MIT Sloan Health Systems Initiative

Agile Collaboration Improves Health Hub Design Adoption


Traditionally, the model for developing and introducing technology is a sequential process. The vendor builds a product and delivers it in its final form to the organization. It is up to the users to adapt themselves to the technology, which may or may not fit in well with their needs. In this model, organizations are likely to overinvest in technology that may not fulfill their expectations.

What’s New

Perhaps a better, albeit a more time-consuming, method for an organization, is an integrated iterative method where technology designers work with end users to develop the product. This is known as the “agile” approach.

There are many potential benefits to the agile or co-design method. The technology can truly address users’ challenges and fit into the workflow with minimum disruption. Users can try out new features to see if they add value prior to a full rollout. Developers may suggest additions that users hadn’t considered that may be useful. This collaboration brings the best of both the developers’ and the users’ knowledge to the final product.


Three members of The Task Force on the Work of the Future, Professor Thomas Kochan, Senior Lecturer Barbara Dyer and MIT Integrated Design & Management graduate Anubhav Arora focused their research on Kaiser-Permanente Southern California’s (KPSCAL) regional Health Hubs. Their working paper covers the range of issues related to the design and implementation of this initiative. One section is devoted to Human-Centered Design and the development of the technology system that would sit in the center of the new Health Hubs.

Key to fostering acceptance of the new IT system was having the people who would be using it deeply involved in the design. This is a process that took months and was not rushed since building this foundation well was crucial to the clinics’ success. Every detail was crafted and tested with care. To get a sense of how the technology would affect workflow, they built a walk-through design studio to simulate the experience of giving and receiving care. The researchers noted “the full array of “users” was engaged in the process from the start as work systems, space, and technology designs were considered as reinforcing elements”. (page 12)


There are several benefits to this method of technology design. For example, an increase in employee and patient satisfaction, less cost in time and money for revisions, and ease of rolling out similar systems within similar units in the company.

A Kaiser Permanente senior IT manager remarked “In IT we have learned that we have to be clear on what business problem we are being asked to help solve and not to just accept the vendor’s product. We learned from prior experience the problems that arise when this is not done well. We’ve been getting much better on this in the last five years—we try to make sure of the change process up front, engage in human-centered design, have clear quality outcomes, and bring in the front line.”

Kaiser Permanente is a bit of an outlier in the health provider landscape. It is intensely patient focused as demonstrated by their initiative, Imagining Care Anywhere . Rather than a fee-for-service model, KP allots a fixed amount of money per patient. They also have a very strong labor union whose representatives are in frequent communication with management. The implications of these specifics may result in it being difficult to replicate their processes. However, as demonstrated in the working paper, there are many innovations and ways of thinking about work that could inform changes in other organizations both within healthcare and beyond.