How Human-centered Design Can Accelerate Digital Health Transformation at the MHS
This second article in the Digital Health Transformation blog series focuses on human-centered design (HCD) as a key pillar of our efforts to improve outcomes by transforming care models within the MHS.
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| Graphic credit: Sofia Echelmeyer, USU |
Oct. 3, 2023 by Retired Rear. Adm. (Dr.) Bruce Gillingham, Dr. Joachim Roski, and Dr. Jonathan Woodson
As part of its mission to support both force medical readiness and medical force readiness, the Military Health System (MHS) is committed to improving health outcomes and access to quality health care among the active-duty personnel and other beneficiaries. This second article in the Digital Health Transformation blog series focuses on human-centered design (HCD) as a key pillar of our efforts to improve outcomes by transforming care models within the MHS.
Designing health care with humans at the center
HCD is an iterative, collaborative and people-focused method of inspiring organizational change by designing innovative services, products and systems, including (but not limited to) technology adoption. In health care HCD adopts a holistic approach to improving the health care experience for all parties by leveraging technology, alternative care settings and other features to meet patients where they are. And amid looming shortages of doctors and other clinicians over the next decade, HCD model design also aims to improve experience and minimize burnout among clinicians. Examples of HCD-driven care redesign include digital “front door” initiatives (e.g., patient portals) allowing scheduling, sending appointment reminders and enabling more instantaneous patient-provider communications, telehealth visits and reimagined staffing models.
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(From left to right): Retired Navy Rear Adm. (Dr.) Bruce Gillingham, former Navy Surgeon General (Photo credit: U.S. Navy); Dr. Joachim Roski, Executive Director, Ernst & Young, LLP (Photo courtesy of Dr. Roski) and Dr. Jonathan Woodson, President, Uniformed Services University of the Health Sciences (Photo by Thomas Balfour, USU). |
Leveraging HCD to drive organizational change
For the MHS, an HCD approach would be useful in implementing redesigned, technology-enabled care models, and shifting mindsets away from initiatives that focus solely on technology adoption. The Department of Defense has already deployed human-centered design to optimize interfaces between technology and people for aviation, naval operations and several other non-medical uses. For example, the Naval Surface Warfare Center (NSWC) Carderock has adopted HCD models to train employees and service members to innovate new tools and methods focused on problem-solving.
Once you understand innovation as a social phenomenon, then it’s only natural to pursue HCD because it starts by putting people at the center — understanding how people’s complex needs, beliefs and behaviors inform the problem and the solution,
― Carderock Director for Innovation, Garth Jensen.*
HCD and digital transformation at the MHS
HCD focuses on three key features in technology-enabled care model (re-)design: desirability, feasibility and viability (see Figure 1). In leveraging HCD, the MHS would consider the experiences and needs of MHS clinicians, managers and leaders, patients, family caregivers as well as other stakeholders throughout the design process. For example, refinement of the operational medicine care delivery platforms within JOMIS (Joint Operational Medical Information System) relies on continued feedback through after-action reports and analytic assessments developed by key stakeholders who participate in operational exercises and real-world deployments. Over time, HCD-driven MHS care initiatives would be subject to regular revision based on continuously emerging insights about their practicality and effectiveness as well as the evolving needs of specific care settings (e.g., home, outpatient, inpatient, and operational settings).
As new MHS care models are designed, a four-phase approach has proven useful across industry:
- Discover: gather information, identify the challenge at issue and understand the underlying context
- Define the challenge or need: formulate key objectives and success criteria to meet it.
- Generate ideas and develop solutions: ideate on solutions to the clearly defined challenge and pursue the most promising path forward through prototyping
- Deliver and test solution: experiment with and refine different iterations of the solution at different scales
Deploying HCD on the battlefield
The MHS is experienced in continuously redesigning care models and service delivery for active-duty members and other TRICARE beneficiaries. For example, combat Army and Air Force medics and Navy corpsmen, along with other first responders, are currently refining care processes relying on the Battlefield Assisted Trauma Distributed Observation Kit (BATDOK), one element of the JOMIS Opmed Care Delivery Platform. BATDOK is a ruggedized, connected handheld device that allows users to document battlefield care accurately and efficiently. The device also supports monitoring multiple casualties simultaneously and aids in triaging care according to AI-based algorithms.
Ongoing improvements to these care models, based on HCD design principles will provide a common operating picture to higher-echelon medical units to optimize the flow of casualties during medical evacuation and the anticipation of and preparation for follow-on treatment. Similarly, the MHS has successfully developed and implemented combat casualty care models and critical care aeromedical evacuation transport protocols, both crucial for the increased survival rates for casualties. These use cases demonstrate both the efficacy and scalability of the HCD approach in MHS care settings.
Summary
As the MHS seeks new ways to support the health and wellbeing of our servicemembers and other beneficiary populations, HCD provides a proven means by which we can improve health outcomes. Incorporating digital technologies into our care models to meet our patients’ needs with the right products and services is an integral part of enhancing both force medical readiness and medical force readiness.
*“NSWC Carderock Embraces Human Centered Design to Strengthen its Innovative Culture,” US Navy website, https://www.secnav.navy.mil/innovation/Documents/2017/11/CarderockHCD.pdf
