Evaluate then improve the current process to increase the patient screening-surgery conversion rate.

Role: Business Designer
Project Type: Design Research and Service Design.
Team: Jason Lam, Zhen Xie, Francisco Porras, and Gump Huang.
Contribution: Contextual Inquiry, Ideation, and Co-creation Workshop. 
Deliverable: Report


Vision in Practice (ViP) partnered with a local hospital, Xinyimin Ophthalmic hospital in Shandong to execute the program. This screening and surgery program became the primary source of income for Xinyimin. Yet the current screening-surgery conversation rate (see.Fig.1) only brings in enough revenue to cover the cost for screen and surgery, but not the hospitals fixed cost. The outreach program was initiated by ViP, a non-profit organization with the goal to "eliminate needless blindness in China". The key to their model is:

  • actively finding potential patients by going to local villages and carrying out free screening for eye diseases.
  • identifying patients with cataract and offering various surgery options, which results in economies of scale that allow for more flexible pricing


  1. Stakeholder Interviews: determine general practices, roles and responsibilities of staff, understand difficulties and problems for surgeons, and gain perspectives on the patients perception of the process.
  2. Ethnography: observe the entire pre-surgery process, including patients who are willing or unwilling to go to surgery.
  3. Co-creation: workshop with ViP staff and Xinyimin hospital to generate concepts that can improve conversation rate and evaluate concepts.


The current model is profitable enough to sustain itself, however the program could significantly increase profitability by addressing 3 key factors.

Farming Season: farming is the primary economic activity for local villagers and is on their top priority. There are significantly less villagers attend our screening/surgery during the busy season. Every year there are two major farming seasons: May-June wheat reaping, and August-September rice harvest. However in reality, farming season can be very long and fragmented, because local farmers grow different crops and thus have different farming schedules.

Amount of Patient Volume Can Be Handled: the amount of patient volume Xinyimin can handle during screening and surgery determines how many potential paying patients the hospital can get. The key barriers here are how streamlined is the process and the number of staff available.

Structured Framework (Planning, Standardization, and Tracking): Overall, planning ahead, envision all possible problems and prepare for solutions is very important. However, what we observed is that planning is lacking in all stages of the screening-surgery process. The screening team reacts very quickly but can only deal with small portion of the problems due to limited resources at hand. Currently there’s clear work flow however the team may not fully follow the standard. At the same time, the team is very quick in adapting change but do not keep track of the change and summarize what changes really worked.




Lessons Learned

Social and cultural factors are essential

Users are complex and there are a multitude of reasons behind their behavior. To borrow an idea from Kentaro Toyama in his book "Geek Heresy",  a people-centric view is critical to create social change. In this project, we had offered free surgery to poor residents and this will still insufficient in getting people to accept our services. It wasn't until we explored issues related to trust between villagers and the local hospital that we began to find tactics that helped increase patient conversion.

design can change lives

This project holds a special place in my heart as it was my first introduction to design. The role I played was minimal and my knowledge of design shallow, but the human centered design methodology intrigued me (enough to return to grad school). In particular, I discovered how qualitative research could be used to capture behaviors and discover insights that could drive product development.