This week (Tuesday) I presented the final designs for the Cook County Bureau of Health Services project I’ve been working on for 2-years. I could not have scripted a better reaction, which highlights for me what design policy is about.
In attendance at the presentation were about 23 financial administrative staff across the entire Bureau. By their surprised and enthusiastic greetings, I knew that it was rare that these groups got together. I opened with a description of the mandate of the project: design an information system about billing and payment that communicates the values of the Bureau’s mission to provide health care regardless of one’s ability to pay, the patients’ own values of health and health service, while recognizing the need for a model of financial sustainability to support both.
I introduced/performed 6 personas of their different patient types. I walked them through the financial aspects of the registration and financial screening processes, and how each of the designs we created fit into the processes. I role played the way in which the designs mediated interactions between the patients and staff. Then, the team and I passed out a set of the materials to each participant, who eagerly took them. We followed with a long Q&A in which the CFO basically used all of the arguments I presented to him, which were based on the testing I did with patients, about certain policy decisions to convince the other participants.
What made it successful is not just the beauty and clarity of the designs, our demonstration of a deep understanding their patients and processes, but how through designing we could affect positive changes in the entire Bureau. The CFO said that the project was one of the first steps towards working as an integrated Bureau with a patient-centered focus. CCBHS has never been integrated or patient-centered, so this is a major first step.
About Design Policy
This is what design policy is for me: changing governmental organizational cultures to make them more accountable in positive ways to the people they serve. This is distinct from design spectacles that can raise awareness about governmental dysfunctionality. It is distinct from design futuring, which perhaps is what Daniel’s Metahaven does, which provides alternative visions for the future. Design policy is the often mundane work of transforming that awareness of governmental dysfunctionality into tangible self-sustaining realities of alternative futures. Since policy is the tool of governmental change, design policy is the design of both the formation and implementation of that tool.