Designing for Chronic Disease Management

From renowned institutions like Mass General Hospital to large pharmaceutical companies, providers are leveraging design as a way to provide higher quality of care at a lower cost over time. The design thinking approach enables this through deep understanding of and empathy for patient and caregiver needs, which can ultimately lead to sustained improvements of patient outcomes.  

According to the National Center for Health Statistics, 133 million Americans are affected by generally incurable chronic conditions and a third of our population lives with multiple conditions (e.g., diabetes, arthritis, depression and heart disease). As the baby boomer generation ages and life expectancies increase, these numbers will only grow. This reality has grave implications on the mental and physical well-being of our population, as well as the healthcare costs our country faces. As a result, there are altruistic and financial incentives for healthcare providers to explore ways to help people more effectively manage their conditions. From renowned institutions like Mass General Hospital to large pharmaceutical companies, providers are leveraging design as a way to provide higher quality of care at a lower cost over time. The design thinking approach enables this through deep understanding of and empathy for patient and caregiver needs, which can ultimately lead to sustained improvements of patient outcomes.  

The design process starts with learning about the people for whom you are designing. A qualitative approach is used to paint a comprehensive narrative of the values and aspirations that inform a patient’s actions (or the barriers leading to in-action). This method extends beyond market and demographic statistics as the researcher is immersed in the patient’s world: viewing where medications are stored, walking through daily routines, meeting family members, and discussing health aspirations. Through in-depth sessions the researcher is exposed to the contextual environment in which a patient manages their health. This intimate perspective helps the researcher to unpack the emotional and psycho-social factors that are difficult to measure or predict, but often strongly influence a person’s decision-making process.

The complexity and nuance uncovered is then distilled into manageable and actionable insights. This is done using analysis frameworks (such as customer journey maps and personas) to map out patterns of unmet needs across patients of varying levels of motivation and engagement with their health. These frameworks help to structure the data gathered and uncover insights around opportunity areas ranging from detailed, product-focused ideas (like reducing the injection button force required for arthritic patients) to broader service strategies (like creating flexible and adaptable on-boarding material that meet patients where they are in their ability to grasp information). The research provides unique qualitative insights and stories that bring to life and personalize design criteria.

Reflecting on multiple projects focused on designing solutions for patients and healthcare professionals managing chronic conditions, several design principles hold true across conditions or problem types. A physical/digital product or service addressing chronic condition management should consider the following:

  1. Holistic patient health perspective: Patients manage conditions in the context of their overall health, not in isolation of other conditions (e.g., a person with high blood pressure and diabetes considers the impact of certain food groups, such as red meat, on both health conditions rather than just one). Healthcare education and self-care tools should consider how health conditions correlate and influence everyday actions, treating the patient and not just the condition.
  2. Tailored approach: Each patient has unique health risks, conditions, motivations, levels of health literacy, and learning styles. Management tools should understand that while some patients are motivated by fear of health degradation, others are motivated by encouragement. A patient’s ability to absorb and retain information varies based on their reception of the way the information is presented (e.g., verbal versus written explanations). Effective solutions will recognize personal needs and goals to provide tailored support.
  3. Simplicity: Taking medications regularly and maintaining lifestyle choices requires mental and physical effort beyond a person’s daily routine. Solutions should reduce the complexity and cognitive load of certain tasks, breaking these tasks into simple actions to support consistent adherence (e.g., doctor/nurse focused solutions should facilitate clinical decision-making rather than add to the existing complexity).
  4. On-going (emotional) support: While the diagnosis of a disease occurs at one point in time, coming to terms with the implications of a diagnosis happens over the course of several months or years. Patients managing chronic conditions should have access to engaging educational and emotional support as they evolve in their disease management.
  5. Self-management as a social concept: Social support and connections play an essential role in helping patients to cope with their chronic condition. These engagements (online and in-person) can enable people to share workarounds, exchange resources, and have their voice heard. As stated by self-determination theorists, “relatedness” or the development and maintenance of close personal relationships, is a basic psychological need that affects well-being as well as the integration and reinforcement of new behaviors.
  6. Hands-on training: To ensure proper understanding for patients with diverse levels of health literacy, providers should use hands-on demonstrations to train patients on medical devices or other new tools introduced.

It is a designer’s role and expertise to elaborate on these guiding design principles to create meaningful patient-centered solutions that positively influence health outcomes, no matter how incremental. Considering changes in population health over time and new technological innovations, it is essential that designers continue to prototype and test their solutions with patients. Solutions that address the unique patient needs identified in the research are more likely to be adopted and lead to sustained behavior change.

Katherine Belk is a Design Researcher in Innovation Strategy at Essential Design.