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Designing
Communities of
Care
Strategic Social Interaction Design in
Healthcare



        Amy Cueva
        Chief Experience Officer
        Map*Pow

        Will Evans
        Director, Experience Design
        Semantic Foundry
Who are these folks?


                 @amycueva
                 @semanticwill




 © 2008 Will Evans Evans & AmyFoundry, LLC
       © 2010 Will | Semantic Cueva
We wonʼt talk about...




   © 2010 Will Evans & Amy Cueva
Definition




              ‣   Social Interaction Design (SxD) is
                  the conceptualization, research,
                  strategy, and production of
                  dynamic ecosystems that support
                  community, conversation &
                  collaboration
                    ‣   me, 2008


     © 2010 Will Evans & Amy Cueva
Social Interaction Design




                 ‣   Social Interaction Design (SxD) is
                     not web design
                 ‣   SxD is about complex, dynamic
                     ecosystem design
                 ‣   The User Interface is the Social
                     Interface
                 ‣   The content is the conversation


     © 2010 Will Evans & Amy Cueva
Social Interaction Design


      People like to talk about conversation...

                                     about authenticity...

                                     What, exactly, is it?

                                             and

  How do you design a community of care to
               facilitate that?
     © 2010 Will Evans & Amy Cueva
Social Interaction Design

  So, if the user interface is the social interface

                                     and

                      If the content is the conversation


                                     then

                  We need a model of conversation

     © 2010 Will Evans & Amy Cueva
Socio-Cybernetic Model


                                    Text






          
       Paul Pangaro
          
       pangaro.com
    © 2010 Will Evans & Amy Cueva
a participant has a goal


                                Text




      
       Paul Pangaro
      
       pangaro.com


© 2010 Will Evans & Amy Cueva
chooses a context


                                Text




      
       Paul Pangaro
      
       pangaro.com


© 2010 Will Evans & Amy Cueva
negotiates a language


                                Text




      
       Paul Pangaro
      
       pangaro.com


© 2010 Will Evans & Amy Cueva
begin an exchange of symbols


                                 Text




       
       Paul Pangaro
       
       pangaro.com


 © 2010 Will Evans & Amy Cueva
causes a reaction


                                Text




      
       Paul Pangaro
      
       pangaro.com


© 2010 Will Evans & Amy Cueva
that evokes a response


                                Text




      
       Paul Pangaro
      
       pangaro.com


© 2010 Will Evans & Amy Cueva
agreement may be reached


                                Text




      
       Paul Pangaro
      
       pangaro.com


© 2010 Will Evans & Amy Cueva
Social Media Design Basics


                                     Basics
                 ‣   You can’t design the conversation
                 ‣   But the interface can mediate,
                     guide, inform the conversation
                 ‣   The interface can encourage or
                     discourage certain types of
                     behavior - through identity,
                     reputation systems, game
                     mechanics...


     © 2010 Will Evans & Amy Cueva
Why Community?


             ‣   Start with the high-level strategic goals and
                 objectives for the site –
                   ‣   then answer: why community?
             ‣   What kinds of engagement do you want to
                 encourage on your site?
             ‣   What is the desired outcome?
             ‣   There is no end-state!
             ‣   This will help map out your strategic direction.




    © 2010 Will Evans & Amy Cueva
Participation vision




                    ‣   Rather than pursue Social Media strategies
                        based on fashion, as designers we need to
                        think about how we want the site to engage
                        with people — who want to engage with
                        each other
                    ‣   and create architectures, features, and
                        functionalities that creates a path for
                        participation
                    ‣   Ask: where is the community going to go?



     © 2010 Will Evans & Amy Cueva
Model of Attributes




                                                              Identity | a way of uniquely identifying people in the
                                                                community
                             presence                         Presence | a way of knowing who is online, available or
                                                                otherwise nearby
                                                              Relationships | a way of describing how two users are
       sharing                                relationships     related (e.g. on Gather, people can be family, friends or
                                                                colleagues)
                                                              Conversations | a way of talking to other people within the
                                                                community
                             identity
                                                              Groups | a way of forming tribes within the context of shared
                                                                interests
                                                              Reputation | a way of knowing the status of other people in
   conversations                               reputation       the community (who's a good citizen? who can be
                                                                trusted? who is a big contributer?) This may be less
                                                                important.
                              groups                          Sharing | a way of sharing things that are meaningful to
                                                                participants (like presentations, articles, methods, design
                                                                patterns, etc)



         Webb/Butterfield/Smith Model

  © 2008 Will Evans | Semantic Foundry, LLC
A Roadmap



      ‣   Completely understand the profile of the audience
      ‣   Map out how users will participate - both today and
          tomorrow
      ‣   Create multiple participation points
      ‣   Find lightweight ways for first time creators to
          contribute
      ‣   Make it easy for Spectators to find and consume
          user-generated content
      ‣   Prepare your organization for participation in the
          conversation

    © 2010 Will Evans & Amy Cueva
Healthcare Considerations


      ‣   People: Patient, family members, primary care physician,
          specialist, pharmacist, nutritionist, chiropractor
      ‣   State of health: Healthy, symptoms, Not yet diagnosed,
          recently diagnosed, chronic
      ‣   Influencers: Emotional state, financial state, level of
          emotional Support, level of knowledge, access to technology,
          laws, level of insurance
      ‣   Interactions: Decision support, online visits, communications,
          conversations
      ‣   Organizations: Hospitals, pharmacies, employers,
          government, communities, Non-Profit orgs
      ‣   Objects: Medications, procedures, claims

    © 2010 Will Evans & Amy Cueva
Ideas & Opportunities




  © 2010 Will Evans & Amy Cueva
PHR + Social Media



      ‣   PHR data feeds profile
      ‣   Profile becomes matching system
      ‣   Rich profile attracts relevant people, objects,
          interactions
      ‣   Social media enables interactions
      ‣   Data makes interactions more meaningful
      ‣   Interactions produce data




    © 2010 Will Evans & Amy Cueva
Relationships, Frequency, & Access
                                     Track
                                     Reflect
                                     Become aware
                                     Encourage
                                     Achieve
                                     Celebrate
                                     Intervene
                                     Reach out
                                     Share
                                     Visit
                                     Inform
                                     Communicate
                                     Coordinate
                                     Escalate
                                     Obtain data
    © 2010 Will Evans & Amy Cueva
Promoting Positive Reflection




     © 2010 Will Evans & Amy Cueva
Enabling & Informing Patient/Doctor Interactions




     © 2010 Will Evans & Amy Cueva
Care Team Coordination




    © 2010 Will Evans & Amy Cueva
Influence of the system




     © 2010 Will Evans & Amy Cueva
Design Considerations




  © 2010 Will Evans & Amy Cueva
Design Considerations

the shit you wish we spent the whole talk on




    © 2010 Will Evans & Amy Cueva
Design Considerations




1. Create articulated contexts




    © 2010 Will Evans & Amy Cueva
Design Considerations
                                    2




2. Design for identity




    © 2010 Will Evans & Amy Cueva
Design Considerations




3. Interests, Passions, Goals




    © 2010 Will Evans & Amy Cueva
Design Considerations




4. Presence




    © 2010 Will Evans & Amy Cueva
Design Considerations




                                    5

5. Groups, Tribes, Cohorts




    © 2010 Will Evans & Amy Cueva
Design Considerations




6. Trust




    © 2010 Will Evans & Amy Cueva
Design Considerations




7. Reputation




    © 2010 Will Evans & Amy Cueva
Design Considerations




8. Conversation




    © 2010 Will Evans & Amy Cueva
Design Considerations




9. Spheres of Intimacy




    © 2010 Will Evans & Amy Cueva
Design Considerations




                                    10
10. Privacy




    © 2010 Will Evans & Amy Cueva
Design Considerations




11. Governance




    © 2010 Will Evans & Amy Cueva
Design Considerations




12. Serendipity




    © 2010 Will Evans & Amy Cueva
In the end: community members will own it


              ‣   Once designed, communities of care are not
                  in the hands of those that funded, designed,
                  built it - it must be handed over to patients
                  and the community - letting go is the hardest
                  thing
              ‣   Shift thinking from “What it does” to “What
                  people are doing and saying”
              ‣   Create a system so that it can become what
                  it will mean to each person, and as a result,
                  service the community

                                     “The street finds it’s own uses for things”
     © 2010 Will Evans & Amy Cueva
Amy Cueva
@amycueva

Will Evans
@semanticwill

HealthcareUX on LinkedIn
Thanks
Amy Cueva
@amycueva

Will Evans
@semanticwill

HealthcareUX on LinkedIn
Thank You!
Stay in touch with Will
@semanticwill

Stay in touch with Amy
@amycueva @madpow

Stay in touch with us
@phillychi
phillychi@yahoogroups.com

phillychi.acm.org

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Communities of Care - Strategic Social Interaction Design in the Healthcare

  • 1. Designing Communities of Care Strategic Social Interaction Design in Healthcare Amy Cueva Chief Experience Officer Map*Pow Will Evans Director, Experience Design Semantic Foundry
  • 2. Who are these folks? @amycueva @semanticwill © 2008 Will Evans Evans & AmyFoundry, LLC © 2010 Will | Semantic Cueva
  • 3. We wonʼt talk about... © 2010 Will Evans & Amy Cueva
  • 4. Definition ‣ Social Interaction Design (SxD) is the conceptualization, research, strategy, and production of dynamic ecosystems that support community, conversation & collaboration ‣ me, 2008 © 2010 Will Evans & Amy Cueva
  • 5. Social Interaction Design ‣ Social Interaction Design (SxD) is not web design ‣ SxD is about complex, dynamic ecosystem design ‣ The User Interface is the Social Interface ‣ The content is the conversation © 2010 Will Evans & Amy Cueva
  • 6. Social Interaction Design People like to talk about conversation... about authenticity... What, exactly, is it? and How do you design a community of care to facilitate that? © 2010 Will Evans & Amy Cueva
  • 7. Social Interaction Design So, if the user interface is the social interface and If the content is the conversation then We need a model of conversation © 2010 Will Evans & Amy Cueva
  • 8. Socio-Cybernetic Model Text Paul Pangaro pangaro.com © 2010 Will Evans & Amy Cueva
  • 9. a participant has a goal Text Paul Pangaro pangaro.com © 2010 Will Evans & Amy Cueva
  • 10. chooses a context Text Paul Pangaro pangaro.com © 2010 Will Evans & Amy Cueva
  • 11. negotiates a language Text Paul Pangaro pangaro.com © 2010 Will Evans & Amy Cueva
  • 12. begin an exchange of symbols Text Paul Pangaro pangaro.com © 2010 Will Evans & Amy Cueva
  • 13. causes a reaction Text Paul Pangaro pangaro.com © 2010 Will Evans & Amy Cueva
  • 14. that evokes a response Text Paul Pangaro pangaro.com © 2010 Will Evans & Amy Cueva
  • 15. agreement may be reached Text Paul Pangaro pangaro.com © 2010 Will Evans & Amy Cueva
  • 16. Social Media Design Basics Basics ‣ You can’t design the conversation ‣ But the interface can mediate, guide, inform the conversation ‣ The interface can encourage or discourage certain types of behavior - through identity, reputation systems, game mechanics... © 2010 Will Evans & Amy Cueva
  • 17. Why Community? ‣ Start with the high-level strategic goals and objectives for the site – ‣ then answer: why community? ‣ What kinds of engagement do you want to encourage on your site? ‣ What is the desired outcome? ‣ There is no end-state! ‣ This will help map out your strategic direction. © 2010 Will Evans & Amy Cueva
  • 18. Participation vision ‣ Rather than pursue Social Media strategies based on fashion, as designers we need to think about how we want the site to engage with people — who want to engage with each other ‣ and create architectures, features, and functionalities that creates a path for participation ‣ Ask: where is the community going to go? © 2010 Will Evans & Amy Cueva
  • 19. Model of Attributes Identity | a way of uniquely identifying people in the community presence Presence | a way of knowing who is online, available or otherwise nearby Relationships | a way of describing how two users are sharing relationships related (e.g. on Gather, people can be family, friends or colleagues) Conversations | a way of talking to other people within the community identity Groups | a way of forming tribes within the context of shared interests Reputation | a way of knowing the status of other people in conversations reputation the community (who's a good citizen? who can be trusted? who is a big contributer?) This may be less important. groups Sharing | a way of sharing things that are meaningful to participants (like presentations, articles, methods, design patterns, etc) Webb/Butterfield/Smith Model © 2008 Will Evans | Semantic Foundry, LLC
  • 20. A Roadmap ‣ Completely understand the profile of the audience ‣ Map out how users will participate - both today and tomorrow ‣ Create multiple participation points ‣ Find lightweight ways for first time creators to contribute ‣ Make it easy for Spectators to find and consume user-generated content ‣ Prepare your organization for participation in the conversation © 2010 Will Evans & Amy Cueva
  • 21. Healthcare Considerations ‣ People: Patient, family members, primary care physician, specialist, pharmacist, nutritionist, chiropractor ‣ State of health: Healthy, symptoms, Not yet diagnosed, recently diagnosed, chronic ‣ Influencers: Emotional state, financial state, level of emotional Support, level of knowledge, access to technology, laws, level of insurance ‣ Interactions: Decision support, online visits, communications, conversations ‣ Organizations: Hospitals, pharmacies, employers, government, communities, Non-Profit orgs ‣ Objects: Medications, procedures, claims © 2010 Will Evans & Amy Cueva
  • 22. Ideas & Opportunities © 2010 Will Evans & Amy Cueva
  • 23. PHR + Social Media ‣ PHR data feeds profile ‣ Profile becomes matching system ‣ Rich profile attracts relevant people, objects, interactions ‣ Social media enables interactions ‣ Data makes interactions more meaningful ‣ Interactions produce data © 2010 Will Evans & Amy Cueva
  • 24. Relationships, Frequency, & Access Track Reflect Become aware Encourage Achieve Celebrate Intervene Reach out Share Visit Inform Communicate Coordinate Escalate Obtain data © 2010 Will Evans & Amy Cueva
  • 25. Promoting Positive Reflection © 2010 Will Evans & Amy Cueva
  • 26. Enabling & Informing Patient/Doctor Interactions © 2010 Will Evans & Amy Cueva
  • 27. Care Team Coordination © 2010 Will Evans & Amy Cueva
  • 28. Influence of the system © 2010 Will Evans & Amy Cueva
  • 29. Design Considerations © 2010 Will Evans & Amy Cueva
  • 30. Design Considerations the shit you wish we spent the whole talk on © 2010 Will Evans & Amy Cueva
  • 31. Design Considerations 1. Create articulated contexts © 2010 Will Evans & Amy Cueva
  • 32. Design Considerations 2 2. Design for identity © 2010 Will Evans & Amy Cueva
  • 33. Design Considerations 3. Interests, Passions, Goals © 2010 Will Evans & Amy Cueva
  • 34. Design Considerations 4. Presence © 2010 Will Evans & Amy Cueva
  • 35. Design Considerations 5 5. Groups, Tribes, Cohorts © 2010 Will Evans & Amy Cueva
  • 36. Design Considerations 6. Trust © 2010 Will Evans & Amy Cueva
  • 37. Design Considerations 7. Reputation © 2010 Will Evans & Amy Cueva
  • 38. Design Considerations 8. Conversation © 2010 Will Evans & Amy Cueva
  • 39. Design Considerations 9. Spheres of Intimacy © 2010 Will Evans & Amy Cueva
  • 40. Design Considerations 10 10. Privacy © 2010 Will Evans & Amy Cueva
  • 41. Design Considerations 11. Governance © 2010 Will Evans & Amy Cueva
  • 42. Design Considerations 12. Serendipity © 2010 Will Evans & Amy Cueva
  • 43. In the end: community members will own it ‣ Once designed, communities of care are not in the hands of those that funded, designed, built it - it must be handed over to patients and the community - letting go is the hardest thing ‣ Shift thinking from “What it does” to “What people are doing and saying” ‣ Create a system so that it can become what it will mean to each person, and as a result, service the community “The street finds it’s own uses for things” © 2010 Will Evans & Amy Cueva
  • 46. Thank You! Stay in touch with Will @semanticwill Stay in touch with Amy @amycueva @madpow Stay in touch with us @phillychi phillychi@yahoogroups.com phillychi.acm.org

Notas do Editor

  1. But first....
  2. But first....
  3. A participant (think patient, family member, care provider) has a goal, in this case their goal is to engage in social activities with other people around health &amp; wellness - like cronic conditions
  4. The participant chooses a context - and this is very important - just like when your boss calls you into his office and closes the door - that frames the kind of possible conversations that might happen. Same thing when dealing with health related communities. If the context is an online community for parents of children with autism - that frames the expectations, kinds of conversation, types of interactions that happen.
  5. The participants must negotiate a shared language. Right now clinicians define the language - it&amp;#x2019;s not patient-centric - in a language that patients would understand - it needs to be a language that is human.
  6. Participants begin to the exchange of symbols - in the offline word those can be body language, but in mediated space, we lose all of that, so we develop a semiotics of conversation best suited to the environment.
  7. &amp;#x2663;Context &amp;#x2663;Language &amp;#x2663;Exchange &amp;#x2663;Agreement &amp;#x2663;Transaction
  8. &amp;#x2663;Context &amp;#x2663;Language &amp;#x2663;Exchange &amp;#x2663;Agreement &amp;#x2663;Transaction
  9. agreement or understanding may be reached, or the transaction of some value may occur - like &amp;#x201C;Wow, your hot, lets go back to my place for a nightcap&amp;#x201D;
  10. In Social Experience Design - we have 7 key attributes that shape the design of online communities - each community is different and features/functions must map to these attributes.
  11. Community: Online and Local Live Connectors Organizational (The System): Digital access to caregivers, health coordinators, health coaches, nutritionists, nurses Interpersonal: Support tools for family and friends, weaving them into the experience, interventions Individual: Goal setting and tracking (where they are &amp;#x2013; SMS, iPhone, etc), personalized program and messaging, health games, health journals, HRAs, PHRs, messages to myself.
  12. Baseline data is being gathered and the people are helping each other. Can the system: Help the user to notice and track the positive Reinforce the positive in order to promote repetition Provide guidance, include support team and introduce professionals at certain points Track behaviors through and integrate with native communication channels: email, text messages, instant messages, twitter, facebook Take pictures of your food &amp;#x2013; nutrition and portion size analyzed for feedback Take pictures of your walk &amp;#x2013; it get&amp;#x2019;s reflected back to you Personalized outreach messages, communication plan to yourself
  13. Dr. and patients can log in to review lab results and xrays, via screenshare or live appointment Log in to take a pre-visit questionnaire, fill out forms, and create questions for your doctor View doctor&amp;#x2019;s notes from visit, (OpenNotes) and follow up care plan, track against it Dr. access to your health journal Ongoing dialogue with Dr: check in to review progress, leave notes, system can escalate, interventions Connect with Dr. online via email, instant chat, SMS, online visit
  14. College kids don&amp;#x2019;t want to water-down their conversations because their mom is now their friend on Facebook - multiple contexts have collided as people are connecting to their family, children, coworkers - there is no delineation, no semi-private space. For Communities of Care to be truly engaging, the context has to be clearly defined so people feel comfortable discussing personal, often emotionally charged topics.
  15. My participation in online social media is informed by my sense of self and self image I actively create, maintain, tweak, and monitor my online Persona I have a self-interest in seeing my online presence acknowledged and reflected back to me I use social media as an extension of myself, often telling about and narrating biographical details and reflecting how I would like to be seen In the health &amp; wellness space, I may be very sensitive to self image, self perception, acknowledgment, status, position, success
  16. People gather around shared interests, passions, goals - this forms the context for sharing. This is not goal or activity centered design - because there is no end-state for engagement.
  17. Know when I am online. Know when others are as well, and the degree to which they are willing to engage.
  18. Social ties are complex. People want to gather around cronic conditions, around shared interests as well - the community of care must allow for sub-groups to develop organically. For groups around cronic conditions, this is where the care team can/should/must contribute.
  19. Patients that are sharing their personal information need to know it won&amp;#x2019;t be traded upon. This trust only develops over time - and it only takes 1 time to destroy it. Trust is not transferrable and is completely dependent on context.
  20. People make mistakes - reputation system &amp; mechanisms to save face and repair a tarnished reputation. One of the mechanisms we designed into Gather was the ability to earn points based on positive contributions to the community. Those points are redeemable for prizes, gift cards, and cash. Yelp.com has a sophisticated reputation system for rewarding good behavior, as does eBay. A means of introducing feedback loops into the system.
  21. Any community has it&amp;#x2019;s own sense of time, and conversations have a tempo, velocity, and flow. Design for conversations - understand how they work, the mechanisms, the value.
  22. People have boundries. Patients &amp; people need to be able to have different types of conversations based on their closeness with other people in social media.
  23. People need to have granular control over what their connections can see - this includes profile information, but also Who I follow, who follows me, what conversations I am engaged in. Patients managing their persona &amp; conversations in the context of cronic conditions must trust the system is designed for this.
  24. A grammar - set of rules - and community managers or high-trust people to oversee the conversation - make sure people are behaving - people are engaging in a positive way
  25. surface compelling, active or high velocity discussions allows more rapid engagement surface people that share interests so people can serendipitously connect.