Creating a New Vision of the Future of Ambulatory Care

After issuing a design competition to re-imagine the ways in which outpatient healthcare is provided, we were invited to partner with Kaiser Permanente on a multi-year engagement known as Project RAD (Re-imagining Ambulatory Design). Kaiser Permanente recognized early on that the project was not about bricks and mortar, but rather an opportunity to rethink how they deliver care, specifically related to patient experience and affordability.

With Kaiser Permanente, we explored how and where healthcare will be delivered in the future, how technology will be leveraged, how social trends influence health behavior and how people will engage in their own care. Over 1,050 frontline staff members, including physicians, nurses, administrators, facility planners, IT and workflow consultants, were engaged in this project through crowdsourcing, ideation sessions and boot camps.

Kaiser Permanente describes Project RAD as “the most inclusive project in KP history."

We began by exploring how technology advancements, an aging population, social trends, culture and values and economic pressures shape the way people seek out care. These baseline factors influenced an extensive ethnographic study in which Kaiser Permanente members and patients from competing organizations were interviewed, shadowed and engaged in the solution design process.

The resulting insights from ethnography fed multiple ideation sessions to generate new concepts for the future of care delivery in response to patient needs. We found that healthcare and patients exist in almost complete isolation from one another, a gap that is bridged only by brief, sporadic interactions.

As a result, the current system of healthcare delivery does not work as soundly as either providers or patients would like. In most cases, healthcare is seen as an inconvenience to patients and most interactions are organized around episodic events rather than continuous interactions. Clinicians validated these insights and used them as a jumping off point.

While many think of Kaiser Permanente as one organization, it is in fact a federation of multiple organizations operating together but also independently. One of our key roles in the project was to bring these different organizations together and help move them toward a common vision and solutions they were willing to implement.

Project RAD produced a single vision for the future of healthcare delivery at Kaiser Permanente. Supporting this vision are three design principles, six strategies, dozens of tactics and five platform solutions. Each platform solution included a detailed patient experience framework that re-cast the entire network delivery strategy with specific recommendations for the service model, operations, facility design and technology.