Beyond Patient Management: Health Care by Design

By Denise C. Tahara and Mary McBride.

Published by The International Journal of the Constructed Environment

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Article: Print $US10.00
Article: Electronic $US5.00

According to the Congressional Budget Office, as a result of the passage of the Patient Protection and Affordable Care Act an additional 32 million Americans will have healthcare coverage by 2019. With the increased participants in the system, an environment needs to be constructed to encourage wellness and healthy behaviors, improve utilization and contain costs. Our paper explores how strategic design and design management can reframe healthcare encounters and community outreach to facilitate appropriate utilization of the system, and create an environment that supports healthy lifestyle choices. A successful system cannot command compliance. Rather, it must encourage behaviors that will evidence a commitment to wellness and design those behaviors in. Designers are trained to encourage behavioral commitment to both new and familiar experiences. They design for specific demographic and socioeconomic patterns of use, which can influence non-compliant behaviors including failure to fill/refill prescriptions, pill splitting, avoidance or delay of immunizations, skipping diagnostic testing and follow-up visits, delayed dental care and high medical bill debt. Designers are trained to discover, define, design and deliver needs-based services effectively, efficiently and with a keen understanding of the rapidly changing needs of a diverse set of users. Adding design leaders to the strategic thinking on remaking healthcare will make it more likely that the system will be designed to meet human needs as well as political ones. The use of strategic design is critical as the factors that influence system-wide cost containment are dependent upon its design and its use. The authors suggest that improving access and utilization is the intention of the healthcare system and that this intention can be achieved through strategic design.

Keywords: Healthcare, Strategic Design, System-Wide Performance Improvement, Design Intelligence, 4–D Model

The International Journal of the Constructed Environment, Volume 2, Issue 4, pp.51-62. Article: Print (Spiral Bound). Article: Electronic (PDF File; 793.254KB).

Dr. Denise C. Tahara

Assistant Professor and Director, MPH Studies, Department of Health Policy and Management, New York Medical College, Valhalla, New York, USA

Dr. Tahara is an Assistant Professor at New York Medical College and Director of MPH Studies. Before joining NYMC full time, she was an independent consultant working to improve the quality, efficiency and effectiveness of service delivery systems. Performance improvement continues to be her primary area of research. Other areas of research include improving birth outcomes and maternal health through preconception healthcare, educating the public about healthy lifestyle choices and increasing sustainability practices in healthcare. Dr. Tahara received her BS from Cornell University, her MBA and PhD from New York University and her CPA from New York State. While at NYU, Dr. Tahara studied operations management and quality improvement with Dr. Deming.

Dr. Mary McBride

Director, Masters in Design Management Program, Pratt Institute, New York, New York, USA

Dr. McBride is the Director of the Design Management Graduate Program at Pratt Institute. It was the first DM program accredited in the United States and now enjoys an international reputation for providing executive education for design professionals that will enable them to assume strategic roles in their organizations and create triple bottom line advantage by design. Dr. McBride received her business training at NYU’s Graduate School of Business and also earned an MA and PhD from NYU specializing in Marketing and Media Communications and Systems Analysis with a focus on the design of organizational systems and management structures for peak performance. Dr. McBride is the founding partner of Strategies for Planned Change, an international consulting group specializing in strategic management and leadership development.