In October of 2011 I presented at the Global Service Design Conference in San Francisco with colleague Ali Baba Attaie from HelloLAB. The following includes our presentation slides and some comments about the project.

Ali and I met over a year ago at a conference on design, technology and innovation. His organization, hellosmile is a pediatric Dental Network that serves low-income and underserved communities in New York City.  The organization has a great value proposition and mission statement, but at time the group struggling to innovate their service model in a holistic way across their clinics and service offerings. Ali and his group at hellosmile  had built a fast growing pediatric dental network in New York and through research and networking, began to recognize how design and design thinking could be applied to healthcare industry to make better patient experience. While there were many project opportunities, one of the biggest questions we asked ourselves was: how can design help solve their wicked problem: to eradicate tooth decay in high disease, low-income communities in NYC?

Like many, I believe in the power of using design for social change. But often a dilemma occurs when trying to design and innovate for businesses that are serving their community in a socially minded way. Often budgets are tight, and time is short. The question became,  how to create a design process on a shoe string budget that provides high level design thinking for small businesses, serving low-income and underserve communities? How can we tap into systems in agile ways?

THE DESIGN LANDSCAPE- where we started:
When I first came aboard, I saw a group with a lot of great ideas and a lot of enthusiasm about design and the design thinking process. There were lots of bits, lots of sketches, lots of nuggets of good ideas being pushed through with out a lot of systematic development. It was a group working at lightening speed and not everyone within the teams implementing the ideas was on the same page.

Service design thinking allowed the group to slow down and see service innovation opportunities in a holistic way. Providing common language, common understanding and having a way to visualizing what IS versus what COULD BE for their service model future. Service design thinking helps us create mutual recognition, connectedness and feeling of responsibility and concern for our common goals. The project begin with a conversations where we look at ‘bits’, business model, numbers. Service design thinking helps us understand how all the ‘bits’ come together as a whole experience and why it matters. We use many tools and techniques of service design that you are familiar with and this helps facilitate more constructive, user-focused conversations between our team members who are coming from disciplines that don’t always speak the same ‘languages’. Here is an agile, fast-moving organization being yielded by service design thinking process, but luckily they were OK with it.

One thing we realized along the way was that to make the process work, we needed to create long-term relationships with our design consultants so we formed a non-profit, helloLAB. Instead of delivering a project and walking away, helloLAB asks designers to embed themselves in our lab as they come together on various projects and initiatives. helloLAB grew out of hellosmile’s work and it is a set up as a non-profit studio where we create interdisciplinary interaction on service design for pediatric healthcare. We work with a young design teams, and partner with universities on student or faculty lead projects, and create a strong network of community partners and mentors who offer support and guidance.

THE PROBLEM There is a gap in the service experience that is causing only 20% of our patient to return- the experience is unfriendly, uncomfortable, generic, or at worst traumatizing. Care givers feel like it’s complex and not sensitive to cultural needs and they don’t see the value in the experience. In order to fulfill on our preventive care model, we need to have high patient retention, so how do we motivate patients to return?

OUR SOLUTION Fill the gap with a great experience.We recognize that MOST HEALTH SOLUTIONS AREN’T MEDICAL, RATHER SOCIAL. There for we put emphasis on creating a valuable experience for our patients and their families one that is memorable, culturally sensitive, meaningful that emphasizes healthy brushing habits and returning for regular check-ups.

In our service blueprint, the group most empowered to help communicate the importance of preventive care is our health coach team. The health coach, ‘hosts’ the child and parent at the clinic to make sure they have a comfortable and engaging experience, encourages behavioral change through education and information. This requires a sequenced narrative that can help guide our ‘hosting’ staff through important touch-points and conversations To create this experience, we  focused on two areas to help our preventive care message stick: talent recruitment and customer retention.

The first step to building trust is to have a staff that is from an ethnographic standpoint, sensitive to our patient population. That means recruiting locally. But, locally available staff are most often under-education and under-professionalized, requiring extensive career development. So, one of the things we want to make clear are the roles, opportunities and career paths. We also want to provide an educational plan for training and graduating the staff that further align the needs, perceptions and understanding between patients and providers.

What we’re interested in is creating a sense of membership. New patients are enrolling as members of our Passport Incentive Program. The program rewards for return check-ups, healthy teeth and builds anticipation for a chance to win big. At the center of the program is the hellosmile Passport, which acts like a membership rewards card and is given to children upon their first visit. For the health coach, the Passport Program provides a series of conversation prompts and props to engage parents in chair-side discussions

But how does the passport fit into a larger system? We mapped our the entire customer journey to see where the passport touchpoint occur and how we could build a more robust experience around the passport incentive program that supports the concept through conversations and interactions. We also recognize that the passport system requires support through the spaces we design- as we continue to grow in clinics, we needed a system that easily scales so that we can map onto distressed clinics that we revitalize.

• It’s possible, but it must be lean to work financially and strategically. It must be agile, but also strategic. For example: Furniture in lobby space is lean prototyping, meaning it is ‘hacked’ ikea furniture vs making big financial investment with more expensive custom furniture. It is agile in that it is iterative and incremental development, so that we can quickly improve the experience as we gather more data and feedback.

  • Embed designers vs delivery hand-off. Creating longer relationships and build a network of designers, and advocate design for social change in local design communities and universities.
  • Once you have exposure, you have demand. Create lean, pilot projects, show potential clients opportunities. This is allowing us to build our team and work with more small business owners in our communities.