The Secret to Redesigning Healthcare: Think Big and Small

October 2, 2013 — 7 Comments


A little empathy goes a long way in an overcrowded emergency room.

You don’t have to be a medical professional to know that affordable healthcare in America is complicated business. The system is so sprawling and intractable, only the biggest and boldest of innovations will make a difference, yet only the tiniest changes seem possible. Coming up with new solutions can feel overwhelming.

That’s why I eagerly accepted an invitation to speak at the recent “Transform2013” conference at the Mayo Clinic Center for Innovation. The Center’s trademark, “Think big. Start Small. Move Fast.” is a powerful call to action. Since the Mayo brothers founded the pioneering medical facility 150 years ago, the Clinic has applied systemic, human-centered thinking to healthcare. Their original—and still relevant—breakthrough was to create an integrated practice where specialists work together in the common interest of their patients. There were many standout presentations at the symposium, but two that really struck me were by Dr. Gary Slutkin and Peter Nicks.

“Vaccinating” Violence
Dr. Slutkin heads up an organization in Chicago called Cure Violence. An epidemiologist by training, Dr. Slutkin believes violence is a public heath issue and should be treated like any other communicable disease. His nonprofit is staffed with “violence interrupters” who isolate “infected” individuals at the source and then “vaccinate” communities. How? By counseling those who have a high-risk of perpetration and changing their behavior. The program has been shown to reduce gun violence by as much as 70 percent, quite an accomplishment. Cure Violence is a great example of “thinking big but acting small”—finding solutions by applying common medical practice to a cultural malaise.

Looking Through the Eyes of Patients
Filmmaker Peter Nicks’ documentary, The Waiting Room, is a heart-wrenching story about a day in life of the crowded emergency room at Highland Hospital in Oakland, California. It’s a stark portrait of the toll our healthcare system takes on medical staff and patients—especially those who are uninsured. By humanizing their experience, we gain new insight into how the system could be redesigned. The Waiting Room airs on PBS on October 21. I strongly encourage you to watch it.

While three days in Minnesota isn’t nearly enough time to untangle healthcare’s Gordian knot, I left armed with some ideas—and renewed hope—about the power that small collective action can have on larger-than-life problems.

What challenges have you faced where small changes added up to a solution?

(Posted also on my LinkedIn Thought Leader blog) 

Tim Brown


7 responses to The Secret to Redesigning Healthcare: Think Big and Small

  1. Tim,

    Thinking through the eyes of customers (patients)…..isn’t it the foundation of all the change and innovations?

  2. Thomas Wing-Evans November 18, 2013 at 3:03 pm

    Hi Tim,

    I wouldn’t be surprised if you had done so already, but if not I suggest reading one or two of Atul Gawande’s fascinating books on his professional life as a surgeon. His empathetic analysis of modern medical practice is stunning and well worth a read, and perhaps something to garner worthwhile design thinking from. I’d love to know if you’re already aware of his writing and to glean some of your own wisdom on the topic of healthcare, as a friend and I are just beginning a project with a view to improving a small part of it.


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