Why is it so difficult to understand patient needs

By Andrés Dochao, partner at ValueCreation

This question was made almost desperately by a physician that participated in the recent workshop on patient involvement for healthcare improvement organized by us and the New Health Foundation in Seville. The question appeared as the worst sudoku for all participants: nurses, physicians, patients, researchers and social scientists. The worst because step by step, while undergoing a co-creation process we realized several things that suddenly looked terrible to us.

Hospitals as “non-places”
We clearly saw that the spaces designed for patient treatment, and also the actual treatments themselves, are designed by people outside the patient’s world. Hospitals, healthcare centers, homes for elderly … all places were the patient experience with the healthcare institutions takes place are, as French anthropologist Marc Augé would point it, so called “non-places”.

Hospitales como "no lugares"
Hospitals as «non places»

“A non-place is a highway, a hotel room, an airport, a metro or a supermarket … is lacks configuration of spaces, it is circumstantial, almost defined for the transit of the individuals”.

Thus, all spaces of the hospital, except perhaps the cafeteria, are non-spaces that influence patients in an absolute way because they are the patient’s vital space: corridors, room, op-room, waiting room…

Social channels for patient communication
But going beyond the problem of spaces, communication channels with those citizens that become patients get cut, reduced, shrunk: they get reduced to the relevant facts that ensure, that the patient becomes soon again a citizen. In a certain way, this process is a sort of social eviction were the patient does not have the right channel to communicate with the healthcare institution and the healthcare professionals as well as the rest of the society, he has been evicted from. He cannot share his patient believes (that should be known by the doctor, as this Medivizor post points so well) and the physician has little information about the so relevant context. The situation is contradictory with the big investments of the healthcare system in treatments and technology.

Yet, returning to the debate of the workshop described at the beginning, the participants sought a possible solution, more a challenge, about how to create healthy spaces for the patient’s “social health” and how to open communication channels between the patient and the world… channels that allow the patient to feel still as part of the society and that society still counts on him or her.

The challenge helped the group to find new ideas on how to use so called 2.0 healthcare and social networks, established patient schools, like those working already in Southern Spain. Other ideas proposed a change in the concept of how hospitals are designed, like the “liquid hospital” concept of Sant Joan de Deu in Catalonia.

Liquid hospital Sant JOan de Deu
Liquid hospital Sant JOan de Deu

At the end of the day, we all are or will be patients and what we need is that our journey as patients is meaningful, which definitely helps to beat disease.


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