Client: Medical cooperative
2017/2018, 7 months - on-site
by Echos Innovation lab
Team & Roles
Francisca Limberger - Design Lead
Laura Dusi - Senior designer, specialized in speculative and futures design
Simone Soledade - Senior designer, specialized in service design and healthcare
Vinicius Aranha - Senior designer, specialized in business design
* Sensitive information has been excluded and images have been adapted for communication purposes.
BRIEFING
Our goal was to support the development of the future scenario for the client, from identifying their necessities and dreams to visualizing the scenario.
The client is a Medical cooperative that works providing both healthcare and health insurance, and owns a medium sized hospital. They had at the time 462 members and 1100+ hired staff. Their hospital, built in 2010, is one of the 2 biggest private hospitals in their region, the Rio Paraíba valley, state of Rio de Janeiro. The cooperative works under a national medical cooperative name that is one of the biggest and best known health insurance providers in the country of Brazil, and they were already a reference in that ecosystem.
By 2017 they had achieved all of their collective dreams. They built a new business model, built and operated their own hospital, voted for a holding business model (not approved).
Challenges
1. For the project to succeed we knew it should be a collaborative process and also that the medical field is prone to create hierarchical environments that hinder collaboration. Identifying and breaking the collaboration barriers was a challenge that we knew we would face from the start of the project, hence it was approached since the negotiation process.
2. Combining both consulting and capacity building to reinforce the possibility of project implementation, since that step was not an official part of the project, and as a support to reinforce collaboration.
3. Accessing individual dreams and fears about the future of the medical coop, to create a collective future.
4. Understanding the region, going beyond the medical service provided, and having a real holistic approach to care.
5. Creating a specific methodology for the project combining speculative, service and business design.
Approach
Combination of 2 human centered approaches:
DESIGN THINKING + DESIGNING DESIRABLE FUTURES
Combination of 2 human centered approaches:
DESIGN THINKING + DESIGNING DESIRABLE FUTURES
Predetermined agreements that supported the design methodology:
· 6 months pre-approved schedule of meetings
· Selection and division of participants into 2 groups:
1. Executive committee, 6 decision makers: president and board of directors
2. Technical Committee, 35 leaders: executive committee + experts from several fields, such as nutritionist, administrative staff, nurses, doctors from different expertise (35 leaders).
Phase 1
Research and engagement: Understanding the issues of the present.
Research and engagement: Understanding the issues of the present.

Activities:
1 Desk research:
- Understanding the context: the coop, the city and the region
- Trends in Health and Care
- Existing Future narratives in Health and Care
2 Design Thinking Experience:
16 hour course for the Technical Committee, with the objective of capacity building in design, meeting the team, opening space for collaboration and setting the tone of how the project will be developed.
3 Workshop 1 -Premisses co-creation with the Executive committee
Creating parameters for the project development and for solutions.
4 Research
- 35 internal interviews
- 19 external interviews
- Observation - 3 internal services
- Observation - 4 external services
- 2 experimental dives
My Role & contributions
1. Focused on the city history and existing futures narratives in Health and Care.
2. Adapting the course for the Medical coop context (together with the team); Facilitation of groups; Support for the lead facilitator.
3. Co-creating the workshops activities and materials, and facilitation support.
4. Co-creating the interviews framework; leading ½ of the internal interviews; leading 1/4 of the external interviews; observation of 1 service (hospitals intensive care unit); participation in all external services observation ( 2 hospitals and 2 universities); and provided support for the experimental dives.

5 Workshop 2: Empathy exercise and scenario identification
We presented the project premises and opened space for feedback and contributions. The participants explored concepts of futures design, such as scenarios, exponentiality, futurism, and weak signals. And went through exercises around empathy and curiosity to prime the group for research support.
6 Workshop 3 : Field research learnings and practice
The research results were presented and then we did exercises to explore and familiarize with the content and also to complement the research. The main activity was prepping and going to the field to collect stories of the city and their inhabitants. The participants got a chance to experiment the design research process and bring in new inputs to the research that complemented the "social needs" output.
5. Workshop co-creation and facilitation support
6. Workshop co-creation and facilitation support; co-created the support materials for the field research.
phase 1 Deliverables
- Trends in the Health Sector in Brazil and the world
- Project and solution premises
- Insights on collaborators and members of the cooperative
- Insights and learnings on the cooperative's relation to the city and other city's players such as large industries, the elderly, youth groups, university, and other hospitals.
- 15 Personas that represent the research results and insights

Phase 2
Tapping into the future. Provoking future possibilities through Design Fiction and generation the coop's intention for their future.