Care Everywhere

The minute I walked into the Sidewalk Labs space, the buzz was palpable. No matter where I turned, people were gathered in small groups chatting animatedly – while often enjoying a glass of wine and small plate of delicious eats – in anticipation of this latest DesignMeets event. Of course, the excitement was completely understandable. We had managed to secure an impressive line-up of six speakers who represented some of the most innovative work from both North America and Europe in addressing various aspects of the evening’s theme, Care Everywhere. Each speaker gave a rousing, yet short, presentation. The presentations were then followed by a robust panel discussion.

Pivot met with each speaker to chat about their individual projects and how they’re advancing the work of care everywhere. Those conversations follow.

Taking it to the streets of Philadelphia

Our first speaker was Robert Pugliese, the Director of Innovation Design at Thomas Jefferson University and Jefferson Health. He spoke about how the CoLabPHL project is tackling the health challenges of poor neighborhoods in Philadelphia.

“When I think care everywhere, it really is thinking beyond the hospital, thinking beyond the institute and the institution,” says Mr. Pugliese. In the poor areas he and his team are trying to serve, taking a top down approach does not work.

Instead, in developing new routes of care, they take health care to the streets in a retrofitted Airstream trailer. The key is to build relationships—and start meaningful conversations—with residents and community organizations.

“As a healthcare organization, it’s hard to start talking about healthcare if you don’t understand all of the other things that go into someone’s life,” Robert says.

Even though the Airstream is mobile, the goal is not to be transient, but to actually become part of the community in order to learn about what specific areas need in terms of improving health and access to healthcare.

How can we move from sick care to well care?

“For me, the most exciting innovation in healthcare everywhere is patients connecting with patients,” says Colleen Young, the Online Community Director of Mayo Clinic Connect. “I love the fact that now we have the technology to make that possible beyond the geographical boundaries that people were generally limited to.”

While technology makes it easy to create online communities, cultivating a successful one is much trickier.

For Young, it’s about giving users a reason to stay connected. Many come to the community seeking advice, but soon, they turn around and help others who are behind them on their healthcare journey. And for those with chronic conditions, this sense of self-care is essential, especially since most healthcare occurs beyond the walls of an institution. One patient in the Mayo community, for instance, calculated that she spends nearly 9,000 hours per year managing her Parkinson’s—and just one hour with her neurologist.

What’s the relationship between architecture and mental health?

For the evening’s third speaker, Architect Xueying Zhang, care everywhere is about how buildings and public spaces affect health and wellbeing.

“My design is about an institution that is specifically designed for personality disorders,” says the recent graduate of the University of Toronto’s Daniels Faculty of Architecture. Ms Zhang presented her masters thesis. Her research looked at the potential relationship between psychology and architecture, or how architecture could be used as a treatment method.

While Ms. Zhang recognizes that in realty, it’s tricky to design institutional spaces for such specific conditions, she knows it’s important to keep contexts of use top-of-mind, especially in her work at MacLennan Jaunkalns Miller Architects (MJMA)—a firm that designs public buildings, such as community centres (which must be accessible).

You can’t rely on technology alone

Mary Lou Ackerman, Vice President of Innovation at Saint Elizabeth, sees a huge opportunity when it comes to accessing care—be it for seniors or for their caregivers.

Ackerman is especially interested in redesigning the housing model for seniors to make it more affordable. She explains how she and her team at SE Futures are exploring voice-enabled technology (such as Amazon Alexa and Google Home) as digital assistants to help seniors stay in their homes longer. But the technology isn’t the entire solution—if that digital assistant recognizes a senior could use a home visit, there needs to be a system in place to ensure someone would be available to drop by. “How can you design a really neat service model and then support it with the technology?” she asks.

In her DesignMeets talk, she spoke about Elizzbot, a chatbot that allows caregivers to anonymously seek support 24/7. When she and her team first developed it, they tested it internally and it wasn’t so popular. But when they allowed caregivers to try it out, it was tremendously successful, showing how important it is to have real people in real situations in order to get real feedback.

Making mental health services more accessible for Ontarians

“I think traditionally, we’ve looked at healthcare as bricks-and-mortar,” says Harriet Ekperigin, Senior Business Lead at the Ontario Telemedicine Network and the Big White Wall. “The concept of healthcare everywhere is turning that on its head.”

Ekperigin, who’s been working in the mental health field for more than 15 years, explains that using technology to improve access to mental health services has been a trend in the healthcare space.

She helped launch Ontario’s Big White Wall, an online, anonymous support community for those dealing with mental health-related issues. In the past year, more than 16,000 people signed up for the free service, blowing past Ekperigin’s target. “I want to make sure people have access,” she says. “But at the same time, when you see such huge numbers of people signing up, it goes to highlight the problem we have in Ontario when it comes to access to mental illness resources.”

How Denmark approaches system-wide healthcare challenges

Demand for healthcare is going up. “The reaction in Denmark is, then we have to deliver healthcare in a different way,” says Hans Erik Henricksen, the CEO of Healthcare DENMARK. “And one of the focuses is to deliver as much healthcare without relying on the hospital.” That includes a focus on preventative care, citizen education, a robust digital healthcare plan and a new hospital strategy with major super-centres that have highly specialized services and new technology in order to meet current and future healthcare demands.

The last speaker of the evening, Mr. Henricksen’s slides showing the dramatic extent of revamping the hospital system across Denmark, arguably drew the largest gasps from the audience.

During the panel discussion that followed, the conversation was wide-ranging yet two lessons can be drawn from it coupled with the prepared talks. First is that in a world in which the design of technology is largely untethering people from physical places all the while enabling meaningful social interaction, that idea of care everywhere is quickly becoming a reality. And finally, in broadening how we access care as well as the expansion of what defines health care, we are moving toward a focus on wellness and prevention. All in all, the application of design and design thinking to these diverse health topics bode well for delivering a higher degree of positive health outcomes in the future.