The Design Observer Twenty





12.27.22
Dana Arnett + Kevin Bethune | Audio

S10E9: Kim Erwin


Kim Erwin is the Director of the Equitable Healthcare Lab and Associate Professor of Practice at IIT Institute of Design.

Kim spoke to the unique position that continues to evolve for designers within the health care multisystem:
I think everyone would like some guidelines about where to put a designer in the org chart. What do you task them with? What do you measure them by? What resources do you give them to succeed? How do you wire them into the organization to get maximal ROI and actually use them to the top of their license? … So, you know, typically a designer comes into a health system and next thing you know, they're on wayfinding, you know, trying to solve environmental issues. That's fine. I think it's an important thing to do, but I think a lot of people who migrate into health care as a focus are looking for greater impact.

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TRANSCRIPT

Kevin Bethune
Welcome to The Design of Business,

Dana Arnett
The Business of Design.

Kevin Bethune
Where we talk with leaders in their fields.

Dana Arnett
About how innovation, access, and curiosity are redesigning their world. I'm Dana Arnett.

Kevin Bethune
And I'm Kevin Bethune.

Dana Arnett
This episode of The Design of Business | The Business of Design is brought to you by Morningstar.

Kevin Bethune
People don't just want financial information. They need to be able to understand it and use it. At Morningstar, great design transforms the way investors interact with financial data. Deeper insights, more personalized strategies, broader definitions of success. Start your journey at Morningstar.com.

Dana Arnett
On today's episode patients, providers, and caregivers.

Kim Erwin
Innovation in health care may mean something different than innovation in a commercial industry.

Kevin Bethune
Kim Erwin is associate professor of practice at the Institute of Design at Illinois Institute of Technology, where she is the director of the Equitable Health Care Lab at the IIT Institute of Design's Action Lab.

Dana Arnett
She's also the co-founder of the Institute for Health Care Delivery Design at University of Illinois, Chicago, and the author of the book Communicating the New Methods to Shape and Accelerate Innovation.

Kevin Bethune
Kim, welcome to the podcast.

Kim Erwin
Thank you for having me.

Dana Arnett
Hello, Kim. You and I are very fluent when it comes to sharing stories about our kids, our current projects, our aspirations for design. But I've yet to hear the story about how you found your way into the profession. Now, did you pick this path to work or did it pick you?

Kim Erwin
My path into design? Yeah, that's a pretty curvy path. Let's just say it was — I'm not someone who has a lot of extended intentions around how I run my life. I actually was introduced to design when I was six years old. I was a kid on the IIT campus in the Institute of Design it was the seventies, open door policy in campus housing. All us kids ran around like a feral pack of animals. And there was a masters of design student there by the name of Barbara Harrington, and I used to run and out of her apartment. She always had interesting work on her table. And one day I just asked her, I was like: What is that? It was a sculpture of some sort. And she said: It's design. I'm a design student. And I was like: Well, what does that mean? And she said: Design is problem solving. And she stopped right there. And that was not super helpful to the six year old me, but it is something that stayed with me. And so she was a mentor for me. And, you know, she passed away too young after starting her firm. Barbara Harrington Design here in Chicago.

Dana Arnett
Yeah.

Kim Erwin
But I do have her-I have her last pieces of artwork on my-the walls of my house.

Dana Arnett
Wow. I did not know that story. What a great one.

Kevin Bethune
You majored in philosophy for your undergraduate degree. Can you tell us how that progression, perhaps leading from philosophy to communication to innovating in the health care space, how is that-how has that path benefited you and the patients that you serve?

Kim Erwin
Yeah. To me, it's the really logical path. It looks logical from the outside. My father used to refer to my philosophy degree as my pre unemployment degree because it really doesn't prepare you for much in the world. Except it does prepare you for logic and thinking about things from sort of a holistic level. So I went from there to journalism and spent five years opinion editorial pages, which they basically as a student allowed me to- they paid me to watch the Senate during the Reagan era, essentially, which was a terrific job. I learned a tremendous amount there. And one of the things that became really clear to me, because my desk was next to the art department, was that there was tremendously important information that people should have access to. And making that information simple and easy to understand was not really happening in really central spheres of life, especially politics. So I wound up going for a master's degree in design because I wanted to make complicated things easier to understand and use. And I realize that writing, which is a strength of mine, was not sufficient. So that took me into design and went into innovation consulting because I had an enormous amount of student debt coming out of graduate school and consulting as well. So I developed other skills through my consulting years and ultimately I went back to the Institute of Design as a professor because I realized that the things that I had been trained to do, especially as a communication strategist, I felt like I had hit-like something had changed in the world, and the skills that I had were no longer sufficient, the way we were accessing information, the things we were doing with information. I had a client who said to me, I need you to be able to explain everything you've learned about my private equity brand to everybody in my organization. And we started looking outwards, very meeting oriented organization and looking outwards at a time where he could convene everyone. And there was no time. We were looking six months out. They were making decisions today. And he finally looked at me and I made some sly remark about: Well, maybe I could just tweet you the results. And he looked to me, says: Do you do that?optimistically. And I was like: No, I don't. How do we get in the span of like 60 seconds from can you please give me all the information to all the people in my organization to can you tweet me the results? And that was an iconic moment where I realized the information that people need and the way they're getting it don't matxh anymore. And as a designer who sees herself as a bridge between those worlds, I needed to teach myself some new ideas and new frameworks and new approaches. So the Institute of Design employed me to teach, and I use my teaching opportunities to develop a new set of thinking skills.

Dana Arnett
So in those early days at IIT —service design, human centered design, those were relatively new terms and this was a young discipline. Let alone service design and delivery in the health care space. Can you tell us about those early days and how the curriculum evolved?

Kim Erwin
Well, I don't know that I'm the best design historian. I can tell you I was fortunate enough to enter the design field at a time of immense change, which was the digital revolution. Nobody even calls it that anymore. It sort of dates me to use the term, but, you know, all of a sudden expert tools are being put in the hands of laypeople, which is a huge influence in design. Everyone all of a sudden could, quote unquote, design materials. You know, the bottom fell out of the market in photography, the impact of digital technology on design as a field was significant. It also revolutionized and was revolutionized how business got done.

Dana Arnett
Right.

Kim Erwin
So design used to be focused on the and the production of things, right?

Dana Arnett
Right.

Kim Erwin
It was product design. And between the intersection of the interruption of technology and design as a field and the interruption of or the injection of design and technology into the cultural aspect of our everyday lives, design went from making stuff to making experiences, and that switch from stuff to experiences created a new opportunity for new frameworks and skill sets and mindsets. And I was very fortunate to be part of that movement. I didn't know it was a movement at the time. I didn't know any better, nor did I understand the genius of the people around me who were making the ways of doing that work happen on an everyday basis. In retrospect, I can step back and say, you know, they're teaching these ideas and these approaches in business school. I was-I worked with the guy who made these frameworks that was very powerful for me. So that was just sheer luck. But I think now we have design switching to being more of a purpose driven field. It is less focused and the training is less focus on your output. And we do have web designers, communication designers, we have product designers. There's this whole other level of training that is the generalist tool set of design that is about solving some of the larger problems that humanity faces. And I think that this is very attractive to people. It's an opportunity to make a difference.

Dana Arnett
And eventually that luck, guts, and smarts spawned the Center for Collaborative Healthcare Design at IIT. Can you share a couple of projects and some of the interpersonal models you and your team designed which pave the way for where we're at now?

Kim Erwin
So I am about ten years into applying design to health care, but especially health care delivery, which is a subcomponent of health care, a lot of different aspects of health care. But I focus on the delivery system, meaning where patients and health systems meet. And the first project I ever did was actually under a funded research grant, which was trying to understand how to improve the care of children coming into the emergency department with asthma attacks, to improve that care and actually get them out of the cycle of returning back to the emergency departments. I was not the principal investigator on that project. I met for the first time a physician researcher and a physician leader who was clearly a visionary. I've worked my whole life with visionary leaders. And, you know, when you see one. And I was in a room with 40 people, we were working with six different health systems, and I had no idea why I was there, and he didn't know why I was there. At one point, they passed around what they considered the primary intervention, which was a communication tool that explained how to manage asthma when you got back home. And I took one look at this and I was like, Okay, now I know I'm here. Because there is nothing in this tool that would pass the sniff test in usability, clarity, desirability, and yet it was quote unquote evidence based. It had proven some significant impact in Canada during a clinical trial there. And I was like: Well, I don't know what else happened in that clincal trial, but there's no way this thing created a 79% improvement in outcomes. So part of the work that we did in that project was understanding the real world factors in the home setting by going and doing home visits, working with caregivers, and understanding their entire trajectory of dealing with their child who had asthma from the day that the onset in the first symptoms started showing up, and how did they create a mental model of asthma and pieced together health care services to help them succeed? Many were not succeeding. And I think one of the things that became a high value proposition is that we came back with pictures of the homes. We came back with stories of the caregivers. And for people who work inside health systems who have never done home visits, they have no idea the distance between what they are telling people to do and people's ability to do it. And this was, I think, probably the highest impact—that we created a much better intervention that went through a randomized clinical trial and is going to have significant impact what they call process measures, meaning that it improves the number of people who got the right prescriptions. Did it improve the people who actually filled their prescriptions, did it improve follow up appointments. Because an emergency department is not the place to solve your child's asthma. In fact, you should never hit an emergency department , and emergency deparmtnet is a terrible setting to manage your child's asthma. Your child should never have an attack. It's completely preventable. But if you're Black and in Chicago, you are eight times more likely to die from an asthma attack than on the north side. And, you know, that's an unacceptable statistic in any perspective. So you have to kind of bring your design thinking skills and your design, your human centered frameworks to be able to go into a home and be compassionate and listen carefully and come back with design requirements. You can do something about. Because compassion — you know, people often talk about empathy as being a primary benefit of human centered design. I am against empathy. My empathy and 2.50 will get you on the train as my Chicago cop friend used to say. You know, it's just not sufficient. My empathy is not going to help my information, my ability to train that design requirements that will get us somehwere.

Kevin Bethune
Wow Kim. I'm just sitting here regretting the fact that I'm just meeting you now, because I wish I would have known you during past escapades working in the space of health care and innovation. Just the space itself — health care is a very challenging ecology to navigate. But when I reflect on your work, learning about your work, I feel this thread of equity and community centric problem solving across your work. Can you explain why you see health care as a as a place based activity versus how we might view health care through the conventional lenses and contexts of hospitals, clinics, and family practices?

Kim Erwin
Yeah, I think that this is maybe a unique angle — there is so many intelligent people in health care. It's a fifth of the GDP of the United States. It employs millions of people. So designers have to be really mindful about what they're bringing to the table. It's not like no one's thought about how to solve these problems. The issue is getting anything to happen at all. So place based mindsets, I think, are something that research is increasingly embracing and promoting, which is that the factors that affect your health are your local context and therefore good health care response to the local context. Pulling people away from their local contacts and cutting off the portion of insight that a physician would have. Because that is a day — You went for an appointment. You probably got up and took a shower. You put your best foot forward. You're so mindful of that 15 minute appointment that you're already edited out all things you think your doctor can't do anything about and therefore doesn't need to know. These are all the aspects that the space between a public health framework, which does acknowledge plays based factors as driving care, and a measurable framework which says this is all about treatment. And we're just going to have the fastest treatment, we don't need all that context. These are the things that I think design can help bridge that gap. You know, in COVID, one of the things that became remarked upon by all physicians was seeing a person with the background of their home on a tele-visit, was a revelation.

Dana Arnett
Right.

Kim Erwin
They had no idea that people were calling from. And I think that this separation we have between the place and the care continues to be a source of misalignment and probably missed prescription. I can give you a very specific example of that. If you are a physician who's taking care, let's go back to the child with asthma, a child with asthma, and somebody is repeatedly going into the emergency department. All your brain and your training can tell you is: Well clearly, this person asthma is not well-controlled, so we need to give them more medication. If you saw some of the housing conditions that landlords are allowed to get away with on the West and South sides of Chicago, you would understand that it would take quite the number of inhalers to compensate for the mold, to compensate for the prevalence of mice and cockroaches which are known to trigger asthma. Landlords are allowed to get away with things that, you know, a mom or a parent of a child with asthma can't do anything about. The amount of particulate matter in the air because many low income communities are stuck between highways. These are- or the light industry sections. These are the issues that are driving a lot of asthma exacerbations and you don't see any of that as a physician. All you know is you have somebody keeps coming back to the emergency department, your health systems getting dinged because they don't, you know, 30 day readmission penalties, all of that. Your job is to try and push more medication on them. And this mom is like, I don't think this is the issue. Like how much medication myself you're putting in my kid's body? Oh, did you say the word steroids? Oh, my God, I'm giving my kids steroids. Like there's all of this context that can't be addressed without a place based view.

Dana Arnett
The Design of Business | The Business of Design is brought to you by Morningstar. Investment research, data, and strategies to empower long term investor success.

Veronica Peterson
Hi, I am Veronica Peterson. My title at Morningstar is Senior Product Engineer.

Kevin Bethune
The projects Veronica works on as an engineer include the design ethos of Morningstar.

Veronica Peterson
Design is the heart of Morningstar. It's that organism that keeps our research, our data, our mission flowing. Essentially, I am working on a project to align Morningstar's data visualization across our org and really help the way that our editorial and research content creators tell stories using visuals. Being able to work with Morningstar's data visualization, you know, and knowing that a picture can be worth a thousand words, we have such rich data. We have so many great things to share, so many great insights at Morningstar. To be able to take, you know, what's on the minds of our researchers and our analysts and to put them into a very understandable, esthetically pleasing visualization that can tell a story at a glance, but then allows you to dive deeper. To me, that is what design affords a company like Morningstar, and it allows us to tell the stories that we really want to tell and the project that I'm working on to be able to be a part of generating those visualizations to tell those stories is so impactful to me and is very gratifying.

Dana Arnett
Morningstar Design. Making sense of data at the intersection of design and investing. Find out more at Morningstar.com slash careers.

Dana Arnett
So Kim, back in 2013, you sort of foreshadowed a lot of this in your book, Communicating the New: Methods to Shape and Accelerate Innovation. And, you know, it's struck me about what you foreshadowed in that book was this interesting intersection between the human condition and medical expertize and how innovation plays a role in in the confusion of that intersection.

Kim Erwin
Yeah. You know, innovation in healthcare may mean something different than innovation in a commercial industry. And the reason I say that is that health care is a multisystem. And what — Jay Doblin, very famously created this concept of the multisystem. And he said the designers need to work at a different scale. So there's the product level, which is a complex but relatively tangible set of concerns that a designer is trying to address. And then he talked about what he called the unisystem that basically is which is that there's a lot of parts and pieces. Those things have to work together inside a system. You have to have an expanded set of methods and approaches for understanding that system and actually making that system kind of work seamlessly. Health care is what he would call a multisystem, meaning it's a system of systems. So what I mean by that is an emergency department is a system. Paramedics are a system. Pharmacies are a system. All of those things have to come together. And a designer working in health care needs to appreciate and be systems aware. Because the thing you're looking at in front of you that you're trying to problem solve is there for a reason. And it's there because all those different systems have different pressures and goals and incentives that create this kind of mess at the frontline that any normal person—you don't have to be a designer could walk in and go: Well, this isn't a really good idea why keep doing this? Right?

Dana Arnett
Right.

Kim Erwin
But in order to fix it, in order to begin to innovate in it, you need to have this systems aware perspective. It's a very complicated domain to work in. So what constitutes an innovation in health care? I think this can be quite variable. Most designers want to move outside the health system because there's more latitude. Self-service health care is a form of innovation that is increasingly taking root because the idea is, well, oh, my gosh, it's so complicated to integrate anything into the electronic medical record. Let's try and sidestep that bees' nest. Or physician uptake is really hard to create, so I have a terrific app. I wish they would recommend it to their patients. But physicians, I can't reach that many physicians and I can't get that to take root as a behavior. So this proliferation of innovations at the periphery of health care, which I characterize as self-service, which is direct to consumer, go download this thing, go find this person, go— there's a whole series of these things. That seems more promising because it's faster, you have more latitude, you can have more impact. However, anything that you create that's outside the system by design is of no interest in the system. And so the ability to get scale, to reach all the people you need to reach. These are the limitations of traditional innovation methods applied to health care. So one of my innovations that I often share with people, just to kind of set expectations for what designers might actually be able to accomplish, I worked in a health system that had a large sickle cell population, and sickle cell population was going to the emergency department. The care for a sickle cell pain crisis is very time, and drug intensive and emergency departments are not really the great settings for that. So this health system that built a day hospital where patients with sickle cell crises could go and get very specialized care for people who understood. And there's a lot of perception issues that were based in reality, actually, that cost sickle cell patients be very dissatisfied with their emergency department care. So I'm looking at these two units and they're mad at each other. The doctors are like: We have a day hospital. Why am I still getting sickle cell patients in the emergency department? And the day hospital is like: Oh my gosh, the emergency department. Why do they not transfer people to us? I spent three months going back and forth, sitting down with the provider, sitting down with the administrators when what is going on here? It ultimately came down to the fact that in the electronic health record, in order, you can't be in two places at once in a health system, you can't be both in an emergency department and in a day hospital. Their batch process for discharging people from an emergency department was every hour. If you were on the wrong side of that hour, you're still in the emergency department and sitting in a waiting room waiting to get into the day hospital. I said, Wait, how do we fix that? They said, What we need is a dropdown menu item that says discharged to observation. And I was like: You're telling me the for years there has been this acrimony between these two units and patients sitting in for at least an hour in a kind of in a gray zone because there's not a dropdown menu. So I call the I.T. guy and I'm like: can you put a dropdown menu in? Done. This whole problem, this piece of the problem has now gone. Is that an innovation? I don't know why somebody with my salary line involved in that particular implementation. But think about the scale effect. That problem went away for every sickle cell patient after that.

Dana Arnett
So therein lies the essence of what design can do. It identifies the issue. And creates a solution. But you, in essence, you also to find a role, correct, that didn't exist in the system.

Kim Erwin
I think that is a great topic. It's actually something I am trying to pull together a writing group on. The role of design and health care, I think everyone would like some guidelines about where to put a designer in the org chart. What do you task them with? What do you measure them by? What resources do you give them to succeed? How do you wire them into the organization to get maximal ROI and actually use them to the top of their license? Top of their license is how we refer to physicians. But I think we should be referring that to designers, too. So, you know, typically a designer comes into a health system and next thing you know, they're on wayfinding, you know, trying to solve environmental issues. That's fine. I think it's an important thing to do, but I think a lot of people who migrate into health care as a focus are looking for greater impact. And I think there's a number of issues with that. One they have to be trained. This is not standard design training that allows you to succeed in health care. Two you need to know how to explain what you're doing and if your strategy is to advocate for design. Nobody cares. Nobody cares about design. Why should they care? Designers who succeed are designers who focus on outcomes and don't try and talk about: Hey, a designer would do this or a design process or, Why aren't we being more human centered? Don't don't bring that kind of missionary zeal. It's not a great strategy. I think that it would be a terrific time because there are lots of designers in health care right now to convene as a tribe, to build a peer network and start creating advice for health care leaders, you know, to write that Harvard Business Review article that says, so you want to hire a designer in your health care system —Here's what you need to do. We need to do that.

Kevin Bethune
If we zero back on process for a moment, if if the creative process overly simplified represents the phases of discovery where we're hopefully distilling the needs of our stakeholders in the health care ecosystem and ideation, so imagining solutions to address those needs— where do things typically fall down in the face of the complexities that we've been talking about in health care?

Kim Erwin
I think it's an issue of scale, scope and speed. I think the design processes have a lot of assumptions built into them. One is that there is a user and that we can define that user. I think when you're in health care, you have to realize it's multiuser and the mindset and training that we give to people to create personas and we discuss — I have very specific feeling about personas — but let's talk about design tools. The tool kit more globally has not been optimized for the scale, scope and speed of health and public health. And health and public health are different domains, but they share common characteristics. They are multisystems. They have inherent complexity. That means that when you're designing for them, you are in design for constraints. Highly constrained environment. I think we need to train people to be multi-stakeholder. We need to train people to think multi-site. Health care is happening in multiple locations, not just in one and those locations are very diverse. Your interventions have to be multi-level. And we are talking about multisystem. So I think the difference is is that multi is the key word. And I don't think our creative processes really support or prepare designers for the scale.

Kevin Bethune
Back in 2017, you co-founded the Institute for Health Care Delivery Design at the University of Illinois at Chicago. What was the genesis that led to the creation of this special pillar for health care within the UIC system?

Kim Erwin
The Institute for Health Care Delivery Design came about because of Dr. Jerry Krishnan, visionary physician researcher that I had the joy of working with. I think we realized something special is happening. He and I just happened to have had a particularly good professional chemistry and we were able together to do things that really changed how people thought about care delivery. So he at some point we'd been on multiple grants together with a multiple projects. Some of them were health care projects, some of them were federally funded. And he said, maybe we should just take this to the next level. And that is the basically the genesis, as I think so many labs come about in that way. It's two people who put their heads together and decide: Hey, we're good together. We could do something interesting. So it brought together a woman I was working with the name of Sarah Norell, who is a terrific designer, who I trusted implicitly to help shape practices and approaches to different kinds of health care work. And the illustrious Hugh Musick, who at the time was the associate dean at the Institute of Design, who's just one of the most creative people I know. So we all went over to UIC and started this institute and thought of it as a delivery science lab, meaning we operate at the intersection of evidence based practices and health care delivery, using design to bridge them.

Kevin Bethune
Amazing.

Dana Arnett
So after your UIC experience, you find yourself back at IIT where you're leading the health and equity initiative at the Design's Action Lab. Tell us about the lab and what you're learning and seeing with this next generation of designers.

Kim Erwin
Yes, the lab's focus is really on equity, which is like not a specialty. We're dealing with a specialty called health care that is affects all of humanity, right. So the slogan at the Equitable Health Care Lab is Helping Medicine Fit People, ALL People. And this shift in focus from when I was doing a IHTD, at the Institute for Healthcare Delivery Design at UIC allows me to pursue a mix of projects and a portfolio of partners that really is interested in addressing systemic drivers of inequity. So Rush University is one of our partners. University of Chicago Medicine has signed on for a significant partnership of multi-year contracts. We have done work with Rosalind Franklin University. And each of those partners addresses a different part of my equity framework. There are lots of equity frameworks out there, and a person validly criticized me for feeling I had to make my own. But what we did is, I had a handful of design students who went and did an enormous lit review of medical journals to understand and create a structure that would identify what are the system level drivers of inequity in health care. And so they turned out to be things like care models that people found difficult to use, and provide limited value, workforce. We have a workforce that is not diverse. It is not able to deliver culturally competent care and is highly constrained and therefore unevenly distributed across the United States. So there are communities that have workforce deserts in the strategies for placing health care professionals in these communities means that those by definition, most people do not understand that community. So that whole place base component is missing. Payment models are an enormous driver of inequities, and I don't know, can designers do anything about that? It's a long game, maybe, but you should sure know about them. Because money controls everything in healthcare. So the Equitable Health Care Lab is moving between ground level demonstration projects with system level goals.

Kevin Bethune
Great.

Dana Arnett
Kim, earlier in the season, we talked with Ernesto Quinteros who is the Chief Design Officer at Johnson & Johnson. And he spoke about how his team is always looking for more designers to enter the health care world that bring both life and their academic experiences to the table. Can you characterize some of the most pressing needs for your students when they go out into the workforce and where you're seeing them land?

Kim Erwin
Yeah, I think the shift towards co-design is really powerful and that is a shift in methodology. You know, co-design for those of us who are sort of long in the tooth, has this Scandinavian roots. It comes from this idea that people who have been marginalized or not been at the table to be when you're actually designing for them. So we should stop designing for and start designing with, and there are so many problems that are coming to the forefront that design is now getting married up with that this participatory approach which is more than just participatory — it's generative, right? So participatory design as will often been a form of working with end users or communities to explore and define the problem. Co-design is actually generative. It's creating solutions with people who are going to be asked to use them. And it's a very different role for designers. I think designers who are older on the spectrum don't often have comfort with letting go of their control and expertize. But this younger generation is ready to do it, and that's what they want to do. They want to be with people creating on the ground changed. The problem is they're coming out with debt that is not well offset by those job. They're not high paying jobs.

Dana Arnett
What do you think the future holds for the evolution of human centered design in the field of health care?

Kim Erwin
Yeah, I don't know. I mean, there are trends that are happening. There are drivers of health care that I think designers are really well-suited to help create effective strategies for. So, for example, it's clear that the future site of health care is going to be the home and community setting. Big buildings, complex campuses, where it takes forever to get there, expensive to park, can't get from the parking lot to your doctor's office because you're not feeling well and they're really far apart from one another like all those components of health care that built environment, I think that even McKinsey agrees that in the next two years and a quarter of $1,000,000,000 of health care is going to be delivered in the home setting. So whether that is kidney infusion-infusion therapies or dialysis or primary care or hospital care of the home by working on a hospital care at home. Now the future site of care, being home is a game changer. Who better than designers to come in and create the principles for home care? This is not the strength of the current health care providers. This is not something communities are well versed to- to create design requirements that health systems would understand. Somebody's got to be in the middle of that to help these two groups of people really talk to each other in an effective way. I think that's a piece of the future that designers are well-positioned to help.

Dana Arnett
Kim, thank you for sharing your story and inspiring us and helping us learn more about this field that is still relatively new but so important in our lives. Thanks for gracing our podcast.

Kim Erwin
I really enjoyed this and it's just a delight.

Kevin Bethune
Kim, thank you so much.

Kevin Bethune
The Design of Business | The Business of Design is a podcast from Design Observer. Our website is DBBD dot Design Observer dot com. There you can find more about our guest today, Kim Erwin. Plus, the complete archive from past guests and hosts. To listen go to DBBD dot Design Observer dot com.

Dana Arnett
If you like what you heard today, please subscribe to this podcast. You can find The Design of Business | The Business of Design in Apple Podcasts, or however you listen to podcasts.

Kevin Bethune
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Dana Arnett
Thank you again to our partner Morningstar for making this conversation possible. Experience the intersection of design and investing at Morningstar.com. And between episodes you can keep up with Design Observer on Facebook, Twitter, and Instagram.

Kevin Bethune
Our producer is Adina Karp. Judybelle Camangyan show. Betsy Vardell is Design Observer's executive producer. Our theme music is by Mike Errico. Thanks, as always, to Design Observer founder Jessica Helfand and other previous hosts, Ellen McGirt and Michael Bierut.

Dana Arnett
See you next time.

Kevin Bethune
Talk to you then.

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