Cognitive Design

Effective disease management programs are a cornerstone for any serious attempt to improve the cost and quality of healthcare in the US. These programs target chronic conditions such as congestive health failure and diabetes and provide services to insure compliance with best practices by clinicians and patients alike. The goal is to improve outcomes, avoid hospitalization and eliminate unnecessary cost.  As most of our healthcare dollars are tied up in chronic conditions, effective disease management programs are a must have.

But how do you design an effective disease management program (DMP)? That question was asked and answered in a recent article in the McKinsey Quarterly.  The researchers studied programs that worked and programs that failed in several countries and found:

“Five traits seemed to be the most important in ensuring that DMPs meet their goals: program size, simplicity of design, a focus on patients’ needs, the ability to collect data easily and analyze results, and the presence of incentives that encourage all stakeholders to comply with the program.”

Although these traits seem basic (and they are), there  are some details especially relevant for cognitive designers.

For example, decreasing cognitive load is key. Under simplicity the cognitive load is decreased in the program by avoiding complicated care pathways that have been customized for multiple sub-groups of patients.  While under the patient need trait it is lowered by avoiding the use of complex technologies to monitor and report results.  Also under patient needs care was taken to support the cognition of self-regulation:

“The patients are given ongoing, disease-specific coaching to maximize their ability to care for themselves”

A careful reading of the article reveals other cognitive factors that help drive the success of disease management programs.   It is not surprising that cognitive factors play a key role but it is very useful to see the details revealed in a empirical study.