Webinar - Design Thinking as a strategy for innovation in Public Sector Health Schemes
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Design Thinking as a strategy for innovation in Public Sector Health Schemes Project Focus: National Health Insurance Scheme, Ghana The ILO’s Impact Insurance Facility Webinar – 10 th January 2018
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Transcript of Webinar - Design Thinking as a strategy for innovation in Public Sector Health Schemes
Design Thinking as a strategy for
innovation in Public Sector Health Schemes
Project Focus: National Health Insurance Scheme, Ghana
The ILO’s Impact Insurance Facility
Webinar – 10th January 2018
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“Design is not just what it looks
like and feels like.
Design is how it works.”Steve Jobs
Interfacing with the webinar system
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Introduction to the ILO’s Impact Insurance Facility
The ILO’s Impact Insurance Facility’s mission: to enable the private sector, governments, and their partners to realise the potential of risk pooling mechanisms (such as insurance or other coverage plans).
• Achieved through a strategy of stimulating innovation and unlocking capacity
• Our work is guided by three principles: • 1) solutions are people-centred;
• 2) they are driven by both evidence and experience-based learning; and
• 3) collaboration among various stakeholders is necessary to deliver results.
Our project, focused on improving the renewal process of the National Health Insurance Scheme (NHIS) of Ghana, is made possible with the generous support of Agence Française de Développement (AFD).
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Introduction to the Joint Learning Network for Universal Health Coverage (JLN)
The Joint Learning Network for Universal Health Coverage (JLN) is an innovative, country-driven network of practitioners and policymakers from around the globe actively engaged in exchanging tacit knowledge on challenges faced and co-developing practical solutions to extend health coverage.
• Resulting tools equip countries with the how-to’s of designing and implementing efficient, equitable and sustainable healthcare systems, while contributing to global knowledge resources for achieving Universal Health Coverage (UHC).
Ghana is a founding member country of the JLN. 5
Agenda
Introduction to NHIS Ghana
Why Design Thinking?
The Design Thinking Sprint at NHIA
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Innovation Outcomes and Benefits of Design Thinking 4
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Design Thinking as a strategy for innovation in Public Sector Health Schemes
Presenter:Dr Lydia Baaba Dsane-Selby
Deputy Chief Executive (Operations), NHIA
Presenter: Shilpi Nanda, ActuaryILO Impact Insurance
Fellow, NHIA
Presenter: Ashlee Tuttleman
Consultant and Design Thinking Expert
Presenter: David Hutchful
Co-founder of Bloom Impact, Consultant and Design Thinking Expert
Facilitator:Lisa Morgan, Health
ActuaryImpact Insurance
Facility
Dr Lydia BaabaDsane-SelbyDeputy Chief Executive (Operations), NHIA
1. Introduction to NHIS Ghana
NHIS in Ghana
• NHIS was established in 2004, and has a goal of universal healthcare in Ghana
• NHIS offers comprehensive healthcare scheme to all citizens of Ghana and is subsidised by tax (National Health Insurance Levy)
• The scheme is distributed via a network of 165 branches
• The scheme penetration attained 40% in 2014 and has stayed relatively flat since
• In 2017 NHIS, with support from ILO Impact Insurance Facility, started a project to digitalise the NHIS renewal process aimed at accelerating population coverage
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40% 2014 - 2016
11% 2006
NHIS Statistics
165 District Offices
c.3,000 Branch Staff
11.2m Active Members
NHIS Comprehensive Healthcare Benefits
NHIS Population Coverage
In-patient Out-Patient Medicines Diagnostics
c.4,000Healthcare Providers
31% 2010
NHIS – Strategies and Project Objectives
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Expand Population Coverage and drive towards Universal HealthCare
Reduce Operational Burden and Costs
Design an efficient digital renewal process that delivers a desirable user experience to NHIS members
Expand adoption of biometric identity authentication to align interests between healthcare providers and NHIS
Design digital solutions that relieve operational burden at district offices and can be scaled at low cost
Design inexpensive and compatible identity and validity authentication solutions at healthcare provider sites
Shilpi Nanda, ActuaryILO Impact Insurance Fellow, NHIA
2. Why Design Thinking?
Why Design Thinking?
In case of NHIA, substantial internal and external research into member behaviour already available!
But research did not propose concrete process innovations based on insights
Design Thinking was chosen at NHIA as a substitutefor standard user-research and pilot launch for following reasons:
Standard User Research
Pilot Design Thinking
Outcomes User InsightsProduction Ready
SolutionUser Insights and
Prototypes
Time 1 to 4 weeks Up to 6 months1 week
to finish first prototype test
Cost
Variesdepending on
scale and nature of research
Substantial as actual systems built
before launch
MinimalResearch and
Prototyping done with in-house tools
Ashlee TuttlemanConsultant and Design
Thinking Expert
David HutchfulCo-founder of Bloom Impact, Consultant and Design Thinking Expert
3. The Design Thinking Sprint at NHIA
What is Design Thinking?
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Applying Design Thinking at NHIA
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Design Thinking in practice can play out as a 6-9 month long process or it can be shortened to deliver quick results.
We tailored the Google Ventures Sprint Methodology for NHIA.
www.gv.com/sprint
The NHIAProcessOverview
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Day 1: Expert Confessions
Day 2: User engagement
Day 3: Reframing problem & Ideation
Day 4: Building prototypes
Day 5: Prototype testing
Day 6: Iteration based on feedback
Day 1: Expert Confessions
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Methods
5-Whys
Mapping the User Journey
Re-Defining User ‘Categories’
Tackling Expert Mindsets
Outcome
Uncover bias based on knowledge, not understanding
Day 2: User engagement in the Field
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Outcome
Beginning to move from knowledge to understanding, from categories to people
Methods
Gathering insights at urban and peri-urban
locations.
Diverse mix of users; Unscripted Interactions.
Focus on broader relationship with healthcare and
insurance.
Day 3: Reframing problem & Ideation
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Methods
User Personas
Affinity Maps
Re-framing the Problem
Inspiration; 8-Fold technique; Ad Gallery
First Design Proposal
Outcome
• Two problems instead of 1• Validation of existing research• Thinking outside the box
Day 4: Build Prototypes
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Methods
Build Prototypes for Free!
Aim to replicate user experience
Scripts for IVR calls
Use Marvel, Lookback and Windows Paint (!)
Phones to record communication prototypes
Outcome
• Two sample USSD apps• Radio show script
Day 5: Prototype testing
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Methods
Test prototypes with users at new locations for
diversity in insights
Unaided interactions with prototypes; Watch for
verbal and non-verbal feedback
Record interactions on Lookback (if applicable)
Outcome
Quick, low-cost feedback from diverse users and user suggestions for improvements
Day 6: Iteration based on user feedback
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Methods
Download and interpret testing insights to
redesign solution
Develop revised prototypes for testing
Risk analysis
Action Plan for future iterations
Outcome
Deepened empathy, organizational awareness and design changes
Shilpi Nanda , ActuaryILO Impact Insurance Fellow, NHIA
4. Innovation Outcomes and Benefits of Design Thinking
Importance of Design Iterations
• Design of Desirable User Experience/Product is only the start of the design process
• Real value of design thinking is persisting with iterations and evaluating technical and economic feasibility of the design
• Stress Testing is recommended!24
Feasibility
What is technically and organisationally feasible?
Viability
What is financially
viable?
Desirability
What is a desirable user-
experience?
START
INNOVATION
Outcomes
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Communication PrototypeAuthentication PrototypeRenewal Prototype
• USSD based renewal process which requires little more than a feature phone, payments via mobile money
• Education and Awareness component
• Airtime incentives for group renewals
• USSD based authentication of policy validity
• Offline biometric authentication using NHIA biometric card or upcoming Ghana Universal ID (match on card)
• Authentication device at a price point that enables national scale-up across the wide network of hospitals
• Radio call-in and spot adverts
• Addresses real doubts in people’s minds e.g. ‘what is the point of insurance’ or ‘traditional medicine vs modern medicine’ or ‘generic medicines vs branded medicines’
• Tackles mis-information propagated by other parties
Benefits from Design Thinking as Approach to Innovation
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Senior Management Buy-In
Prototypes quick and easy to demonstrate
Prototypes more impactful than presentations and process maps
Solve more problems than one
Design Thinking framework allows for reframing of problem statement
based on user-insights
Outcomes from design thinking at NHIA were process and
communication prototypes, with insights regarding role of staff
Change Management
Design Thinking immerses staff deeply into user needs
Promotes user empathy within the team
Benefits from Design Thinking as Approach to Innovation
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Save Money and Time
The entire sprint exercise was covered in 6 days. Subsequent
iterations took a day each
Communication prototype has been recorded and tested by staff in 3
languages
Reduce Rejection Risk
Prototype testing relatively risk-free compared to full-scale launch or pilot
Key when reputational risk is high
Can be used when time for regulatory approval is long
Inputs from Diverse Groups
Design Thinking works best with diverse skills
Exercise allowed us to invite feedback from other government
agencies, peers and wide cross section of staff
Factors to ensure long term success
• Continuous Iteration
• Identify clear ownership within organisation
• Not a silver bullet, part of broader organisational context and should be part of systems approach
• Innovation is difficult part-time, but also important to not ring-fence all innovation to one dedicated team >> make it part of organisational DNA
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Design Thinking as a strategy for innovation in Public Sector Health Schemes
Q&A Session
Presenter:Dr Lydia Baaba Dsane-Selby
Deputy Chief Executive (Operations), NHIA
Presenter: Shilpi Nanda, ActuaryILO Impact Insurance
Fellow, NHIA
Facilitator:Lisa Morgan, Health
ActuaryImpact Insurance
Facility
Presenter: Ashlee Tuttleman
Consultant and Design Thinking Expert
Presenter: David Hutchful
Co-founder of Bloom Impact, Consultant and Design Thinking Expert
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Thank you!
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Panelist Organisation Contact
Lisa Morgan The ILO’s Impact Insurance Facility [email protected]
Shilpi Nanda The ILO’s Impact Insurance Facility [email protected]
Ashlee Tuttleman Consultant [email protected]
David Hutchful Consultant [email protected]
For more information, please visit:
The ILO’s Impact Insurance Facility
www.impactinsurance.org
The Joint Learning Network
www.jointlearningnetwork.org
Get in touch with the panelists:
