staying on top of their health?

How might we improve the healthcare quality and access amongst patients with Limited English Proﬁciency (LEP)

How might Northwell oer support to patients and caregivers to improve treatment & health care outcomes?

Specialist Connector

SDOH Screener

Cultural Advocate

Care Nest

Holistic Care

Cohesive Experience

Holistic Care

Cohesive Experience

Health Advisor

03 Opportunities

Empathetic Communication

Cohesive Experience

Cultivate Belonging

Holistic Care

Cultivate Empathetic Communication Belonging

Holistic Care

Cultivate Belonging

Discover Nearby

Let’s bring these solutions to life and see what a holistic journey could look like

03 Opportunities

ACCESS TO CARE

01 Enable access with Specialist Connector

DELIVERY OF CARE

EXTENDED CARE

Pain Points Pain Points

Lack of precise and clear Lackinformation of precise and clear information ●Ambiguous Ambiguous estimates and costs estimates and costs ●Perception Perception of complexity of complexity ●HardHard to ﬁgure out which speciality to ﬁgure out which speciality of doctor is needed of doctor is needed ●

● ● ● ●

Opportunity Area Opportunity Area

Like when a kid comes to his mom and Like when a kid comes to his mom and asks asks for help to identify his pain, this for help to identify his pain, this tool takes tool takes patients through a series of patients through a series of steps, helping steps, helping them ﬁnd the right them ﬁnd the right specialist according to specialist according to their needs their needs and pains and pains

03 Opportunities

01 ENABLE ACCESS

03 Opportunities

Specialist Connector

01 ENABLE ACCESS

03 Opportunities

Specialist Connector

01 ENABLE ACCESS

03 Opportunities

Specialist Connector

ACCESS TO CARE

02 Care for SDOH with SDOH Screener

DELIVERY OF CARE

EXTENDED CARE

Pain Points

● ● ● ● ●

Distrust in the system Unaware of eligible services Misleading guidance Lack of belonging Feels unheard & self-conscious

Opportunity Area

Asking patients respectfully about external factors can help them reﬂect and help Northwell identify those suering from health disparities that can be geing in the way of accessing healthcare or recovering properly.

03 Opportunities

02 CARE FOR SDOH

03 Opportunities

Screener

02 CARE FOR SDOH

03 Opportunities

Screener

02 CARE FOR SDOH

03 Opportunities

Screener

ACCESS TO CARE

03 Care for SDOH with Discover Nearby

DELIVERY OF CARE

EXTENDED CARE

Pain Points

● ● ● ● ●

Unaware of eligible services Embarrassed to ask for help Feels unheard & self-conscious Lack of sense of belonging Feeling vulnerable

Opportunity Area

Northwell goes beyond expectations. Like a mother when her kids leave the house, Northwell cares for its patients, especially in the most diicult situations, and helps them ﬁgure out how to navigate a system and surroundings, until they are ready to do it by themselves. 03 Opportunities

03 CARE FOR SDOH

03 Opportunities

Discover Nearby

03 CARE FOR SDOH

03 Opportunities

Discover Nearby

ACCESS TO CARE

04 Assist & guide with Health advisor

DELIVERY OF CARE

EXTENDED CARE

Pain Points

● ● ● ● ●

Unaware of eligible services Perception of complexity Lack of sense of belonging Lack of clear information Siloed communication between doctors

Opportunity Area

Most patients do research before visiting a doctor. However, some patients require additional support. The health advisor coaches patients according to their needs across the entire journey. “Like an advisor for college students”

03 Opportunities

04 ASSIST & GUIDE

03 Opportunities

Health Advisor

04 ASSIST & GUIDE

03 Opportunities

Health Advisor

ACCESS TO CARE

Pain Points

Assist & guide with Cultural Advocate

● ● ● ● ●

DELIVERY OF CARE

EXTENDED CARE

Lack of empathy & belonging Unaware of eligible services & cost Lack of guidance to anticipate possible problems Service oered at the wrong moment Communication gap & language barriers

Opportunity Area

Some patients need language assistance, while some also need to feel more understood. Having someone from their culture can make them feel at home, especially those patients who are going through long recovery processes

03 Opportunities

04 ASSIST & GUIDE

03 Opportunities

Cultural Advocate

04 ASSIST & GUIDE

03 Opportunities

Cultural Advocate

04 ASSIST & GUIDE

03 Opportunities

Cultural Advocate

ACCESS TO CARE

06 Support caregivers with Care Nest

DELIVERY OF CARE

EXTENDED CARE

Pain Points

● ● ● ●

Lack of information to take control for recovery Poor coordination between caregivers and care team Siloed communication between doctors Lack of emergency assistance

Opportunity Area

Recovery can be stressful. Taking things o of a patient’s plate to lighten the load would be highly appreciated by them. This journey tracker for patients aims to alleviate stress during a recovery process.

03 Opportunities

06 SUPPORT CAREGIVERS

03 Opportunities

Care Nest

06 SUPPORT CAREGIVERS

03 Opportunities

Care Nest

06 SUPPORT CAREGIVERS

03 Opportunities

Care Nest

06 SUPPORT CAREGIVERS

03 Opportunities

Care Nest

06 SUPPORT CAREGIVERS

03 Opportunities

Care Nest

06 SUPPORT CAREGIVERS

03 Opportunities

Care Nest

PROPOSED SOLUTIONS

Solutions along the patient journey ACCESS TO CARE Symptoms survey

DELIVERY OF CARE

EXTENDED CARE

Specialist suggestion

Specialist Connector

Questions to identify SDOH risk

SDOH Screener

Resources near the patient’s location

Personalized recommendations

03 Expert helping patients navigate

Discover Nearby Personalized reminders and recommendations

Health Advisor Support for people from different cultures

05 Daily care routine checklist

06 04 The Path Forward

Cultural Advocate Journey tracker

Urgency video calls

Knowledge Hub & FAQ

Care Nest 51

The path forward

ROADMAP

Implementing the solutions SHORT TERM 01

Specialist Connector ▾

MID TERM 03

Data integration and standardization

Discover Nearby ▾ ▾

02 SDOH Screener ▾ ▾

Develop questionnaire Build in patient touchpoints

Identify and onboard community partners Integrate resources into app

Care Nest ▾

LONG TERM

Onboard patients and caregivers

Health Advisor ▾ ▾

Cultural Advocate ▾ ▾ ▾

04 The Path Forward

Identify and appoint advisors Design and pilot program

Design program with Language services program team Identify priority patients Launch pilot with priority group

THE PATH FORWARD

Business outcomes & impact Increased accessibility for LEP patients

Increased touchpoints for data collection

Cost savings by reducing no-shows

Improved caregiving coordination

Faster turn around for average care time

1.93m LEP NYC residents1 (23% of total NYC population) will prioritize Northwell services for cultural dierence support

Northwell will have access to 17 more data points per user which can be used for future service development as user needs evolve

Potential annual savings of $30m1 by oering support and resources, thus reducing no-shows by 5% of all appointments (assuming 2m patients per year2)

By incorporating extended care services, Northwell will improve caregiver coordination for at least 8% of family caregivers1

Reduce average time for specialized care from 24 to under 7 days by connecting patients and specialists eectively and directly

Source 1; Source 2

Source 1

Northwell championing holistic wellcare and making a unique business case in healthcare history

04 The Path Forward

OPPORTUNITY AREAS

Key strategic shifts FROM Complex and ambiguous Missing context Lost in translation Not caring for caregivers Healthcare today

04 The Path Forward

TO Transparent and reassuring Identifying & addressing inequities Cultural bridging and advocacy Supporting both patients & caregivers Healthcare tomorrow

Are you ready to build “healthcare tomorrow” with us?

I like… Which opportunities stood out most to you?

I wish… What would you change or do dierently?

I wonder… What do you want to explore further?