Care Design 2016

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#1 Understand the health needs of our populations

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Our first proposed redesign principle is to understand the health of the population and segment by need

If we understand the population’s health needs and create systems to allow stratification and segmentation, services can be matched to patient/user characteristics based on need and risk E.g.

  • Registries
  • Shared assessment processes
  • Proactive care to anticipate need
  • New ways to target and work with different populations (e.g. different models for highly mobile populations or ethnic groups with different expectations of how to use services)


This is about demand-led transformation rather than supply-driven change.


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When designing healthcare systems we begin and end with patients. To do it well we need to know what is on the patient's agenda before we start. It is simple and quick and already works in practice. To find out what patients want we have to ask them and we have to stop asking them questions that they cannot answer and ask them questions that only they can amswer. We only need to ask three questions: What do you expect from this service? What works well in this service? What needs to...

Derek Mitchell
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Quality improvement and six sigma methods are foundational for re-engineering healthcare systems to improve performance. However, these methods were not designed for creating open innovation health enterprises that are essential for addressing the leadership and cultural complexities of: Reversing the epidemics of unhealthy habits Preventing premature deaths and diseases Reducing the mounting burdens of chronic diseases Adding good-years-to-life despite chronic diseases Identify...

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The global renaissance in health innovation will challenge our closed mindsets about people-centered health improvement. Closed mindsets are our greatest impediments to innovation.     Open Our Mindsets To expand beyond mechanistic metaphors of lean, six sigma and quality management methods, we can use organic metaphors to adopt an integrated, whole-systems approach to humanizing people-centered, person-centered and patient-care approaches to health and healthcare innovation.     Adopt...

Rick Botelho
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  The global renaissance in health innovation will challenge our closed mindsets about people-centered health improvement. Closed mindsets are our greatest impediments to innovation.     Open Our Mindsets To expand beyond mechanistic metaphors of lean, six sigma and quality management methods, we can use organic metaphors to adopt an integrated, whole-systems approach to humanizing people-centered, person-centered and patient-care approaches to health and healthcare innovation....

Rick Botelho
by Rick Botelho
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Rick Botelho

Quality improvement and six sigma methods are foundational for re-engineering healthcare systems to improve performance. However, these methods were not designed for creating open innovation health enterprises that are essential for addressing the leadership and cultural complexities of: Reversing the epidemics of unhealthy habits Preventing premature deaths and diseases Reducing the mounting burdens of chronic diseases Adding good-years-to-life despite chronic diseases   Identify...

Rick Botelho
by Rick Botelho
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If I was looking to serve FMCG customers and provide an ideal experience I would be identifying those with the biggest need and focussing on providing a great, cost-effective solution for them.  I do think screening both from a physical and emotional standpoint is critical.  Has physical data from surgeries and hospitals been collated nationally and analysed and has this defined some key indicators for who requires the most time and money for care.  I would do some stats analysis and define...

Keith wart
by Keith wart
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Keith wart

Thinking more broadly than medical diagnosis would really help. Do we stratify our populations into levels of activation? Do we differentiate the offer depending on where someone is at in relation to confidence, competence and motivation to engage and change?  Not only understanding their population health segment needs, but having a richer understanding of the conditions whereby they will flourish, depending on activation levels, seems a fundamental part of effective and person-centred...

Caroline Poole
by Caroline Poole
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Caroline Poole

This is obviously vitally important - but healthcare professionals have always focused on people's needs. The problem has been that this has largely focused solely on clinical needs alone or heavily prioritising clinical needs. Understandings peoples needs has to move beyond just clinical needs to understand a much wider context of people's lives. It is only in this wider context that interventions can be developed that not just address the clinical needs of their health requirements but...

JOE LANGLEY
by JOE LANGLEY
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JOE LANGLEY
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Identifying the health needs of the population in some ways is the easy bit. What is less well known is people's health motivations and behaviours. When we identify needs, it is not uncommon to see the health system as the 'rescuer' of the needs found in society. This may be a necessary view for the acute side of health and care provision, but when wishing to be more proactive in preventing future health needs it may be more helpful to tap into people's motivations, behaviours and outcomes....

Heidi De Wolf
by Heidi De Wolf
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Heidi De Wolf

All people want to feel better, be able to do more for themselves, have excellent service and feel empowered to look after themselves. If this is so we should pay more attention to generic tools to measure these things. See for example www.r-outcomes.com

Tim Benson
by Tim Benson
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