The “Patient” as “Provider”?

SFIP’s newest project, Wellness as a Complex System, embodies a simple but perhaps provocative proposal:

When it comes to social, cultural, and community factors in health and wellness, why not make the individual his or her own doctor?

The so-called “social determinants of health” are well-known to have a significant impact on a broad range of (or even all) disease outcomes. This effect is most evident in “behavioral diseases,” such as obesity/diabetes, that have behavior factors at their root (e.g., diet and exercise).

The U.S. spends $245 billion annually on diabetes care alone, and 17.6% of GDP on healthcare, and both are rising dramatically. We know a lot about what people do to make themselves sick, and what they can do to keep themselves well. Needless to say, it’s time for some innovative thinking about how we use this knowledge, and maybe even some tried-and-true user-centered design.

As one example, take a look at the Business Innovation Factory’s Children’s Wellness Experience Lab (disclosure: BIF is an SFIP alliance partner, and its founder and Chief Catalyst, Saul Kaplan, is an SFIP advisor and one of the smartest innovators we’ve ever met). When Children’s Medical Center in Dallas, TX realized that the system was broken and needed re-imagining, they turned to BIF. The initial stage of ethnographic research and conclusions moves the locus of action and the focus of support to the individual child, and his or her family, peer group, and social environment. As stated in the initial report:

“This ‘new way’ requires transformative, sustainable models that move away from the focus on ‘sick care’ to a broader focus on ‘well care’…. At the Business Innovation Factory, we believe that these models are the product of good human centered design. BIF starts with a strong understanding of how children and their families experience health care within the system as well as their everyday lives. What are their beliefs, attitudes, and values that influence their experience?”

SFIP proposes to investigate a similar approach, featuring “Individual Health Plans” created by the individual, and then mapping connections between these plans, and the social and cultural context. We believe this will yield better ideas for policies, support mechanisms, and interventions, more effective implementation in the field, and significantly improved outcomes. Use the Comments to let us know of any other related work in this area, or your thoughts on these efforts.