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Why these stages matter

HCD practitioners can better understand their own learning process and set appropriate expectations if they know the typical stages of the learning journey. 

NN/g concluded that:

• Most learning journeys feel frustrating at some point. Having insight into the HCD learning journey and the end goal can provide encouragement during “what’s the point” moments. If you’re learning HCD independently, awareness of the journey can help you feel less alone.
• Identifying one’s current phase can help predict future progress, staying focused on the goals of the current learning phase rather than jumping ahead. Jumping ahead runs the risk of creating experiences that may be confusing, and thus less motivated to continue to learn. 

Course facilitators (or managers or mentors), must empathize, create an effective HCD learning experience for others, and enable sustainable, long-term success. 

• Understanding that different people will be at different stages in the learning process is a key part in being an effective educator. It allows for the delivery of effective learning experiences without overwhelming the audience with too much complexity and also preemptively mitigate learners’ pain points at each phase. 

Educating and activating a group of people takes a lot of resources (time, money, and effort). The education process should be intentionally designed, in order to maximize resources and return on investment. Mapping participants’ phases and their progression through the learning journey allows an educator to benchmark progress, and indirectly, success of the training. 

As practitioners progress through the stages, their mastery increases in a nonlinear fashion — experiencing fluctuations due to various factors, especially, lack of self-confidence. Note that mastery is a combination of competence and confidence; both are required to effectively use HCD. If a practitioner is good but still feels insecure, they won’t deviate from the strict steps of HCD and won’t teach others.  The goal is to create alignment between competence and confidence in order to master HCD.

The Structure

Rather than thinking of each phase as a discrete checklist, NN/g created a three-component framework for characterizing each learning stage: criteria, primary activities, and educator goals.

1. Criteria are observable qualities that can help the learner (or an external observer, such as a trainer) identify the learner’s current stage along the learning journey. It includes awareness of one’s own competence, level of exposure, and confidence.
2. Primary activities are the learner’s actions and use of HCD methodologies.
3. Educator goals and obstacles summarize learner’s pain points at any given stage and corresponding educator goals that can help learners overcome them. 

Healthcare leaders recognize the potential of predictive analytics to drive a step change in their ability to achieve their key priorities. At a clinical level, predictive analytics can help healthcare providers deliver the right care, to the right patient, at the right time. Operationally, it equips healthcare systems with the ability to identify trends, enhancing care and reducing costs. But our study suggests that, regardless of their stage of adoption, healthcare leaders are still struggling to unlock its full value. 

Building trust around data capture, storage and governance, while encouraging more widespread and consistent adoption of predictive analytics, are some of the key concerns of healthcare leaders highlighted in the research findings. The gap between the significant improvements to healthcare that data analytics can provide, and the reality of how it is used today, suggests that more technological support is needed to turn predictive analytics into a platform to supercharge care.

This phase is the first in the learning journey. For the majority of HCD practitioners, this exposure occurs via a university or institution, a place of work, or an online resource. The amount of time spent at this first stage depends on how motivated the learner is. Interestingly, many practitioners immediately perceive HCD as useless and never leave this stage.

Criteria

Individuals in this stage have been introduced to HCD, but have limited experience with it. Practitioners in this phase fall into 2 buckets:

1. Individuals who are committed to learn HCD
2. Individuals who are not interested to learn more about HCD. They’ve been exposed to it, but that is where their learning journey halts. Newcomers may remain in this stage indefinitely until they encounter a deeper exposure to HCD that broadens their perspective, experience, or acceptance. 

Newcomers’ knowledge is minimal; they have a surface-level understanding of HCD, often rooted in the definition they received during their first exposure. They may be able to provide a definition, but are not familiar with the details of a framework or its value. They have topical associations with HCD — sticky-notes, phase models, and whiteboards. Newcomers are unaware of their HCD incompetence. In other words, they don’t yet know what they don’t know.

Primary Activities

Newcomers’ primary goal is to understand the basics — what HCD is and why it’s useful. Often, this stage’s activities are self-initiated: browsing articles, reading books, or signing up for a course. In other cases, HCD is learned by necessity or requirement at work or school through onboarding programs, collaborative workshops, required courses, or mandated trainings. Most newcomers have not yet actively practiced HCD activities. If they have practiced HCD at all, their participation is limited and surface-level. 

Educator’s Goals and Obstacles

The goal of an HCD educator at this stage is to communicate the purpose and potential value of HCD and to motivate the newcomer to pursue learning, then make time for it and move on to the next phases. Common obstacles are overcoming learners’ negative sentiments: annoyance with “yet another thing to learn,” unsuccessful previous attempts or experiences, capped bandwidth, and realization of their own limits (in this case, how little they know about HCD). 

Phase 2: Adopter

Individuals in phase 2 have adopted HCD and begun to practice it. They may have had some ups and downs in their limited experience with HCD. It is common for adopters to flip-flop between overconfidence and self-doubt and to feel both confused and successful at the same time. Successful adopters have discovered how relevant HCD is to their work or life and, thus, make a commitment to continue learning.

Criteria

Increased (passive or active) exposure and familiarity with HCD has made adopters aware of their knowledge limits. They understand the potential of HCD, but still have a lot to learn. Adopters have invested time, effort, and energy into HCD and have started applying it to their work with mixed success. The commitment to HCD at this phase can be self-initiated or dictated by an authority with an invested interest (leadership, organization, or supervisor). 

Primary Activities

Adopters practice HCD in a linear way — by the book. They rely heavily on checklists — for example an HCD Phases Model, as well as for the activities associated with each of its steps. Many adopters lean towards a prescribed, branded version of HCD, often provided by their institution, company, or a reputable external organization.  

It is common for HCD practitioners to encounter failure in this phase — especially if they are learning predominately on their own — because of their incomplete understanding of the HCD framework. Common types of failure include jumping to conclusions, using the wrong activity at the wrong time, and lack of buy-in or support from others. These failures push some practitioners to abandon HCD altogether. However, most learning in this phase occurs through failure. Practitioners who embrace failure tend to develop a better understanding of HCD in future phases.

Some adopters might learn primarily by actively participating in HCD training, coaching and activities together with experienced HCD practitioners. While this group of adopters may not have the opportunity to experience a sense of failure because of the support received from their peers, it is still likely they will question the value and legitimacy of HCD from time-to-time.   

Educator’s Goals and Obstacles

Adopters are on the bike, but still need training wheels and coaching. Adopters’ confidence drops as they realize the indirect ways in which HCD can be applied and how much they have to learn — for example, how straightforward they originally thought the process was versus how abstract (and potentially overwhelming) it really is. The goal of the educator at this stage is to help learners through hands-on practice and assistance until they can comfortably use HCD on their own. Many individuals can become confused in this phase when they cannot make a direct connection to the relevance of HCD. Thus, it is imperative that adopters find relevance and application to their everyday work.

Phase 3: Leader 

This is the proficiency stage of HCD. Leaders can articulate HCD succinctly to others, steadily growing their confidence, with varied experiences and continued exposure. Leaders take an active, independent role in their learning journey and begin to think adaptively about HCD; starting to explore new applications and may even have established a reputation as a subject matter expert. 

Criteria

Leaders practice HCD with general ease, confidence, and independence. Leaders become more and more aware of their new knowledge and comfort as they mature through this phase. They often teach others earlier in the learning journey. They are able to consistently and somewhat adaptively perform HCD activities without thinking too much about them. Leaders don’t try to apply HCD by the book, rather use it as needed depending on the goals. 

Primary Activities

HCD practitioners in this phase lead HCD activities with others or perform HCD without coaching, but still apply preparation and focus. While they were previously participants, they now facilitate, initiate, and even advocate for collaborative HCD activities. Activities that leaders are involved in gradually increase in complexity, ranging from involving users in learning opportunities to fostering stakeholders into the process and prototyping. 

Educator’s Goals and Obstacles

The goal of the educator in this phase is to continue to instill confidence and help sustain learner commitment. The goal should be to empower leaders to transition into the role of HCD educators and facilitators. As much as they’ve progressed, they still may not be aware of weaknesses or potential improvements (even though they often recognize a mistake after they made it). Promoting reflection in this phase is the key to helping leaders continue to grow (and progress to grandmasters). They must take an active role in adapting the HCD practice to fit their contextual goals and needs, be sustainable over time, and maximize potential benefits.  

Phase 4: Grandmaster

If you are familiar with the game of chess, the title of grandmaster is only given to the most exceptional players—those who have spent countless hours perfecting their skills and techniques.

HCD practitioners at this stage have not only become teachers of HCD, but create new ways of applying it, thinking about it, and adding to it. The practice of HCD is so embodied in their behavior that they seldom have to think about applying it. Grandmasters view HCD as a flexible, dynamic toolkit. They’ve long departed from the concept of a prescribed process and rather view it as scaffolding to solve both organizational (often internal) and end-user (external, product-related) problems. However, this phase doesn’t come without downsides. Grandmasters are more likely to doubt HCD than leaders, often when early-stage learners fall victim to mismanaged HCD marketing and thus misinterpret, misapply, or undercut the practice as a whole. 

Criteria

Grandmasters’ defining characteristic is the ability to critically reflect on their HCD practice. This enables them to judge what is useful and potentially depart from the traditional ways and activities of HCD. Grandmasters also know how to help others to this same stage of enlightenment. Grandmasters are aware of their competence. They have an in-depth, intuitive understanding and can blend HCD skills together to meet specific needs. 

Primary Activities

Traditional HCD activities are still used by grandmasters, but are altered, adapted, and applied in complex ways, depending on the goal, audience, and potential obstacles. Grandmasters don’t stick to prescribed or branded versions of HCD and more often pull tools and/or activities from other realms, like service design and business strategy. While basic HCD activities are still carried out in this phase, they differ from those in earlier stages because they are inputs or alignment strategies for more complex, involved activities (compared to previous stages where the basic activities are the end goal). 

Educator’s Goals and Obstacle

Grandmasters have very likely surpassed their original teachers. Their goal becomes not just activating and educating individual learners, but rather organizations as a whole. As practitioners themselves, grandmasters face an increasing likelihood of (re)questioning the value of HCD. Increased knowledge and mastery are a blessing and curse; this pessimistic view is often rooted in the realization of what HCD can and cannot solve (contrary to earlier naive ideas that HCD can be a cure-all). However, even grandmasters can get better, by self-reflection, by learning from their peers, and also by learning from their juniors: one of the skills of supreme mastery is the ability to discern which of the hundreds of ideas generated by eager newcomers is actually a stroke of genius.

Other Considerations 

• Trained designers experience the HCD learning journey too, just differently. Many designers view HCD as simply a way to articulate and communicate a creative approach to problem solving. Thus, many designers are likely to feel as if they bypassed this learning journey altogether because this is how they instinctively think. However, designers experience this learning journey too, albeit much earlier in their education or career, and likely not packaged or branded as HCD. This does not mean that all grandmasters are designers, but rather that many successful designers likely are. 
• Individual practitioners can be at multiple levels at the same time. Some skills may fall into one phase, while others into a lower different phase. For example, a practitioner’s mindset and reflection may fall into Grandmaster, while their hands-on experience and exposure to activities into Leader. The goal is to identify this imbalance and invest in experiences that bolster weaker dimensions of our practice. 

The HCD learning journey is a high-level, distilled representation of the most common learning phases observed in the NN/g research. Learning and teaching HCD is messy; not all experiences will fit squarely into this model. 

Regardless, it is imperative to frame and articulate learning HCD as an experiential journey. Doing so can help all practitioners become more effective learners and educators. Learners can gain insight and awareness into the greater journey and goals, while educators can thoughtfully and successfully execute the HCD learning experience they aim to create.  

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Leaders focus on the benefits of Predictive Analytics 

Predictive technologies are seen to improve care and lessen the administrative burden. A broad term used to describe advanced analytics that makes predictions about future events, behaviors and outcomes, predictive analytics increasingly plays a key role in advancing care, improving patient outcomes and the staff experience. Offering both real-time and future clinical decision support, from diagnosis to prognosis and treatment, predictive technologies are a valuable tool across healthcare settings. This was reflected in the Philips Future Health Index 2021 report, where healthcare leaders cited predictive technologies as an important way of preparing for the future, and something they planned to invest in during the next three years (40%).  

Today, many leaders have already embarked on this journey, with 56% reporting they have already adopted, or are in the process of adopting, predictive analytics in some form, in their hospital or healthcare facility. Healthcare leaders are generally united in their recognition of the potential of predictive analytics to improve care outcomes and deliver on their other priorities. The areas they feel predictive analytics could most benefit their hospital or healthcare facility are broad and span both clinical and operational spheres. They include expanding access to healthcare and driving healthcare transformation more generally, for example through improving scheduling and remote patient monitoring. 

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The Promise of Predictive Analytics is still out of reach for many healthcare leaders

The uptake of predictive analytics remains uneven. Predictive analytics promises to transform healthcare. But, while healthcare leaders acknowledge the benefits of the technology, its uptake remains uneven, with Singapore, the US and Brazil far ahead of most European countries. There is also a marked difference in adoption rates between developed and emerging countries (28% vs 20%). Those healthcare leaders who are furthest along in their adoption of predictive analytics do not think they are making the most of its potential. For example, about one-fifth (21%) of first-to-innovate leaders see predictive analytics as delivering the most impact in remote patient monitoring, yet just 12% are using it in this area. It is likely that the barriers to data adoption, highlighted in the previous chapter, are fueling this gap between current and potential use of predictive analytics. Unless leaders can address them, their adoption journeys are likely to stall.

“For us, predictive analytics is part of our roadmap. When we talk about analytics, we want it to be predictive. We want it to be proactive in its ability to provide real time data that we can action.”

Chief Information Officer, suburban hospital, United States 

However, there are pockets of experience that leaders can draw on for guidance as they look to drive adoption of predictive analytics in their own facilities. Healthcare leaders in Asia report the highest rates of adoption. At a global level, healthcare leaders in clinical positions have higher rates of adoption than their peers in operational roles, particularly those working in radiology (31%), where predictive analytics is being used as one of several tools to help clinicians analyze and diagnose images more quickly. Given the preference of many healthcare leaders to learn from their peers, such leaders are well placed to share learnings and best practice with those in the earlier stages of adoption. 

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Security and privacy concerns remain as roadblocks to progress

Data security and privacy are critical factors for healthcare leaders as they seek to foster trust in predictive analytics among staff and patients. Around the world, healthcare data breaches are on the rise. Over 90% of global healthcare organizations have reported at least one security breach within the last three years*. It is against this global backdrop that healthcare leaders are citing greater data security and privacy systems and protocols as the top way to strengthen trust in predictive analytics in both operational and clinical settings.  

Those in developed countries (29%) are more likely than those in emerging markets (25%) to cite increased transparency in how insights are determined on the operational side. This is likely due to the European countries in our research where stringent European data regulations like GDPR place a lot of responsibility for data protection and responsible data use on healthcare providers. Developed countries are also more likely than emerging countries (28% vs 23%) to want improved regulations related to data security and privacy. Initiatives like the European Health Data Space** – a European Commission-led project to promote health data exchange across Europe – improve healthcare, policymaking and research, while ensuring strict protection of the privacy of citizens. Such programs can help to address these concerns and hopefully improve the safe adoption of technologies like predictive analytics.  

While there is a desire to invest in predictive analytics, healthcare leaders are still keen to ensure the human touch is not lost. Over one-quarter (29%) say that increased human involvement, where a human always makes the final decision, is one of the top factors that could potentially enhance their trust in predictive analytics. 

“In healthcare, I don't think there's any data that's worth protecting more than patient health data.”

Chief Operating Officer Urban hospital, Germany 

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Conclusion 

Bridging the gap between the promise of predictive analytics and current usage: From data silos and interoperability concerns to technology infrastructure limitations, many factors are to blame for the uneven uptake of predictive analytics to date. The good news is, we’re now seeing several leaders pioneering this technology and inspiring others to drive adoption in their own facilities. As more organizations reap the rewards of machine generated insights in both clinical and operational settings, such as enhanced decision-making and lowered administrative burdens, we expect to see increased demand for peer-to-peer mentorships between early and late adopters, as well as strategic partnerships with health technology companies, bringing the whole sector up to speed. 

References 

The Future Health Index 2022 report is based on proprietary research conducted from 3000 healthcare respondents in 15 countries. 

* https://www.beckershospitalreview.com/cybersecurity/data-breaches-have-lasting-financial-effects-on-hospitals-report-suggests.html  

**https://ec.europa.eu/health/ehealth-digital-health-and-care/european-health-data-space_en  

*** US and Brazil only 

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This article is based on the Philips Future Health Report Index 2022 Report which can be downloaded here.This article is based on a research study conducted by the Nielsen Norman Group. Originally published January 2021. 

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