Tackling Healthcare's Wicked Problems

The challenges facing Singapore’s healthcare sector are becoming increasingly complex - as more of us live longer, as we tend to suffer from long term chronic illnesses rather than short term acute diseases, and as care delivery becomes entrenched in unsustainable service models.

In 1960, life expectancy in Singapore was 65 years. By 2012, this had increased to 82 years, with Singapore boasting the fourth best life expectancy in the world. In many countries the ‘oldest old’ (those aged above 85 years) is the fastest growing sector of the population. In fact, older persons are expected to outnumber children for the first time in 2047, flipping the classic demographic distribution structure on its head. This evolving population trend threatens to unbalance the traditional care model still featuring in many aspects of care provision, despite various policy and service efforts to adapt to the pressures brought about by changes in patient demand.

The nature of our ailments is also gradually changing. Thanks to incredible clinical advancements, we are able to prevent many of the causes of deaths that once were prevalent. Whereas most deaths previously arose from infectious or parasitic disease, or diseases which were often referred to as poverty-related, now the primary causes of death are non-communicable diseases or chronic conditions, with many the result of wealthier lifestyles. These chronic, long term illnesses require ongoing rather than episodic treatment, further burdening the already struggling healthcare system. Added to such epidemiological trends, patient behaviour and care model design often exacerbates these service challenges. People continue to use the healthcare system in the way they always have done, rather than in a way that reflects changing individual or societal needs. This can place unnecessary burdens on some service areas, while leaving other parts of the healthcare ecosystem ineffectively utilised.

The answer to these complex problems cannot lie in building more hospitals and recruiting more doctors. This is an unsustainable, unaffordable short term fix to a burgeoning long term problem. We exist in a rich ecosystem which hosts a multitude of potential solutions if explored for sustainable, win-win outcomes. The question is how do we identify these new solutions? How do we create transformational breakthroughs set against such complex, challenging conditions?

For several years healthcare providers have been seeking new ways of tackling their hard-to-solve problems. The role of design thinking in transforming healthcare delivery has been gaining popularity around the world as a problem solving methodology that allows innovative, human-centric solutions to be imagined, with notable institutions such as the Mayo Clinic, USA, committing significant investment to such an approach. Design thinking offers a framework that allows new insights to be uncovered, and solutions to be designed in ways that may not previously have been considered, placing the user’s experience at the heart of the desired outcome.

To help Singapore’s healthcare professionals make sense of design thinking and develop the skills needed to effectively apply key techniques, NUS-ISS recently ran a dedicated course on Implementing Design Thinking in Health and Wellbeing.The three day course took participants through the design thinking process and how it can be applied in the context of our healthcare sector. Featuring off-site ethnographic activity (photo on left) and hands-on project work, participants were able to immediately apply what they were being taught for an immersive, high impact learning experience.

Participants were walked through the design thinking process, which showed them how to gain insights about unmet needs using a user-centric approach, to ideate solutions for paradigm-shifting innovative outcomes, all the way through to prototyping and communicating their designs.

At the end of the course, all participants said that they would actively recommend it to other health sector professionals as a programme that allowed them to walk away with tangible practical skills rather than simply theoretical knowledge. They described it as fun if tiring, after three days spent using their brains in entirely new ways! Participants especially liked the hands-on aspects of the programme, working on a real design challenge project during the course and gaining from peer-to-peer learning as they interacted with others from their industry in trying to tackle it. The solutions they designed have been shared with the health service provider that set the challenge, and will be considered further for potential implementation. Our students will be watching with baited breath to find out if their first forays into design thinking might be just what’s needed to sow the seeds of transformation in Singapore’s healthcare sector!