Healing Wicked Problems in Health

Can rethinking challenges together break through our most compelling health design problems?

February’s DwD held an open session for health and design professionals from across sectors in the community. Paolo Korre, Design Consultant at Mount Sinai Hospital, and Peter Jones hosted about 30 people from a diverse range of roles and sectors attended (starting off with a visual mapping of name tags by place and health intention).  Most of us reported as being external to healthcare (bottom of the grid), but we were lucky enough to get 4 or so closer to the front lines of care and practice.


The engagement was typical DwD :

1) Open circle share and introduction
2) Nominal group technique: Generating one well-framed question (or wicked problem) in health of personal interest
3) Selection for first round Open Space (5 groups)
4) Further selection for larger Cafe sessions (4 groups)
5) Post and share Cafe sketches

+ Hanging around to talk with those who wanted to stay longer

What is the possibility for creating better practices and healthier communities through health and care design? What experience and wisdom might emerge if we had the time and place to share it with a community of committed listeners?

The  following three intentions (at least 1 and 2) were upheld by the end of the evening:

  1. Bringing local participants together with opportunities for connection / collaboration
  2. Presenting authentic issues of concern to our work and communities
  3. Inventing possible avenues for action or engagement to follow

Of 30 or so initial wicked problems (or questions), one each proposed by each person, a first set of 5 were selected and engaged for a round:













  1. How can healthcare tech innovation be reconciled with costs?
  2. Why is healthcare so full of “problems?”
  3. What is health and who cares?
  4. How can we take ownership of our own health records?

A second round of Cafe sessions selected the most compelling themes from the first round of ideas. The final set of problems were taken on by four groups, with these responses sketched, posted (see the picture), and discussed in plenary.

James Caldwell (shown here engaged in the “Participaction” group) reviewed the workshop and discovered deeper insights and connections than we had time to develop at the close to the evening.

“Ideally each group was trying to create better practices that improved communication which would allow for better health. We presented real issues that hamper individuals and communities and tried to devise credible actions for health care engagement.”

The three that I will focus on are:
1. How do we redefine how to be radically inclusive?
2. If physical inactivity is the root of all health evil, why not ban it?
3. How do we create and maintain and own our own comprehensive health records?

“The result of any of these would mean that individuals become the drivers or agents of their own health. Ironically, the impact to the government’s financial system would be positive.”




All three issues have a few things in common:
1. They empower the individual
2. They lesson costs for the government
3. They improve the future health of the individual
4. They make for a more engaged society

“Of course any sane person would be asking why are we undertaking these initiatives today? Common sense would dictate that we would all be happier, healthier and more informed if we did. But I guess that’s why we call them “wicked problems”. Unfortunately too many groups that make too much money from individuals with health problems would lose, and I don’t think they will give up their control anytime soon.”

“I guess this is where designers can speak up and more effectively communicate to everyone why initiatives such as the three mentioned could help better our society. Designers could simplify the problem, the parameters, the solution and the message to a wider audience than the health industry or government could which would be seen as self-serving anyway.”

I agree with James that the 3 (actually all four) final problem areas are interconnected in the solutions. James is considering the outcomes, which show a virtuous cycle of healthy behavior (active lifestyles), inclusive public communication, and monitoring through electronic media. The fourth problem-solution (bottom of the board) was “creating community healing spaces.” I”m not sure this one was as well understood by the other groups, but it seems to me that James’ individual solution space is complemented by a public (or co-citizen-led) system of:

  1. Reframing inclusive healthcare to focus on those that need it most (who are unlikely to take individual initiative)
  2. Creating community centres as temporary (but connected) healing spaces,
  3. Thereby providing many opportunities to get off one’s butt
  4. Supported by personal health tracking in ever-decreasing cost and management, providing incentives to maintain a common health record.