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How Do You Make Health Care More Like Amazon? Try Using a Card Game to Generate Ideas.


How would Guy Fieri improve screening for postpartum depression?

It’s a pretty weird question, yet it’s one I found myself trying to answer one afternoon last week. I might have also answered how we could make postpartum depression screening more like Netflix, or more like U-Haul. Those were among the other cards on the table in front of me. Literally. I was playing a card game called Accelerators in Health Care, along with an ad-hoc assembled crowd of staffers from the Penn Medicine Center for Health Care Innovation, where the game was invented.

It’s unlikely that an over-the-top celebrity chef will ever get involved in health care. But health care, perhaps, can learn something from him. He’s extraordinarily well known, and the reasons for his popularity could have instructive analogs in health care.

“Analogy can be a great enabler in ideation,” David Asch, MD, MBA, executive director of the Center for Health Care Innovation, noted to me a few days before I sat down to play the game.

Getting the creative juices flowing to generate ideas is what Accelerators in Health Care is all about. Three or more players or teams face off, each trying to solve the same health care challenge presented on a “challenge” card. The players or teams have one minute to consider the five “Accelerator” cards they’ve drawn (think Guy Fieri, Ikea, or Lego — each with a description of why it’s so successful). They pick one that helps them develop an idea to pitch to solve the problem.

One of the first times Asch ever played the game, at an academic health care summit, he found himself asking senior leaders in academic medicine silly questions like how Ikea would address gingivitis. The game was a great icebreaker; people joked about using allen wrenches to clean teeth. As an analogy, though, there is serious opportunity.

“Ikea is very good at returning to the customer a lot of the effort,” Asch said. Where other, more expensive stores do more on a customer’s behalf, Ikea is affordable because it’s self-serve for unloading your furniture from the warehouse, delivering, and assembling it. And health care, likewise, is returning a lot of work to patients, such as those who have hip and knee replacements who now experience most of their recovery at home. If Ikea does DIY well, maybe it could offer lessons for improving orthopaedics services. “It’s silly to say, ‘Why can’t health care be more like Ikea?” Asch said. “But it’s not silly to say, ‘What can we learn about patients helping themselves from another industry?’”

Through the power of analogy in the postpartum depression challenge, my teammate, Tim Delaney, an innovation intern, and I, played our Guy Fieri card (“Go to great lengths to push something to its extreme”) to suggest that instead of just having social workers available to new moms on the Labor and Delivery Unit, we amp up that service to make social work available in local pediatricians’ offices to see new moms again when they bring their babies back for checkups in the following days and weeks. Another popular card played against us that round was Paul Revere (“Notify users of oncoming hazards or threats”) — the competing team proffered a plan to have pregnant women proactively identify a friend or family member as their personal Paul Revere who would be empowered to contact their health care team in the event they had concerns she might be experiencing postpartum depression.

A Guy Fieri and a Paul Revere of postpartum depression might both be good ideas. Or they might not work well in the real world. At the idea stage, sometimes it’s hard to tell. But because the real world is full of practical constraints, there’s a next round to the game: Monkey Wrenches.

“People think of constraints as problems,” Asch said. But it’s a well-known principle in design that constraints often drive creativity. Asch points to the famous feat of rescue engineering for the Apollo 13 mission, dramatized in the Tom Hanks film by that name, where the NASA team was limited to repairing a damaged spacecraft using only the parts already on board.

Monkey wrench cards in the game include practical matters like privacy concerns, logistical challenges like a shortened project timeframe, and more — and they are part of what make the game fun. People really enjoy sabotaging one another’s ideas, Asch noted. But, he added, when you’ve refined your idea to work around a constraint, it may still work as well, or better, even if that constraint is no longer a factor.

With its combination of analogies and constraints, the Accelerators in Health Care game is kind of a skeleton key to the idea-generating process. But, Asch pointed out, that’s not all that’s involved in innovation.

“It’s not an innovation game,” he said. “It’s an ideation game. Innovation is taking ideas and implementing them so they add value. Ideation is thinking of the ideas in the first place.”

It’s something the innovation center team really does apply in its work. As we faced off against each other in the game, Innovation Manager David Resnick noted that they use the game’s accelerator cards sometimes at the ideation stage when trying to address real health care challenges.

Resnick and Design Strategist Mike Begley were the primary co-creators of the game after Asch initially asked them to help him amp up the engagement level for his talk at a health care summit. (To borrow an analogy, he wanted to Guy Fieri it.)

Now the game itself is emblematic of how the Center for Health Care Innovation approaches its work. They had a fresh idea, and they implemented it. After a few revisions, the game has now been professionally produced and is available for purchase. The center has used it at its own events and at other health care conferences, as well as within the Master’s in Health Care Innovation program at Penn and in Wharton Executive Education programs. They are glad to make it available to any health care system or program that may be interested.

“Our goal was to be entertaining and informative,” Begley said. “We were thinking about the way that expectations of health care are being influenced by companies outside of health care.”

“People say, ‘Why can’t health care be more like Uber or more like Amazon?’” Asch said. “I think those are fundamentally senseless questions when they’re asked that way, but they’re actually very relevant questions when they're asked a different way.”

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