The Convergence of Economics and Design

An Interview with CFI’s Nel Pilgrim-Rukavina

Nel Pilgrim-Rukavina is a Service Designer at the Mayo Clinic Center for Innovation where she collaborates with diverse teams to tackle complex problems. Her current work is focused on taking grassroots ideas within Mayo Clinic to fruition through her work with CFI’s CoDE (Connect Design Enable) innovation grant program. A Minnesotan through and through, she cares deeply about the health, well-being, and future of this region. She recently graduated from the University of Minnesota where she studied economics and product design.

Rose Anderson is also a Service Designer at the Mayo Clinic Center for Innovation where she likes to exercise her habit of curiosity.

Rose: Nel, thanks very much for agreeing to be interviewed. I’ve really enjoyed previous conversations we’ve had about design and behavioral economics and appreciate the opportunity to share your perspectives with the health care innovation community. So, what led you to design and economics? Which came first?

Nel: I started with economics but felt like I was missing something. Design had been simmering in my mind for a while from reading articles (my mom knew I should go into design before I did, she started cutting out design articles for me while I was in high school). While in college, I decided to take a summer class in design at Parsons in New York to dip my toe into the field and I was hooked. I was exposed to design research works like William Whyte’s The Social Life of Small Urban Spaces, and was so excited to see people doing the work that I hoped to do and devoured all of the materials that were given to me. It was so much fun that I went back the next summer and applied what I had learned the year before by completing a project about accessibility to local produce in New York City. It was at this time that I fully realized that economics and design could be applied in harmony rather than as two disparate disciplines.

Rose: How do you bring the disciplines of design and economics together today in your work at CFI?

Nel: I think both disciplines teach you to think from a systems perspective--and help you to acknowledge that externalities result from the decisions you make. I believe in the value of design but sometimes it needs to be translated into a language that others understand and can be persuaded by. This requires turning qualitative insights into quantitative findings. Therefore, my design background acts as inspiration and economics helps with translation. For example, I am currently working on a project regarding pain management in the inpatient setting. We are beginning to explore how to operationalize a concept and have to think strategically about how to get others to recognize the value of this important work. I have many quotes from care team members saying that the tool gives them a holistic view of a patient’s pain, but for the idea to be feasible, it needs to be translated into time and cost savings. We are now working to incorporate that into the narrative so others outside of the project will be able to see the benefit of the idea.

Rose: So you must have been fairly excited that we had Dan Ariely, a leading expert in the field of behavioral economics, on the stage last year at Transform 2015. What stood out to you most from his talk? Have you taken and applied to your own work in service design for health care?

Nel: To say I was excited is an understatement. I have always respected his perspective on economics because unlike theory suggests, people do not always behave rationally. I think that is where design sets in because it begins to interpret why it is that people behave irrationally, despite their best intentions. This has helped me in framing discovery work. For example, I have learned that interviews are not always helpful in identifying an individual’s true need--people often say that they do something and then act in a different way. That is why observation is in my opinion the best design research tool--it allows you to see how individuals actually behave, not how they think they behave.

Rose: In less than a month, another heavy hitter from the world of economics, Stephen Dubner, author of Freakonomics, will be coming to Transform 2016. What have you taken away from his work? How does it compare or differ from Ariely?

Nel: Dubner applies traditional economics to more expansive topics while Ariely reviews the intricacies of behavioral economics. To me, Dubner’s unique perspective lies in his case studies of economic theory, whereas Ariely’s unique perspective lies in the economic theory itself. However, both encourage readers to take traditional ideas, flip them, and review them in new ways. They both present a mindset: to be curious and contemplative and this helps me to think more expansively in my work. Dubner and Ariely are also great storytellers and that is always important to persuade others to the ideas that you are presenting.

Rose: Last question, what is on your reading list?

Nel: I am always re-reading Malcolm Gladwell’s books, but my favorite is The Tipping Point. In the Center for Innovation, we are always trying to figure out how to get ideas to stick and this book helps me to think about that in new ways. Right now, I am also reading Crossing to Safety and The Botany of Desire. I like to go back and forth between fiction and non-fiction. Crossing to Safety is just a wonderful story of lifelong friendship and in The Botany of Desire, Michael Pollan present staple crops in entirely new ways.

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