Outcome-based Design
Design today is thought of in terms of the user.  How the user interacts with the product or service is the user’s experience.   We call this user experience design.  We measure the success or failure of a design using tools like SUS (how well a user can use it) and NPS (how likely they are to recommend the product or service).  

I’ve spent the last year working on a project that aims to provide better healthcare to patients by allowing them to log their symptoms every day and then a doctor can review the data and provide care even when the patient is not in the office.  Throughout the course of the project, I often heard doctors refer to the health of a patient as their “outcome”.  A patient outcome can be good or bad.  For awhile I simply mentally mapped patient outcome to user experience.  It made sense that the patient’s experience with the healthcare system was basically tied to their outcome.  

But over time I realised that patient outcome was not the same as patient experience.  Patient outcome is much broader than their experience.  I came to realize that when a doctor was talking about patient outcomes, they weren’t just talking about the patient’s interaction with the healthcare system.  A patient’s outcome was not just the result of their interaction with the healthcare system and the care that the doctor provided.  It was more than just them taking their medications and following the doctor’s orders.  It was the sum total of everything that a patient does or thinks that leads to their current health outcome.  In other words, the patients outcome wasn’t just the result of the patient’s interaction with the healthcare system (which includes, their doctors visits, their ability to get medications, their interactions with the insurance company, etc).  It also included the patient’s attitudes and habits, their environment, including social and economic factors, where they live, their culture, their beliefs, even their interactions with friends and family.   Everything and anything at all that can affect a patients health was a factor in their outcome.   And with this lens we can see that healthcare professionals understand that what they do, the actions they take to keep people healthy is only a small part of the equation.  A successful outcome is a confluence of factors, many of which the doctors are unable to change.

Let’s apply this to product design:  Let’s say you’re building an e-commerce site that sells clothing.  Your current user experience metrics tell you you’re designs are successful if the user converts, i.e, if they purchase something.  But did the person have a successful outcome?  To answer this, we must know what the outcome was intended to be.  A person doesn’t just buy a piece of clothing because they feel like it.  They want it for a reason.  Maybe a person buys a new dress because they want to look great and make an old boyfriend jealous at their upcoming high school reunion.   In this case, a successful outcome doesn’t stop at the purchase.  A successful outcome is a combination of factors including how the person feels about themselves in the dress, how much it costs, how do other people react to them when they’re wearing it.  

Knowing what a successful outcome should be allows us as designers to think more broadly about how our products and services are designed.  Its similar to taking a jobs-to-be-done approach, and really understanding the social, emotional, and functional needs that affect a person’s decision.  If we think about a person’s desired outcome, then we can design solutions that transcend the person’s interaction with our product or service and resonate with them at a more meaningful level.