A newer approach has been to incorporate focus groups or interviews. While this seems to be a better approach, qualitative research can be technically more challenging and less generalizable.8 With little clarity about the optimal way to understand patients, the best approach is to do what good clinicians do: establish rapport and reduce power differentials to get a more authentic slice of life. Collaborative involvement as equal partners rather than as subjects may be the best way forward.
Defining or Diagnosing?
As Dr. Osler noted in the quote above, listening to patients is important to derive a diagnosis. The designer views empathy in a similar vein. Empathy is part of the convergent and divergent elements of design thinking and HCD. And with the divergence of ideas stemming from empathy comes the convergence during the define stage.9 Like a diagnosis, the pith of the define phase is to frame one problem the design may help address. By identifying and framing the core problem that is leading to dysfunction, we can all get around a strategy to find a solution to that problem.
Necessarily, in the define stage, we have to figure out what the scope of the issue is.10 When it came to The Rheumatologist, our scope was fairly broad. While we couldn’t change the size of the paper or the URL address, we had broad scope to change much so that readers could better digest the information and interface with the various elements of the publication.
In clinic, we have to often toggle our minds between diagnosis and define. Although it is important for us to label a condition as a diagnosis, it often does not define what a patient’s real concern may be. With respect to a rheumatic condition, a diagnosis can be an affirming and positive step, but only when we define the issue at hand. If we think about the patient’s concerns from a more holistic standpoint, incorporating socioeconomic determinants of health and other aspects of their experience, the diagnosis may appear to be only part and parcel of a larger issue requiring definition. This has important ramifications because, while defining is a convergent process, the next step in the design-thinking process is far more divergent.
Ideation: Beyond the Possibilities
The reason for defining or diagnosing an issue is that, once all those observations from the empathy stage are coalesced into a single issue, we are collectively tasked with coming up with ideas about how to proceed. That’s the fun part, at least when it came to redesigning The Rheumatologist. We think about ideation, whether in the clinic or in other settings, as being a hectic, anarchic enterprise. But ideation has a certain structure and form that can be utilized to benefit patients and users in general.
