About the Interviewers
Sophia Testa is a design researcher with a focus on health innovation. Galvanized by a nursing background, she leverages her understanding of clinical processes to design for more equitable and empathic healthcare experiences for all. Equipped with a human centric perspective on strategic implementation, Sophia is apt to collaborate with you in solving the most wicked of healthcare’s problems.
Brittanie Wilczak is a service designer and design researcher with 11 years of experience in project management, collaboration, generating revenue, process improvement, and qualitative research. She is interested in human-centered service design, and normalizing empathy and agility at all levels of the design process. Brittanie is an exceptional visionary with the aptitude and enthusiasm to harness innovation and lead vibrant programs for missions in the social impact and health spaces, currently holding her Masters of Public Health from the University of Illinois at Chicago and formalizing her design experience with an MA in Design in Health from the University of Texas at Austin.
In this interview, Sophia and Brittanie speak with Chris about his career path into design and trajectory into the healthcare innovation space and the future of design in health.
A founding member of the Design Institute for Health’s Advisory Council, Chris Hardesty is a global advisor for healthcare ecosystem innovation and currently serves as a of KPMG’s Global Healthcare & Life Sciences Centre of Excellence, presently based in Singapore and looking after developments in the Asia-Pacfic region.
Chris, it’s so great to sit down with you. Let’s start with basics here. Can you tell us about your academic background?
I grew up in rural Texas, in a family of Longhorns and educators; hence it was always my dream to attend UT Austin. I completed my BBA at the McCombs School of Business in 2008, with a specific focus on Marketing and MIS disciplines as well as an additional certification in Portuguese language studies. This is because I spent one year abroad through a UT exchange program, at a business school in Brazil! It was only the second airplane flight I had taken in my life, quite overwhelming yet incredibly rewarding.
Then I completed my MBA from the Thunderbird School of Global Management in 2013, and am a 2024 candidate for Doctorate in Public Health Policy through UNC Chapel Hill. Whether it be through formal or informal means, the learning never stops, especially in the global health field, and hence I’m inspired by the latest cohort of UT Design in Health cohort faculty, council, and students.
Can you tell us about your career trajectory? Where you started and where you’re going?
I have always been passionate about healthcare, having suffered some major injury trauma growing up which led to a desire to make an impact in the field. Coincidentally, the UT study abroad program in Brazil started my career formalities in this space; I joined a pharmaceutical company there to look at expanding access schemes to remote populations for novel therapies. This is where I started to see the disconnect between healthcare innovation, unmet public need, and self-reflecting on my own injury interventions which were based on the fortunes of living somewhere like US and coming from a family of means.
I then returned to the US and joined consulting firm, KPMG. Projects undertaken stateside included the implementation of electronic medical record keeping systems in hospitals, as well as anti-counterfeiting programs to stop the rising trend of illicit medications entering the market. From there I rotated to KPMG’s Global Healthcare Center of Excellence based in UK, looking after efforts primarily in the European region around care system integration initiatives. For the past three years, I’ve been based in Singapore to handle Asia-Pacific matters, specifically as it pertains to the United Nations Sustainable Development Goal (SDG) #3 for the implementation of Universal Health Coverage (UHC) schemes by 2030. The month marks my tenth year at KPMG, it’s been an incredibly fun and rewarding journey.
More recently, I’m supporting efforts around the industry ecosystem too; giving adjunct lectures at local as well as international universities (blessings of a COVID-19-influenced virtual world), writing position papers with consortia groups on key policy topics, and advising as well as investing in the promising Health/Bio/MedTech start-ups. Perhaps this is a calling back to being raised by a family of educators and entrepreneurs!
How did you arrive at your current role?
For the KPMG role, I navigated my way through the company itself. Starting on discreet healthcare projects in the US, I then took on a rotation to our Global Center of Excellence in the UK. From there I was able to see more about the various global healthcare initiatives going on across the markets, and saw the tremendous potential for impact to be based in the Asia-Pacific region. Home to 60% of the world’s population yet with slow adoption of SDG #3 and lingering unmet need, I felt inspired to try to make an impact. I feel fortunate to work for a company that recognized individualized career journeys.
In terms of the other industry ecosystem roles, this has come about through the various projects and stakeholders I engage with on a day-to-day basis. Especially during the COVID-19 period, the level of cross-ecosystem collaborations as well as focus on healthcare is at an all-time high. Therefore it became natural to extend my KPMG work into other aspects of helping to keep the innovation moving in this field.
The last decade sounds pretty extraordinary, what are your future plans for your career?
At 10 years with KPMG, I’m very content with the role and living in the Asia-Pacific region. There’s much more to be done though. Of course these are tumultuous times on personal and professional levels so there are my agile considerations to reflect on.
Eventually I would like to grow my duties in the academic space, imparting what knowledge that has been gained in healthcare design models so that the next generation can pick up where we left off. In the meantime, I anticipate more involvement in the funding of start-ups as well as the multilateral agencies from a policy-shaping perspective. The career context is no longer a binary decision, so it’s really a mix of various aspects that (I hope) will be self-reinforcing and mutually beneficial.
The phrase “design in health” is picking up a following. What does this mean to you?
I work quite extensively on the (re)design of health system delivery as well as financing models, at the moment with particular focus on the Asia-Pacific region. As we march toward SDG #3, there is question about whether classical UHC models (designed in the West nearly a century ago) are still fit-for-purpose.
So while it’s hard to scrap the system and start over, and there are many cultural and philosophical reasons behind each country’s health system, we must ask ourselves — if we were to design healthcare from a blank page, would it look like what we have now? Typically the answer is “no”, hence the fast movement toward more patient and consumer-friendly constructs. But it’s a slow process and we must be careful in the intention; people’s lives are literally at stake.
Usually when I (re)design the health systems, we start with two fundamental challenge points — does a particular process or payment step need to be done in the hospital, and does it need to be done by a formalized role (e.g. a doctor)? Such discussions can be sensitive especially when we look at task-shifting concepts or adoption of digital tools that may replace job roles; yet I’m inspired by the level of creativity and progress, especially with high focus on this industry following the pandemic.
So for me, “design in health” is about bringing a disruptive level of creativity, from any industry, into healthcare, while retaining a heightened understanding about the nuances of this field. Increasingly I’m also of the belief that we need to work at the “lowest common denominator” of healthcare systems in order to make a true impact; often easier said than done when speaking about sub-populations without access, affordability, or healthcare literacy. Real design innovation in delivery and financing will be born here!
I’m currently leading the World Economic Forum’s sustainable healthcare program for the Asia-Pacific along similar themes; readers can learn more here.
Where do you see design in health intersecting with your current role?
I must profess that I’m not a design- thinking expert by trade, though the word is almost a daily occurrence now. On the face of it, “design” in my work is about having an actionable plan for enacting the changes we want to see in our healthcare systems, now as well as into the future. The ambition remains just a dream until it’s written down on paper, then we have tactical goals to work toward. This is true on the delivery model side, as well as for financing models.
Looking beyond, “design” also has a connotation of decorative patterns. This is where I think there is room for creativity in the typical health system design work. Only making incremental improvements on outdated UHC models won’t be enough; we need people with perspectives from various angles to come together, challenge each other, pave the path we want to see. I’m inspired regularly by innovations from the youth to the elderly, from chronic to infectious disease, from HealthTech to FinTech. The future is bright.
From your perspective, what’s your hope for the future of design in health?
In my lifetime, I would like to see not only SDG #3 achieved but more broadly a transition from demographic dividend period into longevity dividend, associated with an aging population. Again this means working at lowest common denominators so that we can be the rising tide to all life boats. The key will be doing more with less, smarter allocation of existing resources, and bringing a new wave of middle class and civil society as a result of healthcare investment, not in spite of its costs. I will do my best to challenge the existing design paradigms for generational impact, and to encourage the next wave of innovation pioneers to do the same. Finally we can marry the promise of medical innovation with the delivery and financing mechanisms to bring access to the masses.
The other angle I hope to see is expectation for the role of the individual. Too often we design health system schemes that, while good-intentioned and with the key stakeholders around the table, fail at the last mile. This is because people do not have the healthcare literacy, motivations, nor means to take the appropriate actions. I believe concepts like nationalized health savings accounts (rather than co-payment), healthcare banking cards, and policy adoption of self-care are ready to take off. This is the purest form of patient-centered model design, and COVID-19 has been a real boom in overcoming some of the lingering barriers (socially as well as technologically).
How do you envision the design thinking skillset to make an impact on your industry and role?
Again I’m not really a design-thinking expert, so probably I learn more from the UT program and cohort than the other way around! I’m inspired by the level of diverse profiles and creativity that is being aimed at healthcare; it’s long overdue. I do believe design skills will be the “oil” for future healthcare efforts around the globe, much like the role of “data” had been discussed over the past decade. Healthcare is and will always be a people-centric operation; effective design principles that bring together the processes, stakeholders, and technologies are top skills.
Along these lines, I’m a believer in dilemma thinking too. We are too polarized, binary in our ways of working at the moment. In healthcare, especially internationally, I’ve found the role of culture and philosophy weigh very heavily on design models. So rather than right vs wrong, there is a point at which competing ideas actually converge into something beautiful. It’s beyond compromise, it’s dilemma thinking creativity.
An example is value-based contracting models across healthcare services and products. We often get caught in whether something is, or is not, value-based. Rather, the philosophy behind better outcomes at a more reasonable cost base produces a spectrum of possibilities. In the Asia-Pacific we are exploring models such as social impact bonds, decentralized innovation budgets, and micro-financing as mechanisms to achieve the vision of “healthcare value” without getting caught up on binary principles. There is much passion on such topics now, as observed from the WEF program mentioned earlier.
How have you seen disruptive innovation in the field both pre and post pandemic?
I wrote a column on this topic about a year ago. There will be a 2021 update version posted very soon with the latest thinking.