The definition of relationship-centered care that I have seen quoted as “care in which all participants appreciate the importance of their relationships with one another” resonates with me.  It resonates because making that concept a reality requires empathy.  The definition I use for empathy from Merriam-Webster is the ability to share someone else’s feelings.

In the world of healthcare innovation I have observed the onslaught of solutions and designs that, in my opinion, negatively impact the personal relationships that doctors, patients, and caregivers seek.  The issue with design today is that it doesn’t seem to be based on empathy and curiosity.  The common ways we gather an understanding today of people is through surveys, focus groups, conference rooms and conference calls.  The powerful disappointment in all of this is that it overlooks the key pieces of relationship-centered care. The relationship between a clinician, caregiver, and person (I don’t think it is empathetic to think of them as a patient) CANNOT be understood in a setting that doesn’t help us feel and understand the relationships people desire.

For many years I have struggled with the amount of frustration, wasted time, and money that has been spent on solutions that aren’t improving relationship-centered care.  The nagging thought has been “we can do better!” With that struggle in mind I set out to find an answer to the question of “what is a better way to innovate?” That desire to answer this question led me to collaborate with leaders from around the globe. My aim was to create an approach that would help reduce the failures in design that detract from the relationship-centered care that we all seek.

During that journey, I observed that we are fortunate to work in an industry where the two great foundations of innovation already exist: empathy and curiosity.  That isn’t to suggest that we are as empathetic or curious as we can be; it is to suggest that the foundational mindset is inherent in healthcare and that we can build on that.  But those two alone are not enough.  A theory is needed that will help us understand the causal reasons that drive innovation.  A programmatic effort is also needed to house the theory.  The program then needs a toolset that will not only help us articulate what we learn through immersing ourselves in the context of where relationships happen but that would also help us explain innovation to the operating engine in our companies.

That search led me to Clayton Christensen.  Many years ago Clayton Christensen, Scott Anthony, Scott Cook, and Taddy Hall penned an article, “Integrating Around the Job to Be Done” (later published as a Harvard Business School module note). Clayton, Taddy Hall, Karen Dillon and David Duncan have built upon that article in the recently released book Competing Against Luck. The article and book elaborate on the notion that people have “Jobs to Be Done” in their lives.  Clayton defines a job as the progress that someone wants to make in a particular circumstance.  There are three dimensions: the functional dimension, the emotional dimension, and the social dimension.

• The functional dimension is the practical problem a person is trying to solve or the task they are trying to perform;
• The emotional dimension is how a person feels or wants to feel when making the desired progress
• The social dimension is how a person is perceived or wants to be perceived by others;

Uber is a fitting example of innovating around the emotional dimension.  Uber lets a rider know who is coming to pick them up, the timing of that pick up, the car they are driving, and the driver’s rating given by other riders. In addition, Uber doesn’t require the rider to share her or his credit card with the driver. All of these Jobs to Be Done relate directly to the emotional job of reducing anxiety while I am traveling. These are not jobs being done by current transportation companies.  This approach enables Uber to create a relationship with its riders that traditional offerings don’t.

The Jobs to Be Done theory gives me a framework for guiding innovation efforts to search beyond just the functional job to discover the dimensions connected to relationship-centered care: the emotional and social dimensions.  On top of this theory we needed a program that would teach how to get out of the office and observe. We created that program and we call it Design for People.^TM Within that effort we teach empathetic observation skills coupled with the framework of the Jobs to Be Done theory so we can guide observations to look beyond the function.

With Design for People^TM we now have a program that not only teaches how to observe and better understand; we also have an effort that gives permission and sets the expectation for people to augment conference rooms and conference calls with contextual inquiry.  Within the context of where people live, work, learn, pray, and play is where we gain the necessary understanding to innovate in a way that can improve relationship-centered care.  Because within the context is where empathy is enacted and the feelings that people have and the progress they want to make is better understood.

Our industry foundation is empathy.  We are always curious to improve healthcare so that we can help people live the healthiest lives possible.  To understand what causes people to do what they do and to better understand the progress they want to make we need to understand the functional, social, and emotional dimensions of the desired progress.  Designing better relationship-centered care demands that we augment the understanding we gain through conference calls and conference rooms by getting into the context of care using empathetic observation.  People are at the center of our mission.  Let’s take an empathetic stance and Design for People.^TM

Todd Dunn is Director of Innovation, Intermountain Healthcare Transformation Lab, Intermountain Healthcare.