How to create change one behavior at a time.

It’s The Biggest Challenge We’ve Faced. You’re Going to Solve It in 15 Minutes.

There are many things we lose as we grow older. Control over our healthcare should not be one of them.

A belief in, and commitment to, that principle drove Compassion & Choices, the nation’s largest advocacy organization working to protect and expand end-of-life choices, to search for a strategic partner back in 2014 to help them better understand this complex issue from a consumer perspective and identify tools to help people act on their end-of-life preferences.

For our team, it was the challenge of a lifetime, one rooted in critical nuance and mired in dozens of barriers on the individual, societal, and institutional level. It was also a challenge we were thrilled to face.

The first lesson – our assumptions were wrong

Fast forward through three years of research and product design. To say we learned a lot is an understatement. Assumptions that any of us would have proved to be wrong, such as the idea that we should first engage patients at the time of a terminal diagnosis or that we should position our offer as providing the “power that patients want.”

Research showed that for many, there is no clear recognition of an illness being terminal until the very end, and that people actually didn’t feel that they were lacking in power to control their care. Most Americans want to die on their own terms, but many don’t recognize the steps they should take to get the end-of-life care they want — or even that they need to take action at all. 

Furthermore, the healthcare system is structured to favor aggressive treatment, which makes it difficult for doctors to have honest conversations with patients about values, preferences and options at end of life. People tend to think highly of their doctors, but they recognized that there was a lack of candor when it came to discussions about the negatives of potential treatments. We learned advance directives provide a false sense of security because they come into play only when a person can’t speak for themselves — and often are not honored. Research also showed that Americans are not seeking opportunities to talk about death, and most actively avoid the conversation. But people were seeking “better life” tools – things that help them live their best lives now.


The current challenge

Where does that leave us today? We now have a firm understanding of what people really want at the heart of this issue – tools that help them understand treatment options and communicate their values and goals to build trust with their doctors 

doctors not seen as candid about negatives

and loved ones. We used a rapid prototyping approach to get here, a process based on the prototyping method Google Ventures has used to create breakthrough products such as the Nest thermostat. We tweaked it to incorporate our own expertise in behavior change, hoping to not only engage people (read: solve their problem) but also change them (read: solve our problem). Along the way, we involved patients, doctors, caregivers and families and have arrived at two products that help patients take control of their healthcare interactions when they most want and need it: at the onset of and during advanced illness.

The first, the Trust CardTM, is a doctor-patient communication tool that allows patients to quickly communicate their values and priorities during the first three minutes of an appointment. Patients can express their preferences for care by answering three questions that draw out how they want their doctor to deliver information, and what they want the doctor to know about them personally. Patients bring the finished card to their doctors to spur honest conversations and build trust.

Trust Card

Diagnosis DecoderTM, the second product, helps patients generate specific questions for their doctor, nurse or other health provider — questions designed to them the complete information they deserve.

Diagnosis Decoder

So, we’ve developed these tools, but our research indicates that the most successful way to get them to patients will be through their healthcare providers. The challenge we’re faced with now is this: how do we get doctors to act as our distributors?

We need your help

That’s where the 15 minute solution comes in. Specifically, your 15 minute solution. We’ll be facilitating an interactive workshop on May 17th at the World Social Marketing Conference in Washington D.C. aimed at guiding participants through a mini (and we mean really mini) rapid prototyping sprint. Over the course of 45 minutes, we’ll provide background on the issue, conduct a persona development exercise, and conduct our 15 minute “How Might We” exercise, the “meat” of the session where participants brainstorm solutions to the challenge first individually, then in pairs. Again, we’ll have just 15 minutes for this in the session, but in reality, we usually spread this process out over 5 days.

We’ve found the critical difference that makes the “How Might We” exercise so powerful is the fact that it allows our team to maximize learning for a low cost and use insights to quickly move into beta product development. We’re ”best idea wins” people, so all solutions discussed in this workshop will be considered in our work to bring these products to consumers.

If you’re reading this – surprise – you’re an honorary member of our session. We’d like to use this post to hear “How Might We” solutions from fellow social marketing colleagues, students, or simply enthusiasts – we’ll plan to use the most interesting lot as examples at the conference.

So please, comment, tag us, send us an email if you’d like. Just join us. It’s one of the biggest, yet most worthy, challenges we’ve faced.

Meisha Thigpen is Associate Creative Director at Marketing for Change.

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