Designing Healthcare for Generations

At last week’s World Health Summit 2010 (Berlin, Germany), I was most surprised to learn that countries around the world are facing strikingly similar healthcare challenges. For example, the United Kingdom, the United States, Germany, and Japan are all faced with the challenge of providing healthcare services to an aging population without a robust tax-base to support them. Interestingly enough, this global demographic trend can be traced back to the post World War II “baby boom” generation.

Due to this “baby boom” generation, countries across the globe are in a phase where they are readjusting budgets, strategic priorities, and therefore laws, to finance and in many cases provide healthcare services. In terms of feasible solutions to address these issues, I believe there are only a few, long-term, feasible options that may have the desired impact on this large population subset (or at least, there are just a few options presented here). The desired impact aforementioned is to provide meaningful, comprehensive healthcare to an aging population (and to the disabled) without stressing the tax-base.

1.    Create Scalable Economies and Job Opportunities for Older Americans. Historically, in the United States, it has been generally accepted that after 65 years of age, one should (and has the right to) retire, live off Social Security, and receive Medicare benefits. Post the global financial market collapse, this thinking has started to shift. Still, given data that shows people are generally living and working later in life, we should continue to harness the intellectual capacity of the older knowledge and labor workers. These workers, with experience in business and skilled-trades could significantly support the United States economy, while lessening the reliance on the tax-base. The issue inherent is that we have to collectively mentally shift into supporting these workers as a substantial profit and productivity-add to the United States economy.

2.   Design Health into Society. I am borrowing or quite possible creating the term “Health Design” as a means to influence health behavior and population outcomes at the often unrecognizable subconscious level. At last week’s World Health Summit, I posed the question to Rob Moodie, Professor and Chair of Australia’s National Preventative Health Task Force, “How can we get populations to the point where they wake up and say ‘I want to be healthy?’” Paraphrasing, he said quite simply “You have to design it in.” The core of Professor Moodie’s presentation focused on the challenges and success of Australia’s public health campaigns .To glean the gist of Professor Moodie’s presentation you can take a look at Australia: the Healthiest Country by 2020 here—be sure to pay special attention to page 9, Figure 2—great graphic showcasing the effect of Australia’s public health interventions. During his answer, Mr. Moodie cited several “health design” examples. For example, showcasing art in stairwells to influence people to use the stairs—this without them realizing they are doing something for their health. I believe health design can and should be taken several steps further. Examples follow.

a.    In a recent office conversation, I found myself discussing recent headlines regarding the impending U.S. physician shortage. It just so happened that this colleague is a fan of the NBC series Scrubs. The question I posed to my co-worker was “Why haven’t we seen a television program with its setting in a primary care clinic?” The story line could be a lot more interesting than anything that takes place in an emergency room alone. Imagine The Office meets ER—now that sounds like must see television. For decades, television programs such as Scrubs, ER, and even the Cosby Show have had a significant influence on helping or suggesting healthcare career options. Although relatively difficult to measure, the subconscious influence of these programs cannot be shunned. I believe healthcare design should strategically work at this level of population influence to strategically affect psycho-social health behavior.

For further evidence, we can look at examples from the film Thank You for Smoking or the real life example of Patron Tequila. In the film Thank You for Smoking, the viewer witnesses the life of a tobacco lobbyist who faces the morality of explaining his profession to his son. During a key scene in the film, the protagonist discusses marketing cigarettes through movies. During this iconic dialogue, the film executive describes the perfect smoking scene. The idea of product placement is not a new, but why have healthcare workers not actively and strategically worked at this level of healthcare influence?

In the example of Patron Tequila we learn that John Paul DeJoria, Principal (also co-founder of Paul Mitchell—yes salon products) first marketed Patron through movies and television. Consumers were asking for Patron by name before it even reached bars saying “Oh, what’s that new tequila?” Through this marketing strategy John Paul DeJoria has become a billionaire (again) via Patron Tequila. Again, an example of the influence of subtle clues on psycho-social behavior.

b.   Create the Health Design Curriculum. Professor Moodie suggested we create teams of politicians, marketers, public health workers, healthcare lawyers, and health administrators to influence health outcomes in populations. I would like to take this concept a step further and propose the Health Design Curriculum. The health design curriculum would largely follow the case study method and would be comprised of courses in: politics, ethics, general and healthcare marketing, health law, economics, finance, media, film, organizational theory and design. Health designers could also specialize in any of the aforementioned categories. As the most subtle strategic architects of society’s health status, health designers will be able to engage and influence the stakeholders involved in creating laws, programs, products, and services across the entire health spectrum.

The design theory applied to business is not a new. The Rotman School of Management at the University of Toronto is built on this design concept. The design perspective develops systems-level thinking and creative solutions. The single message I heard repeated at the World Health Summit was that we have to think creatively to solve our problems. Integrating design level theories, at the educational level, may develop creative healthcare solution-finders.

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