Designing and aligning on strategic direction for complex Veteran oncology services
Veterans Affairs launched a multi-year initiative to modernize its antiquated and siloed systems and processes, including at the Veteran Health Administration (VHA), the United States’ largest hospital. As a Human Centered Design (HCD) and Research Lead consultant, I worked on supporting clinicians’ clinical decision making processes through modern tooling, including for the Precision Oncology Program, which conducts state-of-the-art precision oncology research and services to improve care for Veterans and others with cancer. Precision oncology is an approach that looks at an individual’s genes to select the best cancer treatment and care for that person. However, across the nation, each VHA location leveraged often varied processes and siloed systems.
CLIENT: Veteran Health Administration (at Coforma)
SERVICES: Design Research, Strategic Insights, Facilitation, Stakeholder Alignment
Question & Framing
Fundamentally, the most important requirement was the persistent documentation of results in patients’ health records, in a format that would be beneficial for clinicians. The opportunity was two-fold: process and data.
How might we create a closed loop process using modern medical data standards to reduce risk and improve clinician decision making capability by ensuring results would be reliably documented in patients’ health records?
Approach
The focus was on identifying opportunities that would generate alignment and buy-in from diverse VHA leadership and policy administrators, as well as provide actionable direction for the delivery team to pursue. To frame the solution to achieve broad value for all involved in the process (oncologists, pathologists, patients, and VA administrators), we looked “upstream” to understand the needs across the ecosystem. From kick-off to stakeholder buy-in to team prioritization, the approach involved a generative research effort across the organization, system mapping, the development of a source of truth artifact that could be used to generate alignment and to transfer research knowledge to the cross functional software product delivery team, as well as a series of team and stakeholder alignment workshops.
In order to create an artifact that could both acknowledge complexity and the need for some standardization, two structures were married: JTBD and the service blueprint. This resulted in clarifying the overall process to distinct jobs to be done (JTBD) that universally applied regardless of site-specific norms, as well as identifying pain points, dependencies, opportunities. This work was then cross-analyzed with the system mapping conversations to indicate system dependencies and requirements for consideration at each JTBD.
Two executive and programmatic stakeholder strategy workshops to establish buy-in on the problem framing, the opportunities identified by the research efforts, and the translation of those efforts into agreed upon priorities using Jobs To Be Done (JTBD) as the main denominator of early product strategy decisions.
Outcomes & Principles
The outcomes of the project included:
- Reduction of risk in the patient care context
- Cross-departmental and programmatic alignment, which had previously been a point of contention between programs
- Hard-to-achieve and rare integration of VA systems with third party service providers
- A thread of consistency and a source of truth in upcoming leadership changes