“We’re Not Tied to a Legacy Model of Medicine”

Stacey Chang is working to redesign healthcare at the Design Institute for Health in Austin.

 Executive Director of the Design Institute for Health Stacey Chang, left, with Managing Director Beto Lopez.

Executive Director of the Design Institute for Health Stacey Chang, left, with Managing Director Beto Lopez.

Stacey Chang’s career reads like a history of the design movement. A mechanical engineer with degrees from MIT and Stanford, he joined the design firm IDEO in the late ‘90s, serving as the very first intern in its Boston office. What followed was more than 15 years when he was in and out of IDEO three times, stepping away to do cool things with a couple of medical startups as the firm evolved into a global force that moved from product design to the design of experiences, services, organizations and systems.

“We worked (at IDEO) in the design of hospitals, insurance, some pharmaceutical. I developed pediatric surgical instruments – I mean, that was the top of the mountain, robotics in surgery – but oddly I began to feel that I wasn’t having the kind of systems impact needed in healthcare,” Chang said. “Design consulting can be really fun and we started demonstrating huge impact through design. But we were never able to shift the system as a whole – only pieces of the system. That was the frustrating part.”

Chang is in a new place now – one where he can face down the kind of systems change that nagged him for years. He left IDEO for the last time in 2014 to become Executive Director of the Design Institute for Health at UT Austin. And though the world of academic medicine may not seem like an obvious next step for a design pioneer and entrepreneur, Chang’s new gig looks like his biggest play of all.

A joint program between UT’s Dell Medical School and its College of Fine Arts, the Design Institute is a first-of-its kind initiative dedicated to applying a creative design-based approach to the nation’s healthcare challenges. Funded primarily by the medical school, the institute engages not only in design education and research, but various hands-on consulting and development projects with the Central Texas healthcare system.

We were never able to shift the system as a whole – only pieces of the system. That was the frustrating part.

A true product of Silicon Valley who wants to do good and get things done, it took only one visit and meeting with inaugural Dean of Dell Medical School Dr. Clay Johnston for Chang to be hooked on the job and its vision.

“I knew Clay from UCSF – he was a clinical translational scientist, doing precision medicine, price transparency and policy work in California,” Chang said. But Johnston framed the confluence of circumstances in Austin as a rare chance to make change happen.

“Austin is a bright blueberry in a bowl of tomato soup – an unusual place within the red state of Texas that has the largest uninsured population in the country,” he said. “I really think it’s a once-in-a-lifetime opportunity.”

If you don’t already know it as the most liberal city in Texas and one of the most fertile cultural hubs in the U.S., here’s a piece of news that tells you something about the community of Austin. In 2012, the city voted on a ballot proposition to raise property taxes by 63% in order to rebuild the county hospital, create a new medical school, and make healthcare services available to the uninsured. In a nation where most academic medical centers are complicit in the dysfunction of the service system – and where preventive care in communities is disincentivized – the opportunity to create something new was great.

“We’re not tied to the legacy model of medicine,” Chang says. “We can move straight to value-based care, to positively impact the health of the community – because the community paid for our creation.”

The Design Institute of Health is approaching this opportunity with three big projects:

1.     Clinical – The design of the new medical clinics in a way that’s expected to fundamentally change the patient-provider relationship to give patients control and agency, enable them to learn, and for providers to eliminate hierarcy to create more collaborative workspaces. They also aim to reduce waiting times and create a more compassionate atmosphere within the clinics.

2.     Community – A new development in East Austin where the community requested affordable housing and access to green space, schools, and health. “They didn’t ask for a clinic,” Chang emphasized, “they wanted to know how to be more healthy.” The Design Institute is part of a multidisciplinary group including, among others, the head of Epidemiology from Johnson & Johnson, the Thinkery (Austin’s readically popular children’s museum), and local artist Jennifer Chenoweth, who created a project called “XYZ Atlas” that uses GPS coordinates to map emotions to place by community members. “This is the kind of stuff we came to Austin to do,” said Chang.

3.     Organizational – The design of the medical school itself, which includes a cross-fuctional collaboration between traditional clinical departments. “This kind of stuff doesn’t often happen in other institutions,” Chang said, “because budgets aren’t shared. Here, a significant part of the overall budget is dedicated to only central projects. In the realm of academic medicine, it’s huge.”

How does all of this get to the core of Chang’s earlier frustration and ambition to create systems change in health? Austin has already become a vanguard, serving as a model to other institutions interested in changing the model of health for communities.

“Long-term, design is just a component of a shift that I hope remakes health for society,” Chang said. “Of all the basic needs, health is an experience that everyone shares. It’s uniquely emotional and we experience it across divides in similar and significant ways. We have a chance to demonstrate that we can bring a lot of stakeholders along to collaborate on a courageous experiment to show better outcomes.

“Central Texas is the sandbox but the goal is to have a broader impact on society. We’re here because this represents the coalescence of the aspirations we’ve all pursued. “

Learn more about the Design Institute of Health.