The health seeker is any person aware of his or her motivation to improve his or her health, whether sick or not. Health seeking is the natural pursuit of one’s appropriate balance of well-being, the continuous moving toward a person’s own centre and recognition of “normal” health. For some, normal is just not feeling any symptoms; for others, it may be achieving the physical performance of an Olympian. (Definition from Design for Care, FAQ) Either way, health seeking is a process view based on both behavior and one’s inner experience of “storing health,” it is not an identity.
There were several reasons for insinuating a new label. I needed a way to identify a person-centred view of care that embraces the full lifecycle of an individual and their circles of care. But we can’t say “person” all the time as a referent – and “patient” I like to reserve for the technical, clinical meaning only. And in a design book, I felt it was important to guide product-level designers away from “users” and user-centred.
The health-seeking impulse is also a systemic concept. Health seeking represents a motivation to restore balance, and is homeostatic in nature. I tend to disagree with the concept of “optimal” health, a concept which, from a person-centered and systems view, seems to overreach the human condition. An individual cannot ever reach or measure optimal, but we do recognize our own “normal.”
To optimize a function means to engineer its relationship to the environment to maximize its success in all known or preferred states. Optimizing ignores the real world complexity of many functions of a person, and presents health more as a engineering concept (where an optimal target can be defined and met as a benchmark). Research and experience shows people “seek normal,” even if normal for some is high performing and for others is merely comfortable. The reference should be with the person, not objective measures associated with an optimal state. That’s the system model chosen for the book.
A visual presentation of the health seeker emerges in the views of a person’s full lifecycle as in the book’s persona Elena’s journey from care-giver to recovering a new normal following a significant series of clinical encounters:
The health seeking journey situates the health seeker in a larger context where each stage of awareness results in (possibly, depending) a different encounter, a different outcome, and even a different circle of care. The journey shown here is not the sequence of supply-sided touchpoints of a service interaction, but the relationship of motivations to chosen touchpoints, leading to encounters and information resources. In this context, health seeking is rather like information seeking – an individual’s process for seeking resources and support to reach preferred outcomes.
Instances of health information seeking, as with the health concerns they reflect, are associated with a person’s experience of ill health. The health seeker is a person acting on the intention to pursue or sustain health, and health seeking is a purposeful activity that aims to restore or improve health. This new, neutral term gives context to the full range of experiences a person encounters in the pursuit of a homeostatic balance of relative good health.
When any concern arises—whether it’s sleeplessness, an unusual internal pain, or a chronic condition—our perspective changes, our information activity becomes focused and intentional, and in some cases our identity changes. A personal mood shifts from the indifference of everyday health to that of relieving a concern. Health seeking begins in earnest. People may undergo a significant change in identity—from a nonmedicalized self to that of a patient or even of a disease sufferer.
An Innovation Town Hall on Mental Wellness
November’s Design with Dialogue invites a wide range of community members to explore the landscape of campus and community mental wellness, the innovation of responsive care, and enhancing health service. With seasoned facilitators and special guests we take on several big questions, as well as those brought to the dialogue in the DwD circle.
- How can we move beyond the conventional views of mental health and learn from each other?
- Are there innovations in community and social health that might enhance awareness and improve mental wellbeing?
- What might we understand together to cultivate empathy and insight about the experience of emotional and mental health journeys?
The Health and Wellness Centre at OCAD University has pursued a positive, innovative course in engaging students and the campus in dialogues to understand experiences in mental health. Partnering with the HWC in this community-focused DwD, we join students, faculty, and community professionals in an exploration into the experience and struggles of mental health and the context of care and health services.
The Innovation Town Hall starts with several perspectives to learn about current, personal and critical issues in mental wellness and care. Moving from whole group to small group, context stories and health awareness journeys are co-created and shared among groups.
Outcomes of this dialogue will help inform the Health and Wellness Centre’s service and will be considered for potential designs for service enhancement. Please register on Eventbrite for this special session.
Peter Jones & Andrea Yip
Andrea Yip, MPH is the Coordinator of Mental Health Initiatives at OCAD U and Ryerson University and is working to co-design a collaborative mental health strategy between both schools. Working along the intersections of art, social design and health promotion, Andrea is coordinates community-led initiatives that have human-centered impact.
Andrea is an advisor to the Canadian Commission for UNESCO and the Wellspring Centre for Innovation. MentalHealthxDesign.com AndreaLYip.com Twitter: @andrealyip
In the current Guardian, American novelist Jonathan Franzen writes “What’s wrong with the modern world?” Franzen retrieves cranky German polemicist Karl Kraus from the 1930′s to buttress a literary critique of the cultural evaporation accelerated by Big Capital solutionist appropriation of the Internets. Perhaps because there are so few public techno-critics in literary culture in the 21st Century, Franzen seems to own this space for an epic rant (and new book) that pierce our culture’s enamoration with all things interactive, online, gamified, and ultimately, trivial. In the face of the scale of real-world problems faced by our civilization, Franzen is warning that our distraction with the entertaining and trivial, and our failure to invent beneficial alternatives, is costing us our culture:
“… the actual substance of our daily lives is total distraction. We can’t face the real problems; we spent a trillion dollars not really solving a problem in Iraq that wasn’t really a problem; we can’t even agree on how to keep healthcare costs from devouring the GNP. What we can all agree to do instead is to deliver ourselves to the cool new media and technologies, to Steve Jobs and Mark Zuckerberg and Jeff Bezos, and to let them profit at our expense.”
Franzen nails our obsessions with cool Silicon Valley “fixes” to the convenience problems of life (or perhaps those problems faced by well-off 20-somethings). He wonders whether our enchantment with sleek design (e.g., Apple products) has created an obsession with coolness as defined by Big Tech. You can’t help but admire the reframing of Apple’s design-led capitalistic optimism in this bit of story:
“Mac versus PC. Isn’t the essence of the Apple product that you achieve coolness simply by virtue of owning it? It doesn’t even matter what you’re creating on your Mac Air. Simply using a Mac Air, experiencing the elegant design of its hardware and software, is a pleasure in itself, like walking down a street in Paris. Whereas, when you’re working on some clunky, utilitarian PC, the only thing to enjoy is the quality of your work itself. As Kraus says of Germanic life, the PC “sobers” what you’re doing; it allows you to see it unadorned. This was especially true in the years of DOS operating systems and early Windows.”
As a “Hodgman” type myself, I’d recommend the social truth of that critique. I posted a rail about the Mac interface and closed hardware a couple years ago, but was too timid perhaps to take on the coolness factor. I am perhaps one of the only design professors at OCADU with a PC laptop … to which I’ve affixed the Apple logo sticker to confuse my students and peers into thinking I’m “with them.” But I’m not really, I’m with Franzen.
I’m also with Morozov. If you’ve read Evgeny Morozov’s recent social critiques of technological solutionism, whether in open dialogues or dialectics with columnists or his 2013 book To Save Everything, Click Here, you already know where we’re going. Franzen is joining a backlash against Silicon Valley smugness and monopolization of culture and access that includes Morozov and Jaron Lanier. Morozov enjoins a continuing movement of thinkers since systems theorists Norbert Wiener (Cybernetics, 1948) and Hasan Ozbekhan’s 1968 The Triumph of Technology: “Can Implies Ought”, Ivan Illich, Neil Postman, and yes, Marshall McLuhan.
Technology ethics has seemed something of a suppressed discipline for the last decade or so. As the new wave of Web 2.0 firms figured out how to make themselves extremely rich while making people happy sharing cat photos on Facebook, the North American impulse was to celebrate what looked to be the return of a magical economic and social force. Those urging that social purposes might change the tech rather than tech changing our norms were considered, well, cranks and Luddites. The occasional mea culpa is not going to change that. Morozov’s arguments are certainly a minority view, and Franzen’s points are getting lost in ad hominen attacks (a weird Millennial backlash against his arrogance that we would never have launched against previous generational authors, such as Mailer or Updike).
We should ask at least one critical question of all technological fixes to the supposed problems of our times: “What possibilities are lost with this solution? What value might be destroyed as a possible consequence?” OK, that’s two questions, but I’m sure you’ll have many more if you read these authors with an open perspective toward the social meaning of innovation.
As Design for Care launched in early June, O’Reilly Media kindly coordinated the second webcast on healthcare service design as an integrated practice of empathic design, to a live audience of about 500. The post-webcast video is now online and at your regular YouTube stations:
The webinar maps design practices and methods found effective in the most critical contexts in healthcare (consumer, clinical, institutional), illustrated by current cases and design research. Brief design research studies are presented to prompt rethinking of the meanings of care, of information sensemaking at point of care, and the design competencies sufficient to healthcare’s complexity.
As designers start to make inroads in the practices of clinical healthcare, they are finding institutions have little context to employ their contributions. In my book research I found very few clinics employing design professionals, unless you count the website staff. Yes, academic researchers and some academic design professionals are involved in funded multidisciplinary research, and then they tend to leave the institution and publish research. Designers and design researchers are not involved in the practical programs of integrating information, communication, and community resources with patient care practice, where significant differences in care and patient experience could be made.
Even as innovation centres start to spread in the US and Canada, they are generally staffed by the traditional health disciplines seeking a better return on process improvement. Except for Mayo Clinic, Kaiser Permanente, and a smattering of forward-thinking institutions, “advanced practice designers” are not engaged in the trenches in healthcare yet. Yes, its easy to understand that with the history and risks of healthcare, hospitals are averse to the risks new skillsets might introduce, and the healthcare culture does not invite the radical creativity expected of design school graduates. But even as newer, advanced facilities are being built, decentralized community care has become the trend, and population changes require new approaches to care, healthcare practices continue to manage their operations with the same staff as in the 1960′s.
We might start to consider the most effective roles and responsibilities for advanced design professionals in healthcare. Even architecture firms, traditionally heavily engaged in the front end planning of new facilities, are unequipped to integrate clinical service design into planning and post-occupancy research. Designing for care complements clinical care practice, improving services and creating innovative and systemic responses to complex human system problems. The book offers many starting points for clinical practice to integrate design research – such as the discussion of research methods associated with individual care needs based on levels of the hierarchy of needs. A simple, effective checklist of research questions for understanding people and patients (health-seekers) and the best methods for investigating these questions in an integrated, yet rigorous epistemology.