Edition 21: Systemic problems with healthcare, the drive to do something with true meaning and why reliable data and a focus on healthspan is the future, with Design Partner Jason Mesut
Tell us a bit about your background in design and your experience in the healthcare sector…
I started as an industrial designer, but really my first proper job was in user experience design. Through the work I was doing this developed into broader service design and product strategy. My work has always been about touching stuff beyond the screen, always focusing on people, processes and environments.
I was working at Oyster Partners 19 years ago, which went on to be acquired by Framfab that then became LBi. One of the founders along with a few others had this startup they called the Map of Medicine. It was a service that translated clinical evidence into “radically simple” visual flowcharts, so medical professionals without certain specialisms could track how to treat a patient from presenting with an issue through to ongoing management or death.
At that time though, the agency’s talent were much more interested in working on the flashier stuff – Nike and the like – and it was hard getting people involved in the more meaningful stuff. Thankfully that script has flipped massively now.
I joined and went from lead designer on the Map of Medicine to heading up the product service design and then managing LBi’s healthcare portfolio. Map of Medicine was a really interesting service at the time, as it was one of the first cross-NHS service software platforms that bypassed the typical fragmentation and allowed us to talk to lots of different players, from patient record providers running GP systems to secondary care. All sorts. We also worked with NHS UK on what would become NHS Choices, which was quite a political, consumer-facing health initiative, among other healthcare projects.
Since then I’ve done lots of interesting innovation and delivery work around health. I got more involved with other NHS initiatives like the National Library for Health and National Library for Medicine. And also working for private companies trying to make new health technologies more accessible – brain scanning, cancer detection and treatment, sleep apnea and snoring.
Are you making a conscious choice to work specifically in the health industry?
I think I got the bug (no pun intended). The weird thing with it, and I often talk about this, is that when I'm really doing healthcare work, I become incredibly unhealthy. I’m very conscious of how much of a paradox that is, or an irony.
I don't know… There's something about it that it's incredibly stressful at times because of the nature of the work, the meaning of it, the weight of it and the complexity. And I love it, I love it. I love the intellectual challenge of it and the complexities and trying to cut through all the risk and red tape and all of those sorts of things to make progress, but it does take a personal toll.
Where do you see the primary problems with the current healthcare sector – its focus, its efficacy and our collective approach towards it?
Essentially, there's loads of progress in certain areas – technology around healthcare and wellness and everything else. And then there's a whole bunch of stuff that's happening in the pharmaceutical world through clinical trials etc. And then there's the clinical practice that lags significantly behind.
The problem is that there are huge deltas between the progress that gets conceived and thought of, and what is actually being realized in everyday practice. Because of legacy systems and personal liability and culpability, healthcare has become naturally risk averse, so getting things done is really, really hard.
For example, when we were working on the Map of Medicine – this idea of a flowchart that’s meant to be a guide. There was so much we had to build in – did someone look at this page? Did someone do these things? Did they follow this process? So part of the problem of the experience you have when you move across multiple touchpoints is that you're asking the same question again and again and again. And a lot of that is because of people covering their ass as much as it is due diligence. So the question is why all this focus on treating sickness and why not on preventative healthcare? Or Healthspan, as Group Of Humans is calling it.
But this isn’t a new viewpoint. As long as I’ve been involved in healthcare that narrative has always been there. It’s not new, it’s just really hard to act upon. Who will fund it, for example?
Tackling it from a public communications perspective is another piece of the puzzle. Especially in the UK and countries where the healthcare service is so entwined with society – private and public care, the welfare state etc.
What direction do you want to see healthcare moving in?
I think there are lots of ways to improve it, but the primary problem is that healthcare is just so large. There are so many dimensions to it. So we have to choose certain things and focus on that.
Within our On Demand Innovation Lab, as we’re building out the Group Of Humans Healthspan service, we talk a lot about the value of everyday evidence around health. A product or service that you could use to create a feedback loop in public that could essentially act as a mass non-traditional clinical trial. Is this medication working or not? What’s going on psychologically, chemically, biologically, genetically? What would work best for them? I’d love to see us get better at capturing, sharing and using data from trusted and accurate sources.
If you listen to podcasts, like 60 or 70 percent is about healthcare stuff. Wellness. You should do this… this is important… this is important… and you’re like “fuck!” It’s too much. So pragmatically, people don’t know where to go and what to do in the first place. Who should they listen to? Where do they start? It’s confusing and overwhelming. For example, even today at an event around the Microbiome with some folk from Zoe, there was a lot of derision of AG1 supplements and Huel versus a more Zoe-friendly diet.
An interesting thing is that there are companies hitting the health care system not in the traditional way, but from consumer perspectives. While that can create a horrible wealth dynamic, it’s an easier way in because it bypasses the bureaucracy that stops so many ideas getting started.
For example in the early days of the Map of Medicine we were helping to develop a hospital-specific tablet device and ecosystem – robust, droppable, easy to clean etc, but it never really got any adoption. Then the iPhone comes along – unsanctioned, looks like you're on a private device, easy to break etc, but people just took to it because it was better for certain things. So if we can create things that are better and done rigorously, even if they’re not from within the system itself, then let’s do it that way. And I think that kind of consumer pressure might have a real effect on the slower national healthcare systems.