Recently the members of API were discussing the difference we have observed between the design of services and the design of products. For products the product itself is visible and tangible to the customer but not the manufacturing system that made the product. We purchase and use a smart phone but have little or no knowledge of where and how it was made. Services are different. The service itself and the system to deliver the service are often tightly linked and observable by the customer, especially in professional services such as health care. One goes to a doctor's office to get treatment. The treatment is the service that is needed. The visit to the doctor's office is the means by which the service is delivered.
This link between service and delivery system can slow down innovation and improvement by distracting from the underlying need of the customer. The customer may have a need for medical treatment but the doctor's office is only one way of delivering the treatment. One method to over come this obstacle is to use a 5x (1, 5, 25, 125, 625, ...) scale up approach when designing or redesigning services. Develop ideas for a service and establish one or more prototypes. Test the prototype with 1 then 5 then 25 potential customers. The aim is to learn how well the service satisfies the need of the customers. If the 25 customers are chosen wisely, a lot can be learned for design and redesign of the service without undue constraint from the delivery system. As the scale is increased by 5x jumps, 125, 625 ... the issues associated with the delivery system come in to play. This approach allows the customer need to drive the design of the service as opposed to the constraints of the delivery system driving the service design. The delivery system design is then in support of the service which is aimed at the need of the customer.