Designing for the 25%

Andrew Barrie at UXDX Community: Australia. Video: https://youtu.be/uoQwT6z-pAU

Readable transcript: edited from the recording's captions for readability (fillers and false starts removed, punctuation and section headings added). Wording is the speaker's own. Timestamps are positions in the video. Names marked [?] could not be verified against the audio.

Introduction and WorkSafe Victoria

[00:00:00] Hey everyone, my name is Andrew Barrie, and I'm an innovation lead at WorkSafe Victoria. Today I'm going to be discussing the topic of designing for the 25%, and share some thoughts from myself and from my team on how we go about creating deliberately inclusive public services.

[00:00:17] I'm going to start today by providing a little bit of context about WorkSafe itself. I'm mindful that some people watching this video may not know anything about WorkSafe Victoria and the work that it does. I'm going to talk a little bit about our team in innovation and the way that we're structured, and then talk about the context in which we work. I'm then going to dive into some thoughts and hopefully some practical learnings on designing inclusive products and services. I'm going to talk about the idea of scaling up, and how we go from initial design exploration through to eventual implementation of our work, but in a safe way, and in a way that's mindful of the context in which we work. And then hopefully I'm going to tie all this together with a few takeaways that might be relevant to your line of work.

[00:01:10] Okay, so let's start with a quick introduction to WorkSafe Victoria. This is the description of WorkSafe that I scraped off our public-facing website the other day, and it does a good job, at least functionally, of describing what we do. That is, WorkSafe Victoria is our state's health and safety regulator and the manager of Victoria's workers compensation scheme. I learned from our website the other day that we've been doing this now for about 35 years or so. To put it a little bit more simply, our purpose is to help prevent injuries in the workplace, and to provide support for workers in the event that they are harmed in that workplace.

[00:01:52] To give you a sense of the scale at which we operate, the number of people that we interact with, and the types of services that we provide: in the last financial year, we provided approximately 82,000 injured workers with financial support for medical treatment, weekly benefits, or a combination of both. Of the 82,000, approximately 28,000 were new claims that came through our system, so 28,000 new injuries in the workplace that then manifested themselves as a workers compensation claim.

[00:02:27] This last statistic here, the 14.3 percent, is the percentage of new claims that came through our system that were for managing a primary mental injury. This last number for us is really quite significant, and it's something that we're spending a lot of time in our team thinking about in terms of the work that we do. The good news is that slowly over time within WorkSafe, we're seeing the number of physical injuries decrease, or at least remain relatively consistent over time. However, we are sadly starting to see a bit of an exponential increase over the last couple of years in the number of people in the workforce who are suffering from a mental injury: post-traumatic stress, or anxiety, or depression. This gives us a lot to contemplate in terms of the sustainability of our scheme, because these injuries can be quite complex and quite difficult to manage, and people tend to spend a lot more time away from work, with a longer claim duration.

The innovation team

[00:03:38] Okay, I want to talk a little bit about our team in innovation. Innovation within WorkSafe has only been in existence for roughly two years now, so in the grand scheme of the 35 years that WorkSafe has been around, we're the new kids on the block. We've only been around for a short amount of time. We've tried to develop what we think is a deliberately multidisciplinary practice. It includes some of us who have come from different areas of design, from the more strategic service design areas right through to some of the more executional elements of design, in user experience and interaction design. We have different technologists in our group as well: front-end developers, back-end developers, and everywhere in between those two spaces.

[00:04:26] We also have a lot of people in our team who are health experts and have come from different areas in the health industry. I like to say, though, that regardless of where you come from, what your background is in our team, and what it says on your LinkedIn profile, we all tend to have a background, to varying degrees, in human-centered design. Most of the people who have joined our team tend to be very driven by making a positive impact on the community.

[00:05:00] Okay, I want to talk to you a little bit about the way that we structure our group. Those 28 people are broken into four different portfolio areas that we've developed to address very specific business and strategic priorities. These areas, in short, starting from left to right here: firstly the prevention group, who partner with different areas of the business to help reduce injuries in the workplace. They spend a lot of time with people like our enforcement and inspectorate teams, who spend a lot of time directly out working with workers and employers to look for opportunities to reduce injuries in the workplace.

[00:05:48] The second team is recovery, and that's the space that I'm responsible for managing at the moment. Our remit is to develop new products and services targeted at improving recovery outcomes for all of the people who are involved in managing a workplace injury. That's not just an injured worker, but can also include the injured worker's employer, the insurance agents who manage those claims, and obviously the different people within the health system who might be managing that injury.

[00:06:18] The last couple of areas are more outward-facing teams. We have the community team, who do really amazing work with different community organizations to co-design new health and safety initiatives. And lastly, our ventures team, who are in the very early stages of figuring out what it means for a government regulator like WorkSafe to collaborate with the startup community and other external providers to explore new product opportunities, R&D ops, et cetera.

Designing for the 25%

[00:06:55] Okay, so I'm now going to dive into sharing a few thoughts and some learnings about how we go about designing inclusive products and services for the Victorian community. I'm also going to touch a little bit on digital transformation, because WorkSafe, like many public service organizations at the moment, is in the middle of large-scale digital transformation, so I think it's important to acknowledge that context.

[00:07:22] To kick off that conversation, I want to first talk about a core assumption of digitally transforming public services that I feel has followed me for the last few years in the work that I've been doing in the public sector, whether it be in the last couple of years that I've been at WorkSafe, or previously when I was working as a design consultant, working with different federal or state organizations.

[00:07:48] The core assumption, for me, around digitally transforming public services at the moment tends to go a little bit like this. If we digitize our current-state processes and create new products and services for our clients and our customers, in the future roughly 75% of the people who currently interact with our organizations, that big green area there, the 75%, will be able to do so in a digital channel and effectively self-serve. And the assumption then follows that if we do that, and we do that well, we'll be able to increase our bandwidth to manage the 25% of customers who we assume have higher servicing needs and potentially fall out of some of those digital channels.

[00:08:41] The assumption sounds logical, and when I first heard it a few years back, I thought to myself, if what we're trying to do here is to increase bandwidth and unlock capabilities to better serve some of the people in our community who we see as potentially being more vulnerable, then that seems like a reasonably sound assumption and a great aspiration. But what we've found in our team, especially over the last couple of years, is that it's really useful to spend more time trying to understand the core needs of the 25% in order to design more inclusively and accessibly for everyone in the community and everyone who interacts with us.

[00:09:29] So what do I mean by this? For an organization like WorkSafe, if we break down that 25% of people who we assume are going to be high-touch or have greater servicing needs, we start to see an incredibly diverse range of backgrounds and lived experience. For example, within that 25% who interact with us, we're going to have people who come from culturally and linguistically diverse backgrounds. We're going to have people in our community who have wildly different experiences and levels of health and digital literacy. We're going to have lots of people as well with varying degrees of injury complexity, be it pre-existing injuries that they've had before a workplace injury, or the fact that they could be managing multiple injuries at the same time.

[00:10:23] And then we've also got the impact that geography and industry type play. We know from our research that for an injured worker, whether you're from a metropolitan area, a suburban area, or regional Victoria is going to have quite a big impact on your access to certain health services. We also know that different industry types have different levels of experience with workers compensation. They can also tend to have different levels of stigma, or acknowledgement, of different injury types.

[00:11:03] It's important at this point to note that some of these attributes and dimensions that we're talking about, in terms of what makes up a high-touch person, may equally apply not only to injured workers, but also to the employers they work for, the healthcare providers who manage their injuries, and also to the insurance agents, the different companies that we work with to provide that service to injured workers.

Flipping the assumption

[00:11:33] So what happens if we flip this assumption? This is what we've ended up doing in our team. What happens if we focus on designing for the 25% first? That doesn't mean that we don't acknowledge the needs of the mainstream 75%, but what if we focus on the people that we think may be more vulnerable first?

[00:11:57] I think the first thing that we discover is that the number is generally a lot higher, especially when we consider the diversity of the entire Victorian community, and the fact that really anyone managing a workplace injury generally isn't at their best. They are generally stressed, they are generally dealing with hardship, and this has a dramatic impact on their experience.

[00:12:21] I think the second thing that we definitely discover is that their needs often don't align with our assumptions about things like their channel preferences and the way they want to interact with the service. A concrete example of this: we've been doing a lot of work around designing certain digital touchpoints that would enable someone who's managing a primary mental injury with us in the future. Our going-in assumption with this work was that if a worker happened to be suffering, for example, from post-traumatic stress, or from depression or anxiety, they'd have a much higher likelihood of wanting to drop out to human services, or spend more time on the phone or directly interacting with claims managers.

[00:13:08] What we've actually found through our research is that this assumption doesn't really hold at all. We've discovered that people who are suffering from a primary mental injury are actually much more likely to interact with us through a digital channel. This is mainly because, especially in the early stages of their injury, they haven't really built up the language or the vocabulary to be comfortable discussing it with another human being, especially someone that they don't know or trust.

[00:13:36] I think the last thing that we definitely discovered by taking this approach is that focusing on the complex, and sometimes really difficult to hear, stories from people who have interacted with our scheme does tend to shape really great work. What I mean by this is not only being able to practically apply the things that we learn from these people's lived experience. There's also something else at play here: the impact tends to be in the way that it increases empathy and creates a space within the organization itself for discussing who we're really designing for, and this definitely plays into the way that we prioritize work.

Speaking to a lot of people

[00:14:28] Okay, so how do we go about actually understanding the needs of diverse audiences, acknowledging those needs, and ensuring we're designing inclusive services? The short answer, in terms of what we've learned in our team, is that we need to speak to people, and a lot of people, from across the community, and try to make sure they play an active role in the development of the work itself.

[00:14:54] To bring this to life a little bit, I want to run through some stats that I've plucked out from the work that we've been doing in the recovery team over the last 18 months. Within those 18 months, we have been developing a lot of these digital touchpoints that all workers will be using in the future to interact with us, if they have been unfortunate enough to suffer an injury in the workplace. Within that time, we've conducted over 120 or so one-on-one interviews and tests with different injured workers from a very deliberately diverse range of injury types, backgrounds and experiences.

[00:15:37] We've also spoken to over 80 healthcare providers, clinical specialists, medico-legal staff, insurance agents and employers, once again from a very deliberately diverse range of backgrounds and organizational scales and types, and diverse as well, hopefully, in terms of the split across both metropolitan and regional Victoria. And within that period, we've developed over 50 individual service interventions or prototypes that have been tested and co-designed with the Victorian working community, which is something that we're very proud of in our group.

Scaling up safely with staged pilots

[00:16:18] Okay, I'm going to talk a little bit about scaling up, and how our work progresses from early design exploration and some of the prototype work that we do right the way through to eventual implementation. At WorkSafe, like any large organization, we are constantly looking for opportunities to scale our work, to get it out faster, and to see the impact from it. But in our line of work, considering the people that we design for and the unfortunate experiences that they can sometimes be moving through, we need to be mindful of the impact, both positive and potentially negative, we could have on people's lives with any of the changes that we make. And beyond this, going back to the reminder of WorkSafe being a health and safety regulator for the state, we also need to consider really carefully the potential for reputational or political risk.

[00:17:25] So how do we go about it? The way that our work progresses from initial ideation and hunches through to a solution would be no great surprise, I don't think, to anyone who has a background in iterative design. Starting here from left to right, our team basically starts in a very divergent and exploratory space. We very deliberately do a lot of prototyping, be it digital prototyping, or service mockups, or different interventions, to try out different concepts and variations.

[00:18:00] Once we've established at least some basic desirability around the idea, we start to narrow our focus and take things into a more formal pilot state, in which we're either testing a single concept, or maybe a couple of competing concepts, in the wild. It's important to point out that for us, piloting means this is the first time that we're hitting the reality of the organization. We're actually starting to test these things out on live claims. And if we start to see the proposed impact, or we're starting to validate our own assumptions or hypotheses about what we thought would happen, we then consider investing in developing an MVP, and then, to an extent, transferring the responsibility for that work into some of our large digital transformation streams and the implementation side of the business.

[00:19:02] In that pilot stage, though, as we're starting to make things more real, we need to really carefully consider risk, and I dare say that sometimes we even need to consider the ethics of what we're doing, of testing new ideas on live claims, when we could be potentially impacting someone's recovery from a workplace injury. The way that we have decided to try and mitigate this risk is to take a very deliberately scaled approach to our pilot design.

[00:19:37] The way we go about this: if we take a look at that first bubble there, in our pilot A, we very deliberately start with a small number of claims, very small numbers. In our world, that could be as little as starting our test with only five live claims that come through our system. If the results are positive from running that pilot for a short amount of time, then we'll potentially scale the numbers, start to look at maybe 20 to 50 live claims coming through the system, and we start to look at potentially including different injury types as well as part of that pilot itself. So we slowly and very deliberately increase the scale, and our learnings, as we go.

[00:20:29] It's important to point out, of course, that in the early stages of these pilots we may not be learning enough to actually drive big decisions, because with those numbers in mind, we're probably not seeing anything at that point that's statistically significant. But what's more important for us and our team at that point in time is that we're at least learning enough to ensure that we're not doing any further harm. This is important not only in terms of recognizing that we're not doing any further harm to the injured worker involved; it's really important as well in terms of de-risking these moves for our stakeholders.

What we've learned about this approach

[00:21:12] Okay, I want to share a little bit about what we've learned about this approach so far. The first one, like I was describing, is that this is basically an opportunity for us to test in a safe way and in a safe environment. What I mean by this is not just safety in terms of an injured worker's experience, and also safety for the staff who support them, but it's also a really great way to bed down nervousness about that work and de-risk that work for our internal stakeholders as well.

[00:21:44] The other thing that we've learned is that doing pilots in this way gives us a great way to understand longitudinal impact for the first time. Up until that point of the pilot, we may have tested multiple prototypes and different interventions that are really just a snapshot in time. Using a scaled pilot approach allows us to understand what the potential impact of those products and services may be over a duration of time, and see what the impact will be on that injured worker, and on our staff members' experience as well.

[00:22:24] The last thing is that this piloting approach gives us a fantastic way to de-risk some of our capability and system assumptions. A lot of the time when we're going to pilot, we certainly haven't developed an end-to-end ecosystem yet, or have all of our ducks lined up in terms of what the future-state product or service may be. But this is a really fantastic way for us to at least test some of the core assumptions that we might have about how our core systems might work, or how this might work in the future.

[00:23:04] I want to sum up by saying that for our team, the most important learning by far is that the organization needs to be exposed to lived experience and feedback right through the design and development process. This is essentially one of the key reasons why we are very deliberate in the approach that we take to moving from early-stage prototyping through to piloting and then through to an MVP state.

Takeaways

[00:23:35] Okay, so I want to sum up today by sharing some key takeaways, a bit of a summary. The first takeaway, for me, is not to rest on latent assumptions, especially when it comes to digital transformation. I think there is a lot of talk about the promise of digital transformation, which I think is great, and I think it's fantastic that in many of our large public sector organizations, many people are on that journey. But when it comes to how we do that inclusively and equitably, we definitely have to test some of those latent assumptions about how people will interact with our public services in the future.

[00:24:21] The second thing is design for complex needs first. What we've discovered is that if you design for the complex needs first, then the other needs generally tend to figure themselves out, or at least you'll end up with a far more holistic overview of what those needs might be.

[00:24:44] The third thing is de-risk your testing by starting really small. I think this is really important, especially in quite risk-averse, quite complex large organizations. There can be a feeling of nervousness around introducing new services or products into an ecosystem, and we definitely find that starting small, learning incrementally and scaling up incrementally does help to de-risk things and bed down that nervousness.

[00:25:13] And the last thing, for me, is to use lived experience to influence culture and increase organizational empathy. I think this is an incredibly important thing when it comes to how we develop better products and services in the future.

[00:25:35] Okay, so that's all from me today. I don't unfortunately do Twitter; I'll blame Donald Trump for that one. But if you want to chat any further about any of the things that I've been talking about today, feel free to catch me at my email address or on LinkedIn. Thanks, have a great day.