envision workshop Designing for Change The Exam Process in 2030 American Academy of Ophthalmology 2015

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1 American Academy of Ophthalmology 2015 Designing for Change The Exam Process in During the, you were challenged to re-imagine the exam process through the lens of the future; the year 2030 to be exact! We also explored what would drive those changes: patient experience, technology, and/or healthcare trends and policies.

2 Human-Centered Design The Envision Workshops employ a human-centered design approach to creative problem solving. Imagining new posssibilities in architecture and patient centered design requires a deep understanding of people and their desired experience, while balancing what is technically feasible and financially viable. Start Here DESIRABILITY What do people desire? FEASIBILITY What is technically / organizationally feasible? VIABILITY What can be financially viable? Human-centered design solutions should hit the overlap of the Desirable, Feasible, and Viable Lenses

3 The Timeline In 2013, the first Envision Workshop was held with the idea that through a gathering of great ophthalmology minds we would be able to work together to Discover what was most important for your continued success. Over the next two years, we held additional s to Analyze the findings from the first and Create the practice of the future. In our original timeline, we believed we would use this information to Develop new designs but our biggest gain was the valuable friendships and information we made along the way. We were also able to use some of the information generated from the first two sessions to design better clinics; one that meets the needs of the practice and patient expectations. More importantly, we learned that this journey of Discovery should not end, but evolve to continue to challenge us DISCOVER ANALYZE CREATE DEVELOP What key trends are challenging our industry? Understanding the Experience Create the desireable patient experience of the future? Develop new concepts that meet the needs of 2030

4 Stumbling Blocks of Healthcare Mega Trends and Responses in Healthcare Political Alignment Intense Government Regulations Affordable Care Act Reimbursement Healthcare Reform Fundamental Shift Baby Boomer Tsunami Integrated Delivery Systems Clinical Technology Innovation Productivity of Resources Engagement MEGATREND Affordable Care Act / Reimbursement Decline RESPONSE Shifting Practice Structure / Re-Structuring Physician Compensation Model Clinical Technology Innovation Consolidations, Expansions, Re-structuring of Delivery Models Engagement Monitoring / Benchmarking /Office Workflow & Satisfaction

5 Impact of Branding To broaden our perspectives and prepare us for the challenge of re-imagining the exam process, we engaged in a brief brainstorming exercise about branding and how a brand can influence process and perception. We broke into two groups and imagined what an ophthalmology practice run by Apple or Disney would be like. What would distinguish that practice? How would the exam process change? Aesthetically Pleasing Perfection Perception of Care Friendly Happy s wear Mickey Mouse ears Pediatrics are fun (I want to go!) Engaged & entertained Balance between illness not feel sick Engaging and Fun Experience Intuitive User Simplicity Simplified Experience Streamlined Premium Service Warm Massage chairs in waiting Space. Design, Perception, No line VIP Connected to Everything In house exams w/ office follow up Fewer Handoffs Personal concierge Escort the elderly patients Connectivity with Remote Diagnostics tour guide Personalization

6 Steelcase: Connected Care w orkshop

7 Technology & the Exam We all realize that new technology advancements, which occur everyday, change how we live, communicate, travel, and receive care. We looked at tools that already impact our work and personal lives, from smart phones to tablets, as well those that are in development so that we could begin to imagine how technology may advance, develop, and impact the ophthalmology office of 2030.

8 Bringing the Exam Lane into Focus 2030 After presentations on megatrends, technology, and human-centered design, we once again divided into groups to harness our collective abilities to the future. This exercise had us on our feet as we worked together to examine how the future may change the way healthcare, and ophthalmology in particular, will be delivered. We challenged each other to predict what the driving forces of this change will be: technology, patient expectations, policies, and / or the healthcare megatrends. FEASIBILITY DESIRABILITY VIABILITY Mega Trends Technology / Space Insights / Inspiration + + = Reimagined Experience Enabling Technology Building upon the trends, technology, and insights throughout the activity, the groups used interactive tools to reimagine the exam experience of Stakeholder Arrive / Check-in Task Arrive Arrive / Check-in Check-in Doctor Arrive / Check-in

9 Bringing the Exam Lane into Focus 2030 Each group was provided discs for people (provider, nurse/tech, patient), tasks (refraction, dilation, waiting, etc.), and potential technology enablers (i.e., apps, driverless cars, vision goggles). The groups then worked together, moving their discs around the board as they shared their predictions for the future and created new exam processes.

10 Bringing the Exam Lane into Focus 2030 Group 1: Valet 3D Printed Optical Optical Home via On-line Portal Home via Mobile Diagnostic Equip / Techs Visual Field Surgery Consults Caregiver Surgery Schedule Consult Visual Acuity Ahead of Time History Lens Reading Dilation Slit-Lamp Exam Fundus Photos DATA Doctor Clinics to Interpret, Diagnose Treatment Docs have Apps - Pay per Use Measure Pressures at Home Pressure Check Mobile Techs for Remote Consults Nurse Nurse Doctor Retinal Exam VIP Remote Consults Nurse Key Themes for 2030 Refraction history and visual acuity will be done at home prior to arrival through on-line portals. Many tests and examinations will be done at home via mobile diagnostic equipment or smart phone applications. For patients who can t administer the self-examinations, mobile techs would be sent to the patient to conduct the exams. Data collected from the patient via remote exams would be analyzed by providers and techs in smaller offices specifically designed for diagnosising and recommending treatment plans. Specialized satellite offices would be used specifically for surgical consultations with the patient and their caregivers.

11 Bringing the Exam Lane into Focus 2030 Group 2: Driverless Valet Dilation Clinic Home At Home V/A Lens Reading Convenience Doctor Check In Indirect Exam Waiting Surgery Schedule Surgery History OCT -PT Filtered -Needs Action Arrive / Check-in Visual Acuity -Walgreens -Macy -OPHTH -OPTOM -Urgent Care CDR Slit-Lamp Exam Visual Field Test Pressure Check Fundus Photos Refraction Caregiver Consult Doctor -Phone Call -Electronic Transaction -Technology Driven Tele-medicine Check- Out Key Themes for 2030 history and lens reading could be done through new, at-home diagnostic equipment. Many tests and examinations will be done at convenience driven locations, such as drug stores and other retailers. Tele-medicine will drive many of the interactions between staff and patients from reviewing testing results and treatment plans to diagnosing. Specialized offices will be designed for a small subset of exams and surgical scheduling.

12 Conclusions A good majority of the changes coming will be driven by technology and many processes will be handled outside of a traditional office. The groups predicted that activities like vision checks, photos, refractions, lens reading, histories, and more could be done outside the office, perhaps even in places like Walgreens or Macy s, drastically reducing the footprint of today s office. While this isn t a solution that is found in a quick meeting or even a series of s, by continuing to work through this process we can develop human-centered design solutions which incorporate technology to meet patient and provider expectations. Our next step is to work together to identify what is holding us back from these predictions. Together, we can work toward change and bring the next exam lane into sharp focus. cafe style waiting consult/exam surgical scheduling testing Join us October 14, 2016 in Chicago for the full reveal of this summary. (venue to be announced soon) The Envision Workshop is moving in The event will now be held the Friday of the ASCRS Annual Symposium. More details to come!