understanding cancer survivorship and creating services for CANCER SURVIVORS at mskcc
ETHNOGRAPHIC RESEARCH, service design AND DESIGN STRATEGY
MEMORIAL SLOAN KETTERING CANCER CENTEr, STRATEGY AND INNOVATION
The Design Innovation Group have conducted significant research into patients’ experience during diagnosis and treatment. As cancer
prognoses continue to improve, the population of survivors at MSK is growing creating a need for further research into survivorship.
Given the nature of cancer, even after the patient has finished active treatment there is an extended monitoring period that can keep the patient connected to MSK for years. During periodic monitoring, the patient requires significant support to ensure an emotionally satisfying transition to survivorship, and out of MSK care.
Research was designed primarily around two questions as follows–
1. UNDERSTANDING MSKCC'S PERSPECTIVE ON SURVIVORSHIP
- Understanding the term 'survivorship' in the institutions context
- Understanding the eligibility of a patient into survivorship program at the institution
- The broader messaging and usage of the term
LEARNING: Understanding the entire patient journey is important because the survivorship experience is linked to the patient's broader cancer experience.
2.UNDERSTANDING PATIENTS' JOURNEY AND THEIR INTERACTION WITH MSK
Breast and Prostate patients are the most common cancer types treated at MSK, collectively making up about 25% of the patients seen. Often the treatment for these cancer types is relatively straightforward. Interaction with MSK escalates after diagnosis, peaks during treatment and then gradually declines as the patient enters the monitoring phase. Ideally their interaction with the institution continues to decline as they transition to a survivorship clinic. Finally, they return to their PCP for all routine care and basic monitoring.
3.UNDERSTANDING PATIENTS' EXPERIENCE THROUGH RITUALS AND SYMBOLIC ACKNOWLEDGEMENT
Conducted research into patients’ experience of ringing a bell to celebrate the end of radiation therapy. This fed into our broader research into rituals and symbolic acknowledgments for patient transitions.
BELL RINGING SPRINT
Radiation Oncology team at MSKCC have been exploring the possibility of installing a bell to be rang by patients at the end of treatment. Strategy and Innovation were asked to conduct research and install a prototype to gauge patient, staff, and caregiver interest in a bell. The outcome of the research was intended to help Radiation Oncology and Operations to decide whether to implement the bell long term.
The research was guided by initial hypotheses from Radiation Oncology and Operations on the potential benefits and risks associated with implementing the bell.
To understand the idea of rituals and symbolic acknowledgement during the patients' experience, we first conducted some interviews with patients at the Radiation Oncology department.
BELL INSTALLATION AND PLACEMENT
ANALYSIS OF PROTOTYPE AND RECOMMENDATIONS FOR INSTALLING THE BELL
GUIDING PRINCIPLES FOR THE BELL
4.UNDERSTANDING SURVIVORS' NEEDS AND WILLINGNESS TO CONTRIBUTE DATA
MSK’s Precision Prevention Program is working towards creating personalized healthcare strategies for patients. Researchers are therefore
interested in collecting survivor data to better understand how cancer behaves.
Researchers are therefore interested in studying the survivor journey to better understand how cancer behaves, and how patient recovery
protocols, lifestyle, and demographics can affect outcomes including recurrence, and other side effects.
USE OF TECHNOLOGY FOR RESEARCH
In order to do this MSK proposes developing digital solutions that will support the needs of survivors, and keep them connected to the institution so that researchers can leverage the large pool of potential respondents.
To explore the potential of creating services for survivors, we undertook research around 2 key questions:
Built two digital interaction platforms in the form of mobile apps that survivors can use and is responsive to their needs of survivorship.
PROTOTYPE FINDINGS AND NEXT STEPS
Prototypes of both apps were tested with survivors in the waiting room at the Breast Cancer Survivorship clinic.
We spoke to 4 breast cancer survivors. All were over the age of 60, and all were more than 5 years out from active treatment. None of them currently interacted with the MSK portal or any digital offering. Similar to our prior interviews with survivors, we found that all of the survivors we tested with expressed enthusiasm in contributing data to research. This included filling out surveys. They did make sure to note that their participation in survey based research would depend on the length and frequency of surveys.
This in turn helps to solve for the needs of survivors, as survivors are only growing.
GUIDING PRINCIPLES based on RESEARCH
Created 6 guiding principles based on research and quick prototyping with patients and MSK staff. These principles are intended to serve as the foundation for any initiatives aimed at the survivor population.
SERVICE DESIGN AND CONCEPTS FOR SURVIVORSHIP
Based on guiding principles analysis and synthesis, 9 design concepts. These proposed interventions cut across the patient journey as we acknowledge that improving the survivor experience requires a holistic approach.
After developing the guiding principles and conducting the 2 design sprints, we identified opportunities for intervention across the patient journey, The concepts proposed align with the principles outlined earlier in this document but are also responsive to the 3 broader opportunity areas for intervention-
The design concepts are placed on the timeline below to show an approximate starting point when they could be inserted in the patient’s journey.
Test the service concepts
Develop services based on initial tests and research
Measure impact as survivors move into survivorship programs
Better information, leading to confidence of tracking progress and milestones.
More transitions to PCP
Increased positive survivorship experiences
Increased and extended support beyond insititutions
Critical Thinking, Insight generation, sense making, creative collaboration, teamwork
Javiera Arenas, Emma Eriksson, Tyler Gumb, Hrudaya Veena Yanamandala
Research, insight generation, research design, analysis, synthesis, visual storytelling, illustration, prototyping and concept creation