The Caffeine Experiment
How do you make an educated person feel ignorant? How about asking her questions such as “do you believe your malnoia is cacestogenous”? How do you expose people familiar (and jaded) with healthcare to the anxiety-inducing experience of healthcare? How about giving them a positive diagnostic for CDS (a condition they never heard of) and sending them to the pharmacy to refill a prescription they cannot understand?
In design we know that experiences convince more than words. This powerful tenet is at the core of what we call the “Caffeine Experiment” which is designed to allow those in healthcare to experience it in an unexpectedly context. We conceived the initial version of this exercise for a pharma client while still at IDEO. Since then, it’s been used with variations in many different settings. We recently applied this method to the first day of class for the Dell Medical School’s third year medical students studying the Distinction in Design and Innovation.
Students who came for their first class on “Design for Health” were sent to our “waiting room” and given a questionnaire to fill out. Some of them were medical students, others design and business students, but the questionnaire was incomprehensible to them all. I got most words from a dictionary of difficult words. The two words that you, like everyone else, did not understand on the phrase above were:
malnoia [n.] A vague feeling of mental discomfort.
cacestogenous [adj.] Caused by an unfavorable home environment.
After filling out the questionnaire with the assistance of an unhelpful assistant, the patients were taken to the management office to deal with their health insurance.
There, after a confusing and exhausting conversation with our insurance specialist, they were assigned one out of three different plans. Some patients, unfortunately for them, got the Medicoffee plan, which only covers the basics.
After the payment situation is cleared out – healthcare does not proceed without this important step – the patients were sent to the doctor, who would give them the bad news.
“We received your results”, the doctor would say, with contrived empathy, “and, unfortunately, they came positive. You have CDS – Caffeine Deficiency Syndrome”. Patients would walk away from the doctor’s office with a prescription for caffeine, 50 mg, to the pharmacy.
At the pharmacy, they were given their treatment according to their plan. Patients who have premium insurance get a nice, fresh-brewed cup of coffee and a cookie. Patients in the mid-tier insurance plan get branded coffee. Patients in the Medicoffee plan, unfortunately, get a package of instant coffee and a cup of hot water from a thermos bottle.
There is more, but you get the idea. The Caffeine Experiment is a warm-up exercise to make people experience the worst of healthcare. Cautioning people not to try to extract from this tongue-in-cheek exercise more than it can give, we followed with a discussion with the participants. The idea is to put them into the right frame of mind for the more serious lecture that would follow. In spite of the limitation of this short skit, a few parallels with real healthcare experiences emerged:
The feeling of powerlessness
The asymmetry of information between patients and providersThe different classes of citizens in healthcare, depending on their insurance
The non-clinical aspects of the experience are important
Communication plays a huge role in patient care
As one participant said: “The doctor, the insurance agent, the pharmacists and the patients had different information, which led to sub-optimal choices. Also, it was clear that not all patients had the same information.” That’s it.