Health Experience Design 2021

The U.S. healthcare system delivers care primarily through hospitals and as the COVID-19 pandemic hit, hospitals in the U.S. were overburdened. While the existing healthcare system struggled to manage the outbreak within communities, the hospitals were also becoming epicenters which increased the spread of the disease.   We have identified the following behavioral challenges related to accessing healthcare based on literature from past epidemics and continuing research on COVID-19: Poor care seeking behavior resulting from low perceived risk, fear within communities, lack of trust in healthcare Poor compliance and adherence behavior   Community distrust and resistance to the COVID-19 response   Increased stress, anxiety, and other mental health challenges for healthcare workers and communities Decreased utilization of health services due to fear and perceived risk of contracting COVID-19   While a hospital-based care delivery system works well in a treatment focused approach to healthcare, during pandemics and infectious disease outbreaks, a more prevention focused approach is required. Most developing nations have utilized a community centered care approach to overcome epidemics including SARS, MERS, TB and HIV. Drawing out conclusions from the vast literature, an increased role of communities and community-based care is suggested for adapting to the new normal and being better prepared for future pandemics. We propose an integrated approach to healthcare that outlays the leading and supporting roles of both hospitals and communities to draw a balance between treatment focused and prevention focused healthcare.   We have seen the promise of programming that focuses on community level originated solutioning to address HIV and COVID-19 in our work in Eswatini and Kenya. This community of practice-based model offers a structured process to encourage and support local ownership of problem-solving initiatives with human centered design as ‘the glue’. By leveraging community knowledge and building capacity in their problem-solving process, we have seen the development of contextually appropriate solutioning that are sustainable and scalable.