ACM Interactions

Authors:
Richard Anderson

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I've been reviewing an excellent manuscript for a book on design thinking and reading about a new game and kit developed by IDEO to help explain it. These things delight me, as for years I've been focused on expanding the role of design/UX to be a full participant in defining business strategy and in being a catalyst for that change. More recently, participation in defining social strategy became an important part of that focus. Design thinking came to be advocated by business visionaries to be a major part of fixing a broken strategy-definition process [1]. Jon Kolko and I wrote about and published others' writings about such things in interactions when we were editors-in-chief.

So, I have been intrigued by proclamations that design thinking is a failed experiment [2], that it is misguided to attempt to describe the process, and that design thinking must be recognized as the purview of the trained designer. Innumerable attempts at explaining the usually less ambitious UCD have been greeted by similar negative reactions over the years.

Just what is going on here? Stepping aside to look at related happenings in a seemingly different context can provide some insight.

In today's world of healthcare, a ballooning number of patients seek at minimum full participation in defining their diagnostic/treatment strategy. Why? Because of an outrageous number of misdiagnoses [3], because of what is often an insulting patient experience that includes doctors who don't listen to or even touch patients anymore [4], because of claims that doctors tend to just "regurgitate [knowledge] rather than think" [5] and disregard limits to their knowledge and experience, because of a system of referrals and approvals that prevent direct and ready access to doctors with needed expertise, among other reasons—in short, because of a healthcare system declared to be "broken" by speaker after speaker at Medicine 2.0'11 held at the Stanford University Medical Center.

Patient efforts to meaningfully pierce the diagnostic/treatment process have been greeted with claims that patients lack the skills and training to do this successfully, that only doctors can diagnose and prescribe correctly, that anything patients learn via the Internet is highly suspect, that reducing diagnosis/treatment to a process in which patients can participate ignores the fact that the practice of medicine is as much of an art as a science—reasons coming from members of a community (i.e., doctors) classified as a stage 3 (of 5) tribe: "I'm great and you're not" [6].

You should be seeing a lot of parallels...

In spite of such proclamations, the "e-patient" movement is growing rapidly, with peer-to-peer healthcare [7] increasingly seen as an essential part of a fully functional healthcare system in which social media play vital roles. A Society for Participatory Medicine has been formed as part of this movement "in which networked patients shift from being mere passengers to responsible drivers of their health, and in which providers encourage and value them as full partners." I'm even seeing suggestions of a need for an Occupy Healthcare movement. Meanwhile, medical rebels such as Jay Parkinson are showing how a patient-centered healthcare practice can work in spite of active resistance from the medical community [8], and programs are being designed to train medical students how to listen and talk to patients [9].

An observation from Twitter by an attendee of Health 2.0 San Francisco 2011 shown on page 9 speaks to all of this. And as I write this, the Occupy Wall Street protests are going global. As Thomas Friedman states in the New York Times, "Occupy Wall Street is like the kid in the fairy story saying what everyone knows but is afraid to say: the emperor has no clothes. The system is broken" [10].

The businesses in which many of you work are broken and are faced with the need to become genuinely user- or customer-centered and connected/social [11]. To achieve this, design/UX leadership is needed. However, as Samantha Starmer warned after learning that design/UX personnel are not the ones getting the many newly created chief customer officer positions [12]:

Given the current power of CX at the C-level, UX practitioners must step up our game, otherwise we will lose progress we have made to be more deeply involved in strategy beyond just performing usability services. We need to act now to be part of the broader CX solution. If we don't proactively collaborate across divisions and organizational structures, we will be stuck playing in the corner by ourselves. If we don't figure out how to manage partnerships with other departments in a collaborative, creative, customer focused way, the discipline of UX as we know it is at risk. CX management will take over.

New social, user/customer-centered businesses are needed [13]. "Citizen-centered" social strategy is needed [14]. And design can lead the way [15,16].

Describing/explaining the design process for others to understand—to enable their effective participation—is essential for this to happen [17]. However, more educational programs akin to that provided by the Austin Center for Design are needed. Perhaps a new professional association—a resurrection of a sort of CPSR—fully focused on this kind of participatory design is needed.

We've reached the point of no more worshiping at the altar of our cathedrals of business. The marginalization of design/UX is on its way to the rag pile.

It is a very good time to be a designer.

  References

1. Martin, R. Why decisions need design (part 1). Businessweek. Aug. 30, 2005; http://www.businessweek.com/innovate/content/aug2005/id20050830_416439.htm

2. Nussbaum, B. Design thinking is a failed experiment. So What's Next? Fast Company Design. Apr. 6, 2011; http://www.fastcodesign.com/1663558/design-thinking-is-a-failed-experiment-so-whats-next.

3. Denning, S. Fixing health care: Innovation needed! Forbes. Apr. 11, 2011; http://www.forbes.com/sites/stevedenning/2011/04/11/fixing-health-care-innovation-needed/

4. Verghese, A. Opening keynote. Medicine 2.0'11, Sept. 16, 2011.

5. Parkinson, J. Personalized healthcare. Medicine 2.0'11, Sept. 16, 2011.

6. Logan, D. Tribal leadership. TedxUSC talk, Mar. 2009; http://www.culturesync.net/ted?awt_l=CofNV&awt_m=3kQBAS6IpX0QHPv

7. Fox, S. Peer-to-peer healthcare. Medicine 2.0'11 keynote; http://e-patients.net/archives/2011/09/peer-to-peer-healthcare-at-medicine-2-0.html

8. Parkinson, J. Why medicine actively and legally stifles innovation. KevinMD.com, August 2011; http://www.kevinmd.com/blog/2011/08/medicine-actively-legally-stifles-innovation.html

9. Levy, P. Teaching bedside manner, $42 million. Not Running A Hospital, Oct. 2, 2011; http://runningahospital.blogspot.com/2011/10/teaching-bedside-manner-42-million.html

10. Friedman, T.L. Something's happening here. The New York Times. Oct. 11, 2011; http://www.nytimes.com/2011/10/12/opinion/theres-something-happening-here.html

11. Gray, D. The connected company. Feb. 8, 2011; http://communicationnation.blogspot.com/2011/02/connected-company.html

12. Starmer, S. Share the sandbox: UX can't own customer experience. UX Magazine. Feb. 23, 2011; http://uxmag.com/articles/share-the-sandbox

13. Kolko, J. Personality, discursion and disruption. UX Australia 2011; http://uxaustralia.com.au/conference-2011/personality-discursion-and-attitude

14. McMullin, J. Putting the citizen back into citizencentric. Nov. 26, 2010; http://www.slideshare.net/jessmcmullin/putting-the-citizen-back-into-citizencentric

15. Nussbaum, B. Designers are the new drivers of American entrepreneurialism. Fast Company Design. Oct. 3, 2011; http://www.fastcodesign.com/1665120/designers-are-the-new-drivers-of-american-entre-preneurialism

16. McGuirk, J. Mr Cameron, it's time to get the designers in. The Guardian. Oct. 11, 2011; http://www.guardian.co.uk/artanddesign/2011/oct/11/government-planning-designers-finland

17. Anderson, R. Developing user-centered tools for strategic business planning. Riander Blog. Jan. 10, 2007; http://riander.blogspot.com/2007/01/developing-user-centered-tools-for.html

  Author

Richard Anderson is a user/customer experience practice, management, and organizational strategy consultant with over 20 years experience focusing on international management and cross-organizational development. On Twitter, Anderson is @Riander.

 

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