Mayo Clinic Applies Design Thinking to Health Care Delivery

Editor’s Note: this article was adapted from a case study developed by Xavier Leadership Center, who based their article on a Yale School of Management case study.)

The Mayo Clinic in Rochester Minnesota has a history of innovation in medicine and consistently ranks as one of the top hospitals in the country.  The clinic, which began as a frontier doctor’s office for Drs. William Worrall and his sons Will & Charles, has been a leader in the modernization of medical care. Among other achievements they are credited with an impressive list of “firsts”:

• First Integrated Group Practice
• First system of Patient Records
• First to found a non-profit medical organization
• First to pay physicians a fixed salary rather than fee for service
• First to develop an intensive care unit with central nursing station
• Early leaders in developing clinical trials

In a 1910 speech, the elder son, “Dr. Will”, argued that for the good of the patient, health care needed to become a “union of forces” among doctors.  He proposed that sole practitioners and small offices couldn’t possibly have enough knowledge and capacity to provide good care for all of their varied cases.  They successfully created a cooperative medical center by combining, clinician, specialist, and laboratory workers into one practice.

By the 1980’s Mayo was famous for its scheduling efficiency: Patients could travel to Rochester for exams & tests on a Monday morning, receive a diagnosis on Monday afternoon, have surgery on Tuesday, and go home on Thursday!

However, even with all the advances and improvements in the practice of medicine at Mayo, significant problems were brewing. By early 2000, the health care experience has become incredibly complex, frustrating, and confusing for patients and providers alike. Physicians were spending more and more time filling out forms and doing administrative chores, and patients needed more and more time and information related to counseling on chronic conditions.  The clinic began to recognize a split between scientific medical advances on one side, and the old-school infrastructure for service delivery that had changed little since the 1950’s.  They wondered if clinical design changes could enhance the practice of medicine.

Design thinking in health care delivery. Mayo contracted with a Design Consultancy, an architecture & engineering firm and, a furniture manufacturer to apply design thinking to the doctor patient interaction. Examples of design thinking include: Product design to create useful and pleasing products for consumers, service design to organize components of complex services to improve effectiveness and customer experience, and Interaction design or usability to improve the interaction between people and technology such as computers.

The design group set a goal to improve the patient’s experience and make the process of delivering health care more efficient. To this end they worked on a number of perceived problem areas including:

• The flow of patient care
• The ways in which patients used the waiting areas
• What patients and families expected from provider interactions
• New ways to integrate technology

After successfully working through some 20 related projects and enjoying success with many of them, Mayo formed The Center for Innovation (CFI) as an inside consulting group for the larger clinic. The CFI currently employs 32 full-time employees and has an additional 45 affiliated employees. The Center for Innovation has physicians, scientists, nurses, administrators, designers, analysts, software programmers, engineers, and legal & HR resources.  

The Mayo Center for Innovation focuses on five types of problems or platforms:

• Mayo Clinic Connection – a distance or e-medicine solution
• Prediction and Prevention – prevention and early detection of chronic disease
• Wellness Experience – promotion of health education and healthy lifestyles
• Destination Mayo Clinic – improve the outpatient health care experience in Rochester
• Culture & Competency of Innovation – classes and discussion to diffuse innovation across Mayo

Gene Kay has a Masters degree in Exercise Science and is a Certified Ergonomics Associate. He has been designing web-based ergonomics programs for 10 years, and owns the ErgoAdvocate Ergonomics Training program.  Gene has served as the American Express Global Ergonomics Manager, a Rehab Services Manager, and is Past-President of the Upper Midwest Chapter of HFES.