The Journal of Health Design has been launched to serve innovators who are inspired by unsatisfactory patient experiences. Stories that suggest that by working with people and focusing on their needs as well as their wants we can develop much more effective healthcare solutions. Stories such as those described below.
I saw him many times over the years. He was Indian and he had diabetes. His blood results were seldom within target and he was obese. He had heard why this condition might impact on his future. We spent many weeks and months getting to know one another. I consulted other members of his family. I saw him through several life events including his spiritual rebirth. Finally his blood sugars come within target and his weight drop to within the ‘normal’ range. All this was achieved through his own efforts.
Diabetes impacts on people in very different ways. The prognosis depends on how the person with the condition responds to their body’s inability to handle sugar.
If medicine can be framed as an art it involves the practitioner being able to elicit information. Then working with that individual within a common frame of reference so that less sugar is consumed.
Therefore context is everything. The following may all apply in assessing outcomes in relation to practitioner-patient dyads:
- The age and gender of those involved
- The social, political and economic conditions
- The history of both in the lead up to current events
- The culture of both
- The professional interests of the practitioner
- The ideas, concerns and expectations of both
Nowhere in medicine is this more important than in general practice. Here the patient is most likely presenting at a very early stage of a potentially life limiting condition. The stakes are high insofar as early intervention leads to better outcomes.
At the same time in most cases, in general practice; what the practitioner offers has only a peripheral impact on the outcome. Most minor self-limiting illness is just that. In time the condition will resolve spontaneously. However there is a significant risk that inappropriate treatment, or for that matter any prescribed treatment could do more harm than good. The outcomes are similarly dependent on the ability to practice the art of medicine.
The first and most important question is why has this person sought the help of this practitioner at this time? If you don’t know then you are unlikely to be able to say if what subsequently transpires is for the best or if it failed, why it failed. The context is often locally and personally defined. Any successful attempt to improve outcomes in healthcare requires attention to context. This is the essence of Patient Experience Design. It is also why general practice is at the heart of the best healthcare systems in the world and why progress in healthcare will be determined by shifting the focus from policies and systems to individuals and relationships. Data is important but no innovation can be deployed without the lens of context.
The JHD invites papers that explore the insights of healthcare practitioners gleaned through their interactions with people. Such insights can be harnessed to deliver more effective ways to achieve outcomes that enhance diagnostic acumen, improve prognosis and satisfaction with what we can provide to alleviate symptoms and reduce distress. Join our facebook page, follow our twitter feeds.
Picture by Christian Senger