Science, Society, and Excellence by Design
Michael Specter does a nice job reminding us of the importance and value of science based understanding and decision making. I highly agree with his concern that while the world has become more connected and more capable, and science has contributed so many advances, there are many people who are still willing to believe falsehoods or unsubstantiated theories, and confuse issues of facts and science, with policy and politics.
This is important to understand for the Designer, because while good design should be rooted in facts, science, and engineering, it must also face the reality of populism and politics. Take health care information technology, or genetically modified foods as two good examples. Both are subjects for which there is a rich and broad potential for designing solutions and improvements that can benefit mankind, yet both are subjected to highly charged debate, filled with both prejudice and confusion.
One must be careful to understand and differentiate between the science/engineering/fact based aspects of the design, and those aspects that are not so grounded. This does not mean the political/emotional/prejudicial is unimportant. It simply means be careful to distinguish the two and address each appropriately.
I have found this in many types of design challenges. When doing process reengineering for example it is easy for an organization to act with fear at the idea of simplifying operations. The facts/science/engineering may show a far better method of organizing work execution, yet the designer must be cognizant of the potential for the organization to resist the changes for reasons that are factually groundless even if personally very real. This is a trivial example.
The examples Michael discusses are real and much larger, and as a human race we must become more skilled at dealing with this challenge because, as science capabilities accelerate (and they are/will due in great degree to the advancements in computer technology) the opportunities for improvement…and debate, will increase.
Several hundred years ago the world debated the science that said the world was round. This one argument was one of the few, and went on for many decades. Today such scientific discoveries happen all the time, and have much greater consequences. As a society we must become skilled at the process of learning about, absorbing, accepting, and reacting to, this increasing pace of scientific advancements.
So Excellence by Design should not only include design based on the underlying principles of science/engineering, must also take into account the very possible and in some cases likely resistance to the design.
Excellence by Design 
If you happen to have an innovation project in play for the health care industry (which would be great), don’t forget to factor in Doctor compensation. Like everyone else,they seem to be gathering funds from wherever they can. e.g. “Health TV” infomercials, drug company magazines instead of Reader’s Digest in the lobby, and possibly payments systems based on volume instead of care.
Think of a doctor that accepted e-mail queries… 85% of the time I need to talk to a doctor, that would be the fastest way. For instance “Hey Doc… I caught poison ivy again, can you send in a zip pack order for me?”. I’ve had poison ivy a dozen times, its the same treatment each time. I know what it looks like, there is little point to having him look at me (and me spend 2 hours in the waiting room). This would be great, but how would he be paid? No co-pay is collected, no paperwork to submit to insurance companies – just quick health care.
I’d be happy to pay my co-pay online, but something would need to be worked out with the insurance companies. Heck, I’d be happy to send him a photo of problem presuming we did this asynchronously (preferred). Lots of fraud potential though.
Still, its easy to envision systems that would make this trivial for the doctor: His system receives an e-mail. Based on address it pulls up my medical records. A keyword scan of the e-mail catches poison ivy and cross references my medical records so that he see its a reoccurring problem for me. A cross-check with my insurance company verifies I’m still covered. My records reveal my local drug store. He reads the e-mail, confirms the keyword scan and that this is routine, clicks the ‘resend’ button for my previous prescription and is done. In the background my credit card is billed for my co-pay, medical records are updated, the insurance company notified, and I get a reply e-mail indicating the prescription request has been sent to my normal pharmacy.
Seems reasonable doesn’t it? For me, I get service via an e-mail. For the doctor, it took 30 seconds not 10 minutes of “Hi, how are you doing today?”. His office size could be cut in half. Most importantly, he gets paid!