Phone trees in healthcare

An opportunity for grassroots innovation?

The past few days I’ve been dealing with a change in dosage for a medication to keep my brain swelling in check. (I’m fine - just walking funny) The care from nurses, admin assistants, docs, patient care attendants has been topnotch. The way people are, I feel like I’m on a secret A list.

Because I am so well cared for, I’ve had the bandwidth to think and write about things I’ve noticed.

Top of mind: phone trees.

OMG

Problem definition and users

You call a number, you hear 4 options, then 3 different numbers you might want to call (hang up before you call), then instructions on leaving a voice mail. My cognition is just fine, so I’m OK to navigate the system. And I have a husband and son nearby who can take over if I’m too tired.

But think of your hearing-impaired 85-year-old grandmother calling a phone line because she has a question about your grandfather’s Alzheimer’s care. Or someone who is new to Canada or Quebec and can’t understand the accent. Or a parent with ADHD rushing home from work at 3:45 to see if they should bring their 6-year-old into the ER after the kid fell down.

Context

Who implements phone trees?

Busy people - nurses often - who need to share complex information for multiple contexts. They want to give people the options they need. They make the options as clear as possible, but there are so many to share.

Who buys phone trees?

IT folks. Their POV: How easy is the system to implement and maintain? Can we do self-serve? Can it be bundled with the VOIP contract? Is it user-friendly? What’s the business case? Because dollars for the phone system must be balanced with dollars for WiFi, cybersecurity, networking equipment, service contracts, everything basic to a healthcare system in the industrialized world.

Problem impact

Let’s be clear. This is not a sexy juicy innovation problem. Phone trees are an irritant, they’re an obstacle. Solving the phone tree problem won’t address life-and-death medical errors or prevent sentinel events.

So why do something?

Because it’s not just the phone tree. Complex systems are filled with Gordian knots of multiple, intersecting irritants that throw up tiny obstacles to the flow of care. These tiny obstacles go unnoticed, imperceptibly gumming up the works, like plaque in an artery.

Human value

There is great cumulative value in people coming together to isolate a small problem space like phone trees and test low-stakes solutions. One solution leads to noticing another. Slowly over time, a ripple of tiny human solutions can change the tide. Then one day, you all look up, and you feel a nice little surprise: wow, it looks nice in here.

Hacking Health

Notice that I didn’t run straight away to ideate on possible solutions: chatbots, AI, digital twins, speech to text, whatever. That’s because I learned about grassroots innovation in healthcare from one of the global organizations that pioneered this work: Hacking Health.

Hacking Health was co-founded by Luc Sirois, now Quebec’s Chief Innovation Officer. He taught me what it is to mobilize people, and the years that I worked with him (as a volunteer, then a direct report) were years of non-stop learning.

Call to action

I’m trying to figure out what i want to say here. Listen, I’m not trying to put the Hacking Health team on the spot, and go hey gang, let’s all do a Design Jam on phone trees. I’m trying to say, please pick up on that problem-solving energy again. I’m trying to say to people who don’t work in healthcare or innovation, just notice the little things you can solve, ideally small things with other people.

There.

That’s the core.

Do small things with other people. See where the small things lead.