Product vs service design, and systems thinking

We will now compare product vs service design, using the example of the GP digital triage discussion. https://www.dhirubhai.net/posts/john-mortimer-06117083_online-gp-consultations-have-led-to-harm-activity-7222166762899869698-aqR4?utm_source=share&utm_medium=member_desktop

And we will incorporate systems thinking into this review.

This example is only one of many. This review is not about the detail but the systemic patterns that emerge from this and other examples. After much discussion and messages, reflecting what we can learn from this is summarised below.

The key element that seems to be directing this example is that the real purpose of the design is:

‘To? reduce waiting lists, by reducing the workload on GPs.’

Please note that this is different to the person-centred purpose of the design, which would be something like

‘to design the most effective way to diagnose abdominal then treat a person’

In this case we are solving a particular problem with a service, rather than redesigning the service to remove the problem. As Lou Downe calls it 'Austerity service design'. This then looks like it is set up as a product design, rather than a service design.

Design:

1. Use design methods, not our standard one, but one suited to the context in-front on us. Design methods are different depending on complexity and other factors.

2. Digital is only one element of change, and should never be seen as a ‘solution’ on its own. Digital is inherently a logical technology, and on its own it is often used to develop product.

3. Co-design with customers and those in the front line.

Design with people from the front line, and the service manager. Innovate and learn what works by doing the design with customers.

4. UX must embed itself in real experience of the flow and interactions.

It is not just about the interactions, follow real people through the whole service, end to end.

5. Design as a discipline can only mature if it is able to reflect on the work of designers and then be able to adjust to improve design competence.

Learning what we do well is good. Learning from what has not gone as intended is a far better way to learn, and more important. Our personal perspectives often get in the way of seeing this. Getting help from those outside of the design discipline can be very helpful.

6. Why is it necessary to even highlight no 5, why is it not there already?

Reflecting on our discipline, its boundaries, its links with other disciplines, and having an ability to see our work from other perspectives is a sign of maturity.

7. Design and leadership decisions and both fundamentally intertwined such that one should be considered part of the other.

The leadership often define the scope of the work, designers undertake it The reality is that, if we are to reframe and understand systemic implications, leaders have to be able to shift their original scope.

8. The difference between the focus on product design vs service design should be clear to all.

In our example, we can design a great digital front end, but end up delivering a poorer service to the person. A great product design does not equate to a good service design. For a true person-centred design, the customer has to define the design, rather than the requirements of the leaders.

9. The purpose and intent of the design should be made clear and challenged. In this case, the purpose of the design was to reduce the workload on GPs. In reality, the issue with too few GPs should be the one that is looked and resolved. Simply designing a triaging product actually adds in new bureaucratic steps that are not person centred, and will impact the service further down the flow.

Systems thinking concepts that are part of design

10. Simply improving one part of a service flow, often creates problems in other parts of the flow.

11. Systems thinking should replace reductionist methods where appropriate.

Traditional design and product based methods are typically reductionist, and by adding in consideration for the wider service, extra ‘tools’. and co-design, does not suddenly make the design a systemic one. Systems thinking is a fundamentally different design and change approach.

12. The systems thinking concept of understanding and designing for the whole system, rather than improving one element of the system, should be part of design thinking.

Even if the design intent is one element of the service, understanding the whole and how it works is necessary in a systemic design.

13. The systems thinking concept of doing the wrong thing righter should be part of design thinking and the development of the scope and intent of the service design.

14. Methods for understanding and designing for complex situations should be part of design. Complex situations require different methods to understand and then deal with those situations. Using methods for one, can often make a complex situation worse.

15. Measure the real end to end of real customers. Product measures often simply focus on the user interactions, the usability and errors. These are typical product measures. Systemic measures are defines by what matters to customers of the whole service, and how this redesign impacts on that throughout the whole service.

The leadership

16. Senior decision-makers would gain huge value in understand the implications of complexity. (They currently don’t)

17. With systemic design leaders and operational managers have to be part of the design team, so that they can learn together and redefine the scope and design of the work as the work progresses.

Please feel free to contribute your thoughts on systemic design and on your reflections on reading this article.

I run workshops to help people to expand from one way of working, to a more systemic one as described here. Here are details about the workshops https://www.improconsult.co.uk/systemic-design-course-workshop.html