Capital as a transformation tool Design as a change tool

Capital as a transformation tool
Design as a change tool
Presenter: Clifford Harvey
Senior Architect, Project Management Office
Health Capital Investment Branch
Ontario Ministry of Health and Long-Term Care
Applied Research
Translational
Research
Basic Research
Applied Research
Translational
Research
Basic Research
The Market:
New Environments / New Model of Care
1. System (Action Plan)
• International
• Public/Private
• Translational e.g. Telomere
• Research
• Distributed Health
2. Care (new models of care)
• Continuum of Care
• Preventive / Home - Residential
• Wellness
• Primary
• Ambulatory
• Acute
• Post Acute / Rehabilitation
• Senior
• Pharmacies
• Mental Health
3. Health
• Technology
• Personal health
• Schools
• Workplace
• Cities
• Transit
• Wellness
• Sustainability
4. Inspirational Case Studies
• Canada/US
• Europe
• Asia
The Board:
Clayton Christensen
Bio: Clayton M. Christensen is the Kim B. Clark Professor of Business Administration at the Harvard Business School, with a
joint appointment in the Technology & Operations Management and General Management faculty groups
Nigel Crisp
Bio: Edmund Nigel Ramsay Crisp, Baron Crisp KCB, is a British former senior civil servant in the Department of Health and
Senior Manager in the NHS. He was awarded a life peerage upon retirement, and sits as a crossbencher in the House of
Lords
Chris Downey
Bio: Chris Downey AIA, is an architect, planner and consultant who lost his sight in 2008. As one of the few architects in the
world practicing without sight, Chris speaks regularly about insights of life and architecture through the apparent paradox of a
blind architect.
Michael Graves
Bio: American architect who is identified as one of The New York Five. An architect in public practice in Princeton, New
Jersey, since 1964, Graves is also the Robert Schirmer Professor of Architecture, Emeritus at Princeton University. He
directs the firm Michael Graves & Associates, which has offices in Princeton and in New York City
Ian Brown
Bio: Author and feature writer for The Globe and Mail, and his work has won many National Magazine and National
Newspaper awards. He was the host of CBC Radio's Talking Books, and is the anchor of TVOntario's two documentary
series, Human Edge and The View from Here
Tim Brown
Bio: Tim Brown is President and CEO of IDEO. Ranked independently among the 20 most innovative companies in the
world, IDEO is a design consultancy whose clients include Steelcase, Mayo Clinic, US Department of Health. IDEO has
contributed to such standard-setting innovations as the first mouse for Apple, the Palm V, and Shimano’s new Coasting
bike.
Bruce Mau
Bio: Founder of Bruce Mau Design and the Massive Change Network. As Chief Creative Officer from 1985 to 2010, Mau's
clients included Coca-Cola, McDonald's, MTV, Arizona State University, Miami's American Airlines Arena, New
Meadowlands Stadium, Frank Gehry, Herman Miller, and Santa Monica's Big Blue Bus. Bruce Mau is recognized as an
author and publisher of award-winning books, including the celebrated Zone Books series and S,M,L,XL in collaboration
with Rem Koolhaas.
Mark Kingwell
Bio: Author of twelve books, including the national bestsellers Better Living, The World We Want and Catch & Release:
Trout Fishing and the Meaning of Life. Mark Kingwell is a Professor of Philosophy at the University of Toronto, where he
has taught since 1991 after finishing a PhD at Yale University and Master's degree at Edinburgh University. He has also
been, since 2001, a contributing editor of Harper’s Magazine.
Paul Farmer
Bio: Medical anthropologist and physician Paul Farmer. Founding director of Partners In Health (PIH), and Kolokotrones
University Professor and Chair of the Department of Global Health and Social Medicine at Harvard Medical School; Chief of
the Division of Global Health Equity at Brigham and Women's Hospital; and the United Nations Deputy Special Envoy for
Haiti, under Special Envoy Bill Clinton; as well as the author of numerous books on public and global health.
Bill Davenhall
Bio: Worked in the health and human service field since the early seventies, during which time he has directed many
different initiatives that involve the progressive use of information systems within healthcare and human service delivery
organizations. Davenhall is a frequent speaker and writer and is well known as one of the leading advocates for the use
of GIS to help solve the challenges in health and human services.
John Maeda
Bio: President of Rhode Island School of Design since June 1, 2008. Mr. Maeda has a distinguished career in humanizing
technology for creative endeavors. He has been a practicing designer since 1990 and has developed advanced projects for
an array of major corporations including Cartier, Google, Philips, Reebok, Samsung, among others.
Steve Paikin
Bio: Canadian journalist, author, and documentary producer at TVOntario. He is currently anchor and senior editor of
TVO's flagship current affairs program The Agenda with Steve Paikin, and previously hosted TVO's Studio 2 and
Diplomatic Immunity. Aside from his hosting and journalistic endeavors, Paikin has produced a number of feature length
documentaries: Return to the Warsaw Ghetto, A Main Street Man, Balkan Madness, Teachers, Tories and Turmoil and
Chairman of the Board: The Life and Death of John Robarts.
Eric Topol
Bio: Eric Topol is a premier cardiologist, genetic researcher, and technologist. As a leader in the movement to modernize
medical treatment through the latest technology, Dr. Topol is creating new, more effective ways to treat patients — ways
that will dramatically bring down the costs of health care. Dr. Topol's new book is titled The Creative Destruction of
Medicine: How The Digital Revolution Will Create Better Health Care
Atul Gawande
Atul Gawande is a surgeon, writer and public health researcher. He practices general and endocrine surgery at Brigham
and Women’s Hospital in Boston. He is also Professor of Surgery at Harvard medical School and Professor in the
Department of Health Policy and Management at the Harvard School of Public Health. He has been a staff writer for the
New Yorker magazine since 1998. He has written three New York Times bestselling books: Complications, Better and
The Checklist Manifesto.
Debra J. Levin
Debra has a master's degree in management and organizational leadership from the John F. Kennedy School of
Management and a bachelor's degree from Arizona State University's College of Architecture. She serves on advisory
boards for the Healthier Hospitals Initiative, American Academy of Healthcare Interior Designers, and Arizona State
University Healthcare Design Initiative. A Fellow of the Jim Whittaker Discovery Camp for Innovation and Leadership,
Debra was named one of “Twenty People Making Healthcare Better” in 2007 by HealthLeaders magazine.
Alan Dilani
Professor Alan Dilani is a founder and General Director of the International Academy for Design and Health. He is cofounder of the journal, World Health Design, www.worldhealthdesign.com. He is founder and director of international
master program on Design and Health with University of Portsmouth in UK. Dr Dilani has been engaged worldwide in
several universities in the field of design and health developing "Psychosocially Supportive Design Program", both in
medical and design institutions. He holds a PhD in Health Facility Design from the Royal Institute of Technology,
Stockholm and a Masters of Architecture in Environmental Design from the Polytechnic of Turin, Italy.
Clayton Christensen
Bio: Clayton M. Christensen is the Kim B. Clark Professor of Business Administration at the Harvard Business School, with a
joint appointment in the Technology & Operations Management and General Management faculty groups
Nigel Crisp
Bio: Edmund Nigel Ramsay Crisp, Baron Crisp KCB, is a British former senior civil servant in the Department of Health and
Senior Manager in the NHS. He was awarded a life peerage upon retirement, and sits as a crossbencher in the House of
Lords
Chris Downey
Bio: Chris Downey AIA, is an architect, planner and consultant who lost his sight in 2008. As one of the few architects in the
world practicing without sight, Chris speaks regularly about insights of life and architecture through the apparent paradox of a
blind architect.
Michael Graves
Bio: American architect who is identified as one of The New York Five. An architect in public practice in Princeton, New
Jersey, since 1964, Graves is also the Robert Schirmer Professor of Architecture, Emeritus at Princeton University. He
directs the firm Michael Graves & Associates, which has offices in Princeton and in New York City
Ian Brown
Bio: Author and feature writer for The Globe and Mail, and his work has won many National Magazine and National
Newspaper awards. He was the host of CBC Radio's Talking Books, and is the anchor of TVOntario's two documentary
series, Human Edge and The View from Here
Tim Brown
Bio: Tim Brown is President and CEO of IDEO. Ranked independently among the 20 most innovative companies in the
world, IDEO is a design consultancy whose clients include Steelcase, Mayo Clinic, US Department of Health. IDEO has
contributed to such standard-setting innovations as the first mouse for Apple, the Palm V, and Shimano’s new Coasting
bike.
Bruce Mau
Bio: Founder of Bruce Mau Design and the Massive Change Network. As Chief Creative Officer from 1985 to 2010, Mau's
clients included Coca-Cola, McDonald's, MTV, Arizona State University, Miami's American Airlines Arena, New
Meadowlands Stadium, Frank Gehry, Herman Miller, and Santa Monica's Big Blue Bus. Bruce Mau is recognized as an
author and publisher of award-winning books, including the celebrated Zone Books series and S,M,L,XL in collaboration
with Rem Koolhaas.
Mark Kingwell
Bio: Author of twelve books, including the national bestsellers Better Living, The World We Want and Catch & Release:
Trout Fishing and the Meaning of Life. Mark Kingwell is a Professor of Philosophy at the University of Toronto, where he
has taught since 1991 after finishing a PhD at Yale University and Master's degree at Edinburgh University. He has also
been, since 2001, a contributing editor of Harper’s Magazine.
Paul Farmer
Bio: Medical anthropologist and physician Paul Farmer. Founding director of Partners In Health (PIH), and Kolokotrones
University Professor and Chair of the Department of Global Health and Social Medicine at Harvard Medical School; Chief of
the Division of Global Health Equity at Brigham and Women's Hospital; and the United Nations Deputy Special Envoy for
Haiti, under Special Envoy Bill Clinton; as well as the author of numerous books on public and global health.
Bill Davenhall
Bio: Worked in the health and human service field since the early seventies, during which time he has directed many
different initiatives that involve the progressive use of information systems within healthcare and human service delivery
organizations. Davenhall is a frequent speaker and writer and is well known as one of the leading advocates for the use
of GIS to help solve the challenges in health and human services.
John Maeda
Bio: President of Rhode Island School of Design since June 1, 2008. Mr. Maeda has a distinguished career in humanizing
technology for creative endeavors. He has been a practicing designer since 1990 and has developed advanced projects for
an array of major corporations including Cartier, Google, Philips, Reebok, Samsung, among others.
Steve Paikin
Bio: Canadian journalist, author, and documentary producer at TVOntario. He is currently anchor and senior editor of
TVO's flagship current affairs program The Agenda with Steve Paikin, and previously hosted TVO's Studio 2 and
Diplomatic Immunity. Aside from his hosting and journalistic endeavors, Paikin has produced a number of feature length
documentaries: Return to the Warsaw Ghetto, A Main Street Man, Balkan Madness, Teachers, Tories and Turmoil and
Chairman of the Board: The Life and Death of John Robarts.
Eric Topol
Bio: Eric Topol is a premier cardiologist, genetic researcher, and technologist. As a leader in the movement to modernize
medical treatment through the latest technology, Dr. Topol is creating new, more effective ways to treat patients — ways
that will dramatically bring down the costs of health care. Dr. Topol's new book is titled The Creative Destruction of
Medicine: How The Digital Revolution Will Create Better Health Care
Atul Gawande
Atul Gawande is a surgeon, writer and public health researcher. He practices general and endocrine surgery at Brigham
and Women’s Hospital in Boston. He is also Professor of Surgery at Harvard medical School and Professor in the
Department of Health Policy and Management at the Harvard School of Public Health. He has been a staff writer for the
New Yorker magazine since 1998. He has written three New York Times bestselling books: Complications, Better and
The Checklist Manifesto.
Debra J. Levin
Debra has a master's degree in management and organizational leadership from the John F. Kennedy School of
Management and a bachelor's degree from Arizona State University's College of Architecture. She serves on advisory
boards for the Healthier Hospitals Initiative, American Academy of Healthcare Interior Designers, and Arizona State
University Healthcare Design Initiative. A Fellow of the Jim Whittaker Discovery Camp for Innovation and Leadership,
Debra was named one of “Twenty People Making Healthcare Better” in 2007 by HealthLeaders magazine.
Alan Dilani
Professor Alan Dilani is a founder and General Director of the International Academy for Design and Health. He is cofounder of the journal, World Health Design, www.worldhealthdesign.com. He is founder and director of international
master program on Design and Health with University of Portsmouth in UK. Dr Dilani has been engaged worldwide in
several universities in the field of design and health developing "Psychosocially Supportive Design Program", both in
medical and design institutions. He holds a PhD in Health Facility Design from the Royal Institute of Technology,
Stockholm and a Masters of Architecture in Environmental Design from the Polytechnic of Turin, Italy.
Values:
Discovery
(Curious)
Generally, research is perceived as either basic or applied (and these days
linked by the increasingly popular category of translational research). This
structure implies a linear process, wherein basic discoveries are made by
scientists who just want to know the truth, and other scientists who
recognize some possible applications for a basic discovery try to translate
it into a practical context. Applied scientists only care about research
that is practical and clearly goal-directed outcome, so only after the
translational guys have enough evidence to indicate that it might do
the applied guys test something new in the real world of caring for
human beings.
Predictive Health
Michael Johns
Voyage of Discovery
The real voyage of discovery consists not in seeking new landscapes but in
having new eyes
Marcel Proust
Challenges
To flourish, translational research requires a knowledge-driven ecosystem, in
which constituents generate, contribute, manage and analyze data available from
all parts of the landscape. The goal is a continuous feedback loop to
accelerate the translation of data into knowledge. Collaboration, data sharing,
data integration and standards are very important. Only by seamlessly structuring
and integrating these data types will the complex and underlying causes and
outcomes of illness be revealed, and effective prevention, early detection and
personalized treatments be realized.
Translational research requires that information and data flow from hospitals,
clinics and study participants in an organized and structured format, to
repositories and laboratories. Also, the scale, scope and multi-disciplinary
approach that translational research requires means a new level of operations
management capabilities within and across studies, repositories and laboratories.
Meeting the increased operational requirements of larger studies, with ever
increasing specimen counts, larger and more complex systems biology data sets,
and government regulations, requires informatics that enables the integration of
both operational capabilities and clinical and basic data. Most informatics
systems today are inadequate to handle the tasks of complicated operations and
contextually in data management and analysis.
Investment Models: Venture
Value = ∑ (Quality) / (Cost)
Quality = (Q1+ Q2+ Q3+ Q4+ Q5+ Q6)
Q1 = Effectiveness of Care
Q2 = Efficiency of Care
Q3 = Timeliness of Care
Q4 = Equitable
Q5 = Safety
Q6 = Patient Centre Careii
Cost = (Operation + Capital)
Direct
Operations = Reimbursement (Volume x Costii) – (Staff + Supplies + Facility Costsi)
Indirect
Capital = Equipment + Buildings
Notes
i) Independent Health Facilities (IHF) include a facility fee to cover lease / rent
ii) There is a direct relationship between decreased quality and increased operating cost, especially when one looks at the
continuum of care versus procedures. For example a Hospital Acquired Infection (HAI) increases the operating costs and
decreases the quality of care.
Includes the patient experience
Investment Models: Public
(Voice of the Customer)
(Gemba)
Experience
Resource:
(Big) Data
Search for Innovation and Quality
Quality Improvement Project:
“Making the System Better, One Project at a Time”
Moving from Quality Assurance to Quality Improvement in the
Ministry of Health and Long Term Care (MOHLTC) Capital Approval
Process
Clifford Harvey
10081899
Masters of Science in Healthcare Quality
MScHQ 841: Process Improvement in Health Care
Queens University
Benchmarking Healthcare Design
Case Study: The Emergency Department
Clifford Harvey
10081899
Master of Science in Healthcare Quality
MScHQ 842 Research and Evaluation Methods to Assess Healthcare Quality, Risk and
Safety
Queen’s University, Kingston
Platform
(eco system)
Thoughts?
Clifford.Harvey@Ontario.ca