Update From the Field: National Association of Community Health Centers April 2019

The Business Innovation Factory (BIF) team just recently visited Castle Family Health Center in Atwater, California and Lawndale Christian Health Center in Chicago, Illinois where we conducted interviews with the health centers’ leaders, staff, and patients. Our work with the National Association of Community Health Centers (NACHC) is focused on creating more opportunities for transformation within their network. As we began to analyze and synthesize our findings, a few emerging curiosities came to the surface:

How do you create the conditions where people are able to advocate for their own health and wellness – both physical and mental?

What practices, processes, and mindsets are central to creating a culture of trust in a health center?

How are community health centers uniquely situated to be transformative players in the changing landscape of healthcare?  Beyond providing health care services, what roles do community health centers play in their ecosystem?

Throughout our travels to Florida, California, and Illinois we had rich discussions with patients that offered insights into their perspectives around these questions. Combined with over 14 years and 70 BIF projects seeking to understand customer (patient, student, and citizen) experience particularly in underserved communities we have a solid design foundation to explore opportunities with NACHC to accelerate patient-centered transformation in the communities it’s Members serve.

 

Prioritizing Personal Health, Wellness, and Self Advocacy

 

When individuals have the mindsets, time, resources, and/or support to invest in themselves, they can better advocate and have greater ownership over their healthcare and wellbeing experience beyond their visit to the doctor’s office. Patients will be better agents of their own health and wellbeing when their life experiences are understood in a full context. Health and wellness start by unleashing patient agency to take advantage of the right knowledge, tools, expertise, and resources when and where patients need them.

A patient from Castle Family Health Center explained,  “An important decision for me is to take care of myself because I was always worried about other people, what they were feeling, and making them happy….but getting to the point where I had allowed myself to be a little selfish, and take the time for me, that was a big decision. ”

The healthcare system today relies on the expertise of the doctor to provide knowledge or tell a patient what they need to change to improve their health and assumes people will take this advice and act on it. People need to feel empowered and enabled to make these changes in the face of other life stressors, and feel supported by their doctor. Providing the opportunities for patients to be engaged in their healthcare journey, rather than passively being told what they need to do by a doctor, will enable patients to actively sustain the steps towards improved health and wellness.

 

Cultivating a Culture of Trust

 

Individuals make important decisions based on the people, places, and information that they trust, which can lead to positive, negative, or neutral health and wellness outcomes in their life. When patients feel that both the staff and doctors truly listen and understand them, it helps build their trust and relationship with the health center they are utilizing. A patient at Castle Family Health Center described, “Right here is where my entire self-care comes from… They listen to what I’m feeling, you know?” This patient has entrusted the health center to help her on a path to taking better care of herself due to the positive experience she has had over time.

When trust is developed, patients are more open and comfortable sharing their experiences and problems, allowing health centers to better help them in reaching their health and wellness goals. In this day and age, there are many different options of providers and services available to individuals that it can be difficult to know who to trust. When health care centers are able to meet the needs of individuals and value them as more than patient X of the day, this moves from a transactional experience to one based on relationships.

This was demonstrated when another patient from Castle Family Health Center explained,  “They were kind. They were caring, attentive, and quick. If I came early, they called the doctor to see if there were any slots open or if someone didn’t show….I had two appointments today, and I checked in and they communicated with me and made me feel like I wasn’t just going to be brushed aside until my appointment time.”

Overcoming barriers of distrust within healthcare institutions requires creating a culture of trust where patients know their care is personalized for their life, resulting in a healthcare journey that has their best interests at heart.

 

Reflecting Community Values and Catalyzing Patients’ Narratives

 

People want to share their stories and contribute their knowledge and passion to their wider community. As noted before, the healthcare experience is often a one-way transfer of information, knowledge, and values. However, we heard from patients that it is just as important that they are able to see their values and knowledge reflected in the health center. They noted that generosity and collective support kept them engaged in spaces both in the health center and beyond.

A patient at Lawndale Christian Health Center shared that values of the health center help her have trust in the staff and services provided. Those values also made her more likely to share her story with members of her community and support them in living healthier lives.  

She shared: “If a testimony was ever required of me I’ll be sure to make some space for it to make people aware that this [depression and other mental health struggles] is a real thing and that there’s help out there and there is proper medication for this… Whenever you guys want to call me to initiate a conversation for me to express my own story, to share with others I’ll make time for it for sure.”

A patient from Bond Community Health Center shared a story where he saw himself reflected in the community. “Today a lady came in and she didn’t have her copayment. Another lady sitting in the waiting room walked up and said ‘I will pay her copayment. If she has any problems I’ll pay it for her.’ These are the people who touch you. She said the copay was $25 and she only had $20. And I looked at the receptionist and she already knew that I had it, but before I could reach to get the five dollars the other lady came up and said ‘I’ll do it.’ So you know, it’s people like me that are here with open hearts and they will do for others. So I feel really comfortable with the people here.”

When patients see a health center emulating the same values and beliefs that they adhere to, it creates a sense of trust and commitment as they are aligned together through a common purpose. Health centers have an opportunity to lift up patients’ narratives and create pathways for patients to become core to their recruitment, retention, and reform efforts.

As we continue our exploration, we look forward to more storytelling and actionable insights from the field to put patient experience at the core of our design and innovation process.

 

Read Part 1: Emerging Insights from the Leadership Perspective

Are you ready to transform healthcare? Email us at hello@bif.is


Update From the Field: National Association of Community Health Centers March 2019

Last week, the BIF team visited Bond Community Health Center in Tallahassee, Florida and Eau Claire Cooperative Health in Columbia, South Carolina to conduct interviews with leaders, staff, and patients as we continue our work with the National Association of Community Health Centers (NACHC). BIF and NACHC leadership are joining forces to explore the questions:

How might we shift our lens to uncover innovation opportunities that will transform how we serve patients?

How might we collaboratively innovate, going farther together?

How might we continue to promote equality in the healthcare system?

We learned a lot in our four day trip down South, and a few insights emerged as we look toward the next phase of the project.

 

Key Insights we Learned from their Healthcare Leaders:

 

The role of Technology in healthcare systems

When speaking with leadership teams at the sites, we learned that technology is helpful but not the long term solution to fix the healthcare system. According to Donnell Durden, Coordinator of Community Relations and Outreach at Bond Community Health Center:

“All of the technology works, it helps, it helps us amplify our message. But nothing is more important than getting outside, touching the people, shaking hands… reaching out to them; letting them know that we are here for them, we want their business, but more so, we’re here.”

Emerging technologies help deliver value in the real world, but are not at the core of creating healthier communities. Technology can be utilized as a component to support larger system changes that focus on the human experience first. If they’re constrained by today’s business model, technologies will only deliver tweaks, not transformation. It is crucial that we consider technology to be a supplementary aspect of innovation, rather than innovation itself.

 

Medical services are only 20% of the health centers job-to-be-done

Keeping in mind the increased importance of the social determinants of health when considering the actual services needed to successfully run a community health center, medical services only cover about 20% of all patient needs. The remaining patient’s jobs-to-be-done are met through enabling wraparound services like transportation, having access to childcare, caseworkers, insurance specialists, social workers, and nutrition education outreach, among others. While none of these wraparound services are actually separate from a comprehensive care model, often these services are unacknowledged in traditional healthcare experiences. The wraparound enabling services compose the majority of what community health centers do for people, but these services are often non-billable and intangible in healthcare. By adopting a more evolved definition of what health and wellness look like for individuals, we gain a better understanding of service gaps and experiences, realizing that wraparound services provide a more holistic and comprehensive solution to their pain points.

What innovation means to healthcare leaders

When speaking with community health center leadership teams, we gathered that innovation means changing the way care is provided to better serve patients and families, leading to healthier, wholesome outcomes. It also means not accepting the status quo. But what does innovation look like within community health centers? Dr. Robinson, CEO of Bond Community Health Center posed the question:

“When we consider innovation, we need to ask ourselves- Is it a good fit in the community? Does it fit the mission? Is it feasible and sustainable? Can you see passion and excitement among your team and will that lead to lasting partnerships?”

 

Innovation means staying true to your core values while also not allowing the way systems work today to dictate what’s possible for a better future. Eau Claire Cooperative Health Center’s leadership team focuses on how their founder instilled in them the mindset and perspective that there isn’t anything they can’t do. Innovation isn’t easy in this context, but core business models need to change if we strive to continue breaking down the barriers of inequality in healthcare.

 

Looking Forward

Look out for the next update from the field highlighting the patient perspective as we continue to make discoveries in our research with NACHC.

 

For more on our work, visit our case study here: National Association of Community Health Centers Case Study


Healthcare Storytellers to Watch at #BIF2018

This September 13-14, 500 innovation junkies will convene in Providence, Rhode Island to listen to 32 storytellers share their passionate stories about transformation at the annual Business Innovation Factory (BIF) Collaborative Innovation Summit. BIF’s Patient Experience Lab is most excited to listen and learn from these 5 speakers from the healthcare industry:  

Andrew Hessel

Andrew Hessel

Andrew Hessel is the CEO of Humane Genomics Inc., a seed-stage company developing virus-based therapies for cancer, starting with dogs. Andrew is also the co-founder of Genome Project-write, an international scientific effort working to engineer large genomes, including the human genome. He is also a Distinguished Researcher at Autodesk Life Sciences and a faculty member at Singularity University.  Andrew is a reputable speaker helping people understand the biotech industry. He enjoys presenting to groups with government, academic, and commercial backgrounds. Check out Andrew at BIF 2016

Dr. Nneka Jones Tapia

Dr. Nneka Jones Tapia

Dr. Nneka Jones Tapia is the Executive Director of the Cook County Department of Corrections where she oversees mental health strategy. The Cook County Jail, located in Chicago, is home to 2000-2500 inmates suffering from mental illnesses. Nneka focuses her work to slow the rate of mentally ill individuals re-entering the prison system by developing the Mental Health Transition Center to build a system of support for inmates re-entering the community. She became warden of the Cook County Jail in the Spring of 2015, emerging as one of the first clinical psychologists to run a prison, understanding how a large portion of the jail’s population suffers from mental illness. Read more about Dr. Nneka Jones Tapia here.

Darden Smith

Darden Smith

Darden Smith is a singer-songwriter, a founder of a non-profit, an author, and a return BIF Summit speaker. Darden has produced 15 critically-acclaimed albums in his 32-year career. Mental health is often hard to talk about, however, Darden is helping American heroes tell their story, release often invisible pain and forge new connections. His non-profit, SongwritingWith: Soldiers helps soldiers and their families cope with the aftermath of combat by using music as a form of expression. Darden is an accomplished speaker and often shares insight into the lessons he learned as a singer-songwriter, how he re-made himself into a non-profit founder and entrepreneur, and his evolution as an artist. Check out Darden at BIF 10.

Ken Falke

Ken Falke

Ken Falke is a 21-year combat veteran of the US Navy Explosive Ordnance Disposal community and retired as a Master Chief Petty Officer. Ken’s passion for taking care of his fellow vets led him to develop Boulder Crest, America’s first privately funded wellness center that assists combat veterans and their families. Boulder Crest focuses on an alternative approach to treating PTSD and depression. Ken is also an accomplished author and recently released his book, Struggle Well which focuses on post-traumatic growth. Ken is highly respected around the world as an innovative and forwardthinking leader on the subjects of wounded warrior care, military and veteran transition, counterterrorism, military training, and innovative technology development.

Emily Levy

Emily Levy is the CEO and founder of Mightywell, a company that aims to “turn sickness into strength”. Her products allow patients to live a more comfortable life by helping them to maintain their dignity, health, and confidence through functional and stylish apparel and accessories. At Mightywell, Emily encourages a strong, digitally-driven community where peers can talk about their experiences and find strength in each other.

 

This year’s BIF Summit will be a welcome place for healthcare innovators and leaders to connect and find inspiration to transform the industry. Are you a healthcare leader who shares BIF’s passion to innovate and transform? Email Will to talk about this year’s Collaborative Innovation Summit

Connect. Inspire. Transform. Register #BIF2018


Voices of the Innovative Learning Network (ILN)

On May 8-10, the Innovative Learning Network (ILN) met in Charlotte, North Carolina to discuss and explore business model innovation in the healthcare industry. I found it amazing to see such a diverse group of innovators – senior leaders, doctors, nurses, and directors of innovation just to name a few. With everyone’s different backgrounds, we were able to tackle the looming question of business model innovation in healthcare from all angles and perspectives in a safe space where thinking outside the box was encouraged.

Business Innovation Factory (BIF) hosted the meeting to lead a 3-day workshop with Atrium Health. The workshop was designed to take the ILNers through our Design Methodology and Playbook for Next Practices and New Business Models process using a case study from our past work with Children’s Health in Dallas. In groups, we started by shifting our lens to understand the pains, gains, and job-to-be-done from the customer’s perspective. Then, we took the customer’s current experience as a foundation for imagining a new customer experience that relieves the customer’s pain points, maximize the gains, and completes the job-to-be-done. Finally, we tested a low fidelity prototype and put it up to the constructive criticism of the other groups.

We met with a few top healthcare trailblazers from a variety of different organizations and backgrounds who aren’t afraid to operate in the ‘scary’ space of business model innovation to ask them a few questions. We asked them about their personal take on innovation, the obstacles they must circumnavigate to innovate within their company, what innovative questions they want to explore in their company, how they prepare for future business models, and how they differentiate between transformational and incremental change.

While healthcare leaders understand the imperative of business model innovation, it is often scary to disrupt a large system that has been in place for years. When the motto of healthcare is “do no harm,” it is hard to be the guinea pig to test out new business models and next practices. Our goal was to help them make the business model innovation process safer and easier to manage.

I found it fascinating how unique, yet similar each person’s response was to these questions. The ILN is such a great catalyst for future business models because it provides a place for members to discuss and explore business model innovation in a safe way. Tim Rawson from ILN said that the event was a meeting, not a conference because in a meeting, things can go wrong. It was clear that everybody, no matter who they were felt confident sharing their perspective and wasn’t afraid of failure, rather they embraced it.

From the ILN In-Person meeting and the interviews, I learned how there is a clear imperative for business model innovation in the healthcare industry. Leaders are ready and willing to make that next step to transform their business models, but they just need a clear path forward. At BIF, we make the step towards next practices transformation safer and easier to manage. It is no question that patient’s values have changed; they want to feel empowered to take control over their health and overall wellness. They want to understand their health in normal terms and have a clear path to achieving their wellness goals. By transforming business models to align with customer values, not only will the customer be happier and healthier, but the business itself will perform better under new metrics of success.

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Changing the Quality of Patient Experiences for Families with Autism

For my first blog post as the new Patient Experience Lab Manager at the Business Innovation Factory, I wanted to talk about something that I am passionate about because it is personal. I want to share a story about Autism awareness month and my little cousin Cole, a 12-year-old boy who was diagnosed with Autism right around his first birthday.

As Cole grew older, I saw the pain and struggle that my family went through on a day to day basis just to trying to live a normal life. To gain a deeper understanding, I called my aunt last night to ask her a few questions. What are the challenges? What needs to be transformed? What is missing from the social aspect of families and family members afflicted with Autism and other disabilities?

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According to the Centers for Disease Control and Prevention, one in 68 children has Autism Spectrum Disorder, a shocking 30% increase in the last two years. Further, the Associated Press reveals that 8% of all children born in 2018 in America will have a disability, and 10% of children stuck below the poverty line will be born with a disability.  

 

 

After speaking with my aunt, she revealed that there is little to no social support for families with members that have disabilities. When a child has autism, it can be hard for families to do normal things like go out to dinner or meet other families that have similar pain points and struggles. “We often feel isolated and alone,” she revealed. “We just need a place where families can be families.”  This inevitably puts immense pressure on the family – there are not many ways that these families can connect, unwind and relax, to just be human. Virtually no support groups exist for parents, everything is social media driven and parent run. There are not enough support systems for siblings to talk about their sisters and brothers who are different. In terms of overall wellness, there is a huge gap between what parents and siblings need and what is available to them. Mothers and fathers just want a normal life for their family, and siblings can find it hard to fathom why their family is different and are often embarrassed because they think that others don’t understand.

Even though the services available to families with autistic members are often not enough, there are not nearly enough resources present for social support systems. In other words, there are services available to cover the clinical definition of well-being, but that is not enough. There are not enough resources available for families with members that have disabilities to cover the emotional definition of well-being. In past work, we at BIF have identified the key drivers in overall well-being as a balanced outlook, sense of self, a solid support system, connected knowledge, and personal power. From our research, we know that children with medical complexities have extremely high needs and unpredictability, causing moms, dads and family members to live under constant stress.

We have examined the experiences of medically complex kids and identified new opportunities to support the whole family better in ways by connecting moms and families in similar medical situations, relieving unnecessary burdens that fall on parents, adapting homes and hospitals so that they feel more comfortable and familiar, equipping parents with the skills they need to provide for their child, providing parents with opportunities to personally develop, and reducing barriers to social life.  It pains me to see how many elements of complete well-being are missing for families with members that have disabilities.

There is absolutely a job-to-be-done for these families and I am excited to explore the possibilities of working with families with children on the autism spectrum to gain a deeper understanding of their pain points, their needs, and how we can support their overall wellness beyond the few services that are currently available. I hope for a future where children with autism and their families do not feel ostracized. I hope for a future where families are connected and given the tools that they need to thrive so that living a normal, peaceful and happy life isn’t out of the question.

To learn more about the work we are doing in PXL, visit us here.


BIF to Co-Host and Facilitate a Business Model Bootcamp at #ILN2018 In-Person Meeting

On May 7-10, Business Innovation Factory will be co-hosting The Innovative Learning Network’s (ILN) in-person spring meeting in Charlotte, NC with an expected attendance of over 200 healthcare leaders, with our friends and partners at Atrium Health to help top healthcare leaders in the country identify pain points from the customer’s perspective and apply transformation to next practices and new business models.

This collaboration is made possible, in part, by our newest member: The Innovation Learning Network.  “We are thrilled to engage in a joint partnership with the Innovation Learning Network. ILN and BIF have a shared vision of a transforming health care system that engages patients in their own care and employs innovative new models that improve the patient experience,” said Eli MacLaren, Chief Market Maker at BIF. We are looking forward to participating in The ILN in-person spring meeting to connect with transformational healthcare leaders.

ILN is a global, membership-based organization that exists to share innovations across systems, teach innovation and design techniques, and create innovation friendships. Its mission focuses on accelerating innovation by sharing the pains and joys of transformation. “The ILN pillars are future-forward solutions, innovation techniques, and above all, friendships. It’s these unlikely friendships that drive the magic,” says Chris McCarthy, Executive Director of ILN and BIF Summit Storyteller.

Eli, BIF’s Chief Market Maker, will be co-facilitating with the team at Atrium to introduce BIF’s Design Methodology for exploring testing, and prototyping new business models. The methodology was formed to help leaders identify current pain points within their organizations by shifting perspective to the lens of the customer experience. Once the customer’s pain points are recognized, a job-to-be-done is formed based off of the fundamental problem a customer is trying to solve. The job-to-be-done will then be designed and prototyped, eventually leading to how the new transformative strategy can be tested, implemented and commercialized in the real world.

Do you have an innovation challenge but are not quite sure where to start? BIF membership enabled business leaders to start small and scale fast based on our proven methodology. Members get the unique opportunity to get involved with our network of leaders and big thinkers to transform fast. To learn more about membership opportunities, click here.

Start Your BIF Membership Today


BIF Collaborating with Mass General Hospital Healthcare Transformation Lab

The Business Innovation Factory (BIF) Patient Experience Lab is pleased to announce that it will be collaborating with the Massachusetts General Hospital Healthcare Transformation Lab (MGH HTL) and Lab of Computer Science (MGH LCS) to build up the teams’ internal innovation capacity through human-centered design and storytelling.

The Healthcare Transformation Lab was founded on a mission to improve the experience and value of healthcare through collaborative innovation. The Lab of Computer Science was founded in 1964 and has enhanced the lives of clinicians, researchers, and patients with innovative healthcare technology for half a century. Both located in Boston, Massachusetts and situated within the Massachusetts General Hospital, the HTL and LCS work to connect, inspire, and support a diverse group of people as they collaborate on ways to improve healthcare.

Working with both teams and core leadership from the MGH HTL/LCS, BIF will structure, design, and facilitate a series of design sprints in a “learning by doing approach.” Through these design sessions, BIF will help to create the conditions necessary for innovation to thrive.  

Through this collaboration, the MGH team will learn to leverage internal conditions, develop human-centered design and storytelling capabilities, and catalyze innovation throughout the organization.

BIF is excited and honored to support the MGH team on their journey to build internal storytelling, human-centered design, and innovation capacity.


Community Supported Health

With the growing demand and availability of digital and telehealth services and the proliferation of holistic medicine, much of what we used to define as medicine occurs outside of the medical environment.

The points and models of care must change. No longer is health confined to the doctor’s office or the hospital emergency room.  As the industry moves away from medicalized care and towards personalized care, we are asking people to take increased ownership of their own health, but are we giving them the necessary tools to do this?

Addressing the upstream social determinants that undermine and affect personal and community health such as environment, access, and income is essential, yet it overlooks a fundamental truth about many health conditions: they are driven and sustained by personal behaviors.

Eating healthier, being more active, and reducing your stress are all often ‘prescribed’ behaviors, but these prescriptions don’t come in a bottle or from a pharmacy. They must be personally directed and pursued. How do we ensure that individuals and families are supported and empowered to make the necessary changes to their own behaviors? A few months ago, I was given the opportunity to visit an organization eagerly tackling that question.

Open Source Wellness, based in Oakland, CA, combines an overwhelmingly welcoming space with the behavioral coaching and support needed to improve overall health and wellbeing. They term themselves a ‘behavioral pharmacy,’ a place that enables individuals to easily and joyfully comply with the often vague ‘behavioral prescriptions’ given by their doctors.

The program works by creating a culture where health is powered by connection and community support. They focus on four discrete yet uniquely connected areas:

Move (physical activity), Nourish (healthy eating), Connect (social support), Be (stress reduction)

A members group is decided based on a one-to-one personal assessment of needs and goals. The participants and coaches take part in fun and enjoyable moments of activity and play, share a healthy meal and then move into smaller cohorts focused on individual goals and priorities.

Open Source Wellness is redefining the model of how we engage with and deliver whole-person, holistic, behavior-centric care. They are leveraging the powers of community and belonging to create a sense of agency for their members. Members leave with the tools they need to embark on their own wellness journeys and return week after week feeling supported, powerful, and healthy.

As new models of care emerge, we are reminded that while access and quality will always be at the forefront of healthcare, they are not the only things that matter for a person’s health. At the Business Innovation Factory, we believe in models that are human (patient, student, or citizen) centered, and in models that create and capture value from the whole person.

Open Source Wellness is one of those models; an organization determined to see every patient as a whole person, and address individual needs in a human-centered way. Every meeting starts and ends with a moment of energized connection; a tangible sense of support and community (oh, and there’s chocolate!).

Learn more about Open Source Wellness by clicking here.


The Fourth Pillar of Transforming our Health System

Traditional models of reform have focused on the three conventional pillars of health care: cost, access, and efficiency. Though these pillars functioned as the foundation of the ACA, we still have yet to resolve the underlying pain points that continue to resonant across the country, seven years’ post-ACA implementation.
A study commissioned by the Robert Wood Johnson Foundation, National Public Radio, and the Harvard T.H. Chan School of Public Health tells us:
  • 61% of adults would rate the nation’s healthcare system fair or poor
  • 45% of adults have seen the cost of their health insurance premium rise over the last two years

Just over two weeks ago, a resounding thumb down from Senior Arizona Senator John McCain spelled the latest failed attempt at the repeal and replacement of Obamacare (The Affordable Care Act, or ACA).

Much like our health system, our political system acts more stubborn than transformational, clinging to the comfort of the familiar, rather than forging toward the true change of disruptive innovation and there is no telling what leaders of either system are going to do next.

As uncertainty around current market stabilization continues, political leaders in Washington are moving on and healthcare leaders across the country are hedging their bets and limiting their risk — all to the detriments of the individuals and families that rely on the American health system.

When marooned in a sea of uncertainty, our health and political leaders struggle to explore, prototype, and test new models that yield significant and lasting change and resign themselves to conventional, albeit broken models.

Today, we have a health system that is not valuable to individuals and families. Their needs are not prioritized or solved for, often leaving many unable to access, obtain, or afford needed medical care. This oversight sustains the current model, overlooking the necessary addition of a fourth pillar to transform our health system; the experience and needs of individuals and families.

We need a new way of delivering a valuable health experience in this country.

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This new way requires that we design a health system (inclusive of wellness and care models in addition to insurance and payment models) that delivers on two different value propositions: one that offers equity, access, and affordability to consumers, and one that offers efficiency, cost-reductions, and predictability to payers and providers.

What do we do when our healthcare system is overshadowed by our health insurance system? We design for the one thing they have in common: the patient. This requires leaders to step away from the conventional mindset, and get out of the mental valley that accepts the present system as gospel and attempts only to make tweaks around the edges.

Here in the Patient Experience Lab (PXL) at Business Innovation Factory (BIF), we believe that by placing individuals and families at the center of their own experience, we transform the health system in a more inclusive way. We use a human-centered design-driven methodology, making it easier and safer for institutions and organizations across the health system to transform the ways that they create, capture, and deliver value to the individuals, families, and communities they serve.

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We start by shifting the focus of institutional leaders away from the traditional three pillars of healthcare (cost, access, and efficiency) to design a system informed by the experience and needs of individuals and families: the fourth pillar of our health system. With this fourth pillar, a new set of questions and challenges emerge loud and clear; questions that we have been asking throughout our work here at BIF.

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How might we shift the current experience of health and wellness to be one that is understood and claimed by families and children, rather than simply available to them?

How might we better understand what contributes to poor health outcomes and lack of engagement in a personal health and wellness journey?

How might we promote effective cross-sector partnerships and models between clinical and nonclinical entities in service of whole person health?

When we co-design the care and cost models that make up our health system using insights from institutional leaders, politicians, clinicians, insurance companies and patients, we create a holistic system that adds value and improves the health and wellness experience for individuals and families. Using a human-centered design approach ensures that the fourth pillar of care is first understood and then built-in as a central component. By designing with the consumer and not for them, we can create a more stable system that delivers new and sustainable value.

To do this, institutions and leaders across the health ecosystem must be willing to prototype and test new models and next practices that incorporate this fourth pillar of care. When the voice of individuals and families is incorporated from the start, meaningful models and strategies for health will be formed to create, capture and deliver new value across all pillars at scale.

At the core, BIF’s methodology serves as a roadmap for leaders who are ready to integrate the fourth pillar to transform our health system; challenging not only themselves but the entire health ecosystem to co-design a better way to deliver health across this country by leveraging the experiences of those it serves.


PXL Shares Family Well-Being Experimentation Stories

Patient Experience Lab partnered with Children’s Health and Dallas families and communities to prototype, test, and iterate on two new approaches to improving family well-being.

These experiments were intended to help us learn: how can we begin to understand the conditions that encourage positive behavior change, and improve well-being for the whole family?

We are excited to present video stories that highlight families’ experiences with each, as well as key elements of the family-centered designs:

1. What’s Cookin’ Dallas

A healthy cooking and eating experience in the Lake Highlands community, co-created and run by families. Multiple iterations of the model allowed families to continually address their community’s needs: transportation to increase access to healthy foods, tangible, affordable, and relevant nutrition information, and cooking experiences created and facilitated by trusted community members.

2. Your Best You

A three-week youth leadership program to facilitate creative expression and reflection, enable self-awareness, and harness change-making power. A curricular fusion of design thinking and Roberto Rivera’s Fullfill the Dream, a creative pathway to self-discovery, provided teens with tools to identify and apply their personal skills and superpowers to address challenges – both those they face as individuals, and those their communities confront.


One of the many important insights gleaned from experimenting alongside Children’s Health and local families is that enabling agency (putting families in charge of well-being initiatives and catalyzing purposeful networks among them) is crucial to ensuring that families can continually strive to live healthy and well lives. To move from a model that provides sick care to a model that keeps populations healthy, we need to reframe the roles that families and institutions play.

Partner, don’t prescribe.

By engaging families in the design and delivery of models, we’ve learned that families know the challenges they face in striving to be well and what the needs of their communities are. Giving families access to the institutional resources to address those needs creates the conditions in which hope can grow: specifically, the hope that self-directed changes will pave the road to healthier futures.

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Dallas Families in the Driver’s Seat

“Fulfillment comes when we attach ourselves to activities, not outcomes.” – Michael Samuelson, BIF2015 storyteller

With just over a week of the experimentation phase under their belts, Team Family Well-Being has already fallen into a daily rhythm:

They rise early, meet participating families, and prep the site (which changes daily, hence the new wheels at left). They divide their day: collaborating with families to create the healthy cooking and eating experience, assess participation, and gather feedback. They make smoothies, salads, and pasta. They hone their chopping skills in the prep kitchen, thankfully with minimal casualties. They spend their evenings communicating with families and community partners, and integrating suggested changes into the next day’s plan. Sleep. Wake. Repeat.

As eventful as this daily schedule is, it barely scratches the surface of the first week’s story. In catching up with our team, I heard many anecdotes about families’ integral role in making the model work. 

Before kick-off, the team facilitated a workshop for families to identify their strengths, and to design team-based roles for the experimentation phase accordingly. Families self-selected onto five teams – Design, Marketing & Communication, Cultural Advisory, Curriculum Design, and Logistics & Planning – and they’ve been owning and running with those roles ever since: 

As part of the Design & Marketing teams’ first session, families renamed the model formerly known as Edu-Shoppe What’s Cookin’ Dallas (and, with support from our Digital Media Generalist, designed some snazzy new branding to match).

Parents suggested areas of higher foot traffic and invited friends to participate in the cooking demos. Even the kids got involved, supplementing the marketing strategy with makeshift signs advertising smoothies to passerbys (left). One mom on the Marketing & Communication team noted that the handouts could use some sprucing. After the team integrated her feedback and redesigned them, she nodded, “Now that’s more like it!” 

The Curriculum Design & Cultural Advisory Teams suggested that recipes be adapted to different dietary needs and taste profiles, so the team developed two new lists – “Family Suggestions” and “Healthy Ingredient Alternatives” – to pass out on-site. Checking out the new handouts, a mom exclaimed how useful it would be in adapting recipes for her daughter, who was recently diagnosed with pre-diabetes. Another participant commented that these were changes she’d “always wanted to make, but wasn’t sure how.”

The impact of the model on the elements of family well-being is, in large part, still to be determined. But these stories? Strong evidence of the power of designing, iterating, and executing in partnership with our end-users.

How might relevant, engaging healthy cooking and eating experiences – designed by families, for families – impact the elements of family well-being? Stay tuned, because we’re about to find out.

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