We Made This Thing….

An Interview with CFI’s Amy Wicks

Amy Wicks is a service designer at the Mayo Clinic Center for Innovation, where she works directly with patients and care team members to enhance the health care experience from both perspectives. She will be part of an interactive breakout session during Transform in which a team from the Center for Innovation will discuss Smart Space, a mobile prototype designed to optimize providers' interactions with the electronic health record, the care team, and the patient.

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

Rose: Amy, thank you for taking some time to chat, I’m excited to highlight what you’ve been up to inside Mayo Clinic and what you’re planning for Transform next week. Your breakout has such a great title - “We Made This Thing, But It Didn’t Go As Planned. Now What?” - what is the experience of this session going to be like for attendees?

Amy: With this breakout session, we really want to dig into the conference’s overall theme of making change possible by talking about the barriers to change we experience in a healthcare setting. We know a lot of people come to Transform with great ideas and a lot of passion but with challenges in turning those things into reality.

We want this breakout to be an opportunity for a really honest discussion about the challenges we have faced in the context of project called Smart Space, which was part of a larger initiative that Meredith DeZutter talked about last year at Transform. We were trying to reduce cost in the practice and the Smart Space piece of that was about reducing the burden of clinical data entry for providers. The “Thing” we talk about trying to build in the breakout session is the Smart Space platform, which ending up being a really difficult process but it gave us a lot of insight, not only into care teams’ needs, but also into the process of developing a new system within a large, complex medical practice.

I think we have a great opportunity at Transform to involve the audience in talking about the challenges they see in their work and how we can mitigate them by being really flexible and thoughtful in our process. Working on the Smart Space project, one of the hardest but most rewarding parts was being willing to change from what we thought we were making to what our users really needed us to make. We have to constantly re-evaluate not only “What is the user need?” but also how can we meet that need within a huge system that can be really hard to change. Sometimes your big grand design has to be tweaked and deconstructed to make change more manageable and implementable.

Rose: Core principles of a human-centered design process include allowing for that flexibility to pivot and for the solution to emerge from understanding users’ needs, but putting that into practice can be challenging. What does it mean for a team to be disciplined enough to let that happen, to be driven by focusing on people’s needs, rather than being led by what the technology can or can’t do?

Amy: It comes down to understanding the user needs and understanding how those needs fit within the overall system. You can hand someone the coolest technology but if it doesn’t integrate into their day-to-day life and fill a purpose, they are never going to use it. You have to understand the user and see where you can create something to support their needs. And then you have to try the idea out and then iterate on it because the first thing you make is never going to be a perfect fit. Sometimes that first thing actually creates unexpected consequences that you then have to solve for. Or it fits the user need but doesn’t integrate into the larger system. So you have to try things and learn and rebuild until you know how to solve the problem most effectively.

Rose: Back in 2014, CFI hosted Jim Hackett, Vice Chair of the Board of Directors of Steelcase Inc, as part of our Unexpected Speaker series . After that presentation, we sat down in conversation with him and I recall him sharing the idea of a “now, near, far” leadership mentality. That approach seems particularly relevant to both the opportunities and challenges you experienced with Smart Space. How did you balance the now, near, and far?

Amy: I think it is important, when you are working on a project, to know the limits. Those might be technological, they might be cultural, they might be based on regulations, but you need to know what they are and how to design a system within those parameters. At the same time you have to think about the future and how those parameters might change. You plan for those things and how you could make enhancements based on what changes. That way you can put the building blocks in place now, with the current limitations, and then work past that as those limitations shift.

On Smart Space, we were working with a lot of emerging technology. We were trying real-time tracking systems, speech recognition, natural language processing. As we prototyped using these technologies we ran into a lot of limitations in terms of what those systems were able to do and what our internal infrastructure was capable of supporting. So as we started thinking about how to translate what we had learned into a production-level system, we had to determine what we could build now, within the available technical parameters. But we also had to predict how the technology and our own infrastructure would evolve and how we could incorporate those changes in future versions of the platform.

Rose: “Embrace failure” is a bit of an innovation cliche. Your breakout session is about how things didn’t go as planned, but is it really about failure? Is there such a thing as failure? Or is this about a different way of thinking about success?

Amy: I’m not idealistic enough to believe there is no such thing as failure. I’ve done things that have failed and I may have learned something but it’s still failure. But I also think that we shouldn’t be narrow in the way we define success and failure. When you are working iteratively and are willing to change your plan and your process and your design based on the new things you learn, then that is going to change what success looks like. The thing you envisioned when you started is probably not what you are going to end up with.

So you have to think about what failure and success mean in a particular instance, at that particular moment. As the project has progressed, how has the objective changed? How has that changed the way you approach the problem or solve for a need?

In the breakout session that I am helping facilitate we want to talk about a lot of the barriers we faced in the Smart Space project but we also want to explore whether or not that project should be considered a success or failure. I don’t want to give away the end of the story but it did not go exactly as planned. I think it is important to reflect on that and see if there is still value and how we can still leverage the work to make change, rather than writing something off as soon as it doesn’t go as planned.

Rose: Each year, Transform gives us the opportunity for to hear from people who inspire our work and invite us to think differently. What parts of the program are you looking forward to this year? What have you taken away from Transform in past years that you’ve carried into your current projects?

Amy: There are some great speakers lined up this year but I am really excited about the PlaceMakers Prototyping Festival that will be going on during Transform at the end of the Thursday session. People from the community are creating prototypes of ideas they have to improve public spaces in Rochester in order to learn about how those ideas might play out if they are implemented. It ties in really well to the process at CFI and will allow Transform attendees to see that process in action. Plus, I’ve had the chance to break out my old design school “craft” skills, helping you and your prototype team with your project.

In terms of past Transform speakers, a few years ago Eric Dishman talked about his experience as a patient. It was striking to hear first-hand how challenging the system can be for patients and how little control they have. He really had to fight to get his perspective considered. I try to keep those kinds of stories in mind in my current work, which is focused on the patient experience as Mayo transitions to Epic, our new electronic health record system.

We need to make sure we are considering the ways in which patient will be interacting with the Mayo system and try to identify where there might be confusion or frustration during that process. There is so much potential, when we are building something new, to consider how we impact our users and how we can guide them through a process that is often a scary and overwhelming. People interact with health care at very vulnerable times in their lives and we want them to be able to focus on things that are meaningful to them, not get bogged down in navigating the system. To do that we have to make sure patient’s voices are represented in the design and development process.

Rose: Two-part question. First, what is it like to train in Graphic Design and end up in Service Design? Second, why is that so many great designers seem come from Ohio?

Amy: Why Ohio? Well, the University of Cincinnati, where we both went, has a co-op program that requires students to apply for internships within their field. So by the time you graduate you have about a year and a half of professional experience and you’ve made contacts and you’ve explored different parts of the field. A lot of CFI designers are UC grads and have helped recruit interns from UC. That’s actually how I started here, as an intern from their graphic design program.

When I started the internship, I thought I was going to be designing communication pieces, presentations and reports, and instead I found myself in exam rooms, observing appointments, helping with the first Smart Space prototype. Our provider partners were dictating their clinical notes, orders, and billing into iPads and I was observing how it fit their workflows and the impact on patients while also desperately trying to troubleshoot wifi drops and application crashes. I had no idea what was going on! I was like, “Where are the Photoshop files? Why am I not picking color palettes and setting type?” But by the end I started to understand this whole other application of design that is a lot broader than what I was used to. I loved that I got to leave the computer to go observe and meet people and learn about their perspectives.

I switched paths in a pretty extreme way when I decided to come back to CFI and pursue service design but the graphic design background definitely applies. The way you learn to think about the hierarchy of information and decide what is and is not important. And when we go to communicate what we learn, graphic design can play a huge role in making that clear and helping the audience understand the information. But my family is still pretty confused. My mom was like, “Can you send me some bullet points about your job because people ask me what you do and I don’t know what to say.” Now she can send them this and then they will be really confused!

Rose: Last question. How about some reading suggestions?

Amy: In terms of design books, or “books for work,” I like to have a few that I can skim through when I have a chance. This Is Service Design Thinking gives a really good overview of the design process and tools. Another good one is Exposing The Magic of Design, which focuses on synthesis and how to make meaning from what you learn during the design process which is a really important skill that can be hard to quantify or describe.