Practicing physician hired to help Kahler Slater design for health care’s future

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Dr. Manuel Hernandez, an emergency physician and health care executive, wanted to have a bigger impact on his industry so he added another job to his resume – designer and innovation strategist.

That career pivot isn’t so unusual. What is: Hernandez kept his day job, too.


Hernandez recently joined Milwaukee-based architecture and design firm Kahler Slater Inc., putting all of those credentials to work as principal of strategic innovation and co-practice leader of the health care team, while remaining a clinically active physician.

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As one of very few to maintain those roles in tandem, Hernandez sees his position as doctor-and-designer giving him unique insight into the patient experience.

“I’m living the challenges that Kahler Slater’s clients are facing every day,” he said. “Every day that I step into the emergency department to take care of patients, I’m dealing with the challenges of the U.S. health care system. I’m dealing with the expectations of our patients with respect to not only quality, but also efficiency, service excellence, cost and price. I’m dealing with the challenges physicians are facing in terms of trying to deliver health care in the new environment. So it really gives me a strong leg up in terms of understanding the challenges. It enables me to work with clients and craft better solutions with them.”

While Hernandez’s resume puts him in rare company, he said his professional journey has followed a logical path. He knew from a young age that he wanted to be a doctor.

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“I have always been excited about the prospect of helping people,” he said.

After completing medical school at the University of Pittsburgh School of Medicine and his residency at Temple University Hospital in Philadelphia, Hernandez realized he wanted to take on projects that were larger in scope.

“I really wanted to impact health care at a system level and change the way we deliver health care and the way we think about health care,” he said.

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Hernandez returned to school to get his MBA at the University of California-Irvine, initially thinking he would pursue an administrative role in a health care system or consulting agency.

After serving in those roles, Hernandez again was itching to make a bigger impact on the industry, finding it difficult to transform health care from within the system.

“I was finding that the solutions we were trying to create, they just didn’t go far enough,” he said. “They didn’t push the envelope and ask, ‘How do we change these processes in a way that delivers value in a way that hasn’t been delivered before? How do we think outside of ourselves? How do we learn from other industries? How do we learn from the health systems of other countries?’”

He found the answer to those questions by pivoting his career into the design industry.

Hernandez joined New York-based architectural firm CannonDesign, where he provided insight on health care strategy, operations, consumer experiences and facility solutions as a health market and advisory services leader.

Simultaneously, he’s been an assistant professor of emergency medicine at Penn State Health Milton S. Hershey Medical Center and an attending physician at University of Florida Health in Jacksonville. This year, Hernandez will receive his master’s in strategic design and management from Parsons School of Design in New York City.

Now at Kahler Slater, Hernandez will work with Al Krueger, vice president and co-practice leader of the firm’s health care team.

“We’re really on a mission to understand the current state of turmoil that the health care industry is in and be on a path to design the future of health care,” Krueger said. “There are so many things that are broken today in the health care system, so by utilizing the power of design and expertise and industry knowledge, and in Manny’s case, his clinical expertise and his perspective on design, there is a boatload of knowledge that we’re going to leverage at the firm.”

The other part of Hernandez’s role will be focusing on strategic innovation at the company, crafting a plan for how Kahler Slater will keep up with a rapidly evolving architecture and design industry.

“We’re not far off from the day when architecture is going to be assisted by artificial intelligence,” Hernandez said. “And we have to think very differently about what do we do as a business and how we deliver our product. That’s a lot of what I’ll be thinking about.”

While technology and procedures have become more sophisticated and propelled the industry forward in recent decades, Hernandez said, the same strides have not been made in the area of design and processes.

These days, Hernandez said, patients expect more out of their health care experience, having grown used to the conveniences of other industries, such as banking and retail.

“There are a lot of conveniences that people have now that they don’t see in health care,” he said. “We haven’t really taken the time to step back and look at things from a system level and say ‘What is it that our patients are defining as value?’ We often create solutions based on what we think our patients want and without a full understanding of what our patients actually truly value.”

Hernandez points to previous design challenges he’s taken on. Working with Hamad Medical Corp. in Qatar, Hernandez led an effort to design an emergency department capable of seeing 550,000 patients annually – one of the largest facilities in the world.

“We were designing an emergency room for volumes that didn’t exist anywhere else,” he said. “It forced us to rethink things. There would be times when people would be lined up out the door and around the building waiting to get checked in. So we had to think very differently about how you design an arrival process and a facility when you can have a situation where literally a bus pulls up and 50 or 60 laborers step off a bus and come in for various types of treatment.”

Adding layers of challenge was the fact that the emergency department served patients from 127 countries with different cultural customs that influenced the way they received care.

“We had to understand that we were also not dealing with an emergency department that functions like a North American emergency department,” he said. “There were aspects that functioned more like an Australian health care system, and others that functioned much more like a British system, some much more like an Indian health care system. So we really had to spend a lot of time learning how the people that lived in that country expected delivery differently.”

Patients in the U.S., likewise, have varying expectations of their health care experience. And the challenge for designers, he said, is to stay ahead of the curve.

“Right now, there are seven generations of patients receiving health care in the American health care system,” Hernandez said. “Our oldest generation of patients was born before penicillin was discovered. Our youngest are being born at a time when we can pretty much conduct all the business of our lives from a handheld device. Their future holds cures for cancer, cures for diseases that we may not have even discovered yet. Every new generation that comes is going to have a very different set of experiences and expectations with regards to how they want to interact with the health care system. We have to meet all these people where they are – not where we are.”

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