The healthcare sector is a highly regulated environment that is subject to numerous constraints. Standards around medical protocol, medical device certification, and data protection ensure that the wellbeing and privacy of patients is protected during all encounters with the healthcare system. However, a gap has opened up between the need to meet these constraints, improve performance, and also deliver good patient experience. For example, the medical protocol for hypertension during pregnancy establishes a set of clinically validated treatment guidelines, but does not consider the unique nature of patient experience. We assert that design research principles can be used to create visual tools that pay homage to these constraints and performance improvement goals without compromising patient experience. In this paper, we describe such a tool that has been developed during a healthcare project using a human-centred design research approach. The integrated tool for patient journey mapping addresses the shortcomings of existing methodologies by supporting multidisciplinary practitioners in designing healthcare solutions that meet the demands of existing constraints, performance improvement, and patient experience. In addition, we document how patient journey maps were used on the project to facilitate collaboration among a team of multidisciplinary stakeholders.

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The minimum viable product (MVP) is a fundamental concept of the Lean Start-up approach as it enables a company to quickly start the learning process by integrating feedback from early adopters. Although the MVP concept has evolved over the years, its application is most often reported in a start-up context, even though established companies struggle to develop MVPs. This study reports on the experience and lessons learned at Texuna Technologies, an established company, where the software product innovation team created a process map for developing MVPs. This is the first study that allows the original MVP approach to be extended and applied to established organisations.

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Background Health information technology (HIT) and associated data analytics offer significant opportunities for tackling some of the more complex challenges currently facing the health care sector. However, to deliver robust health care service improvements, it is essential that HIT solutions be designed by parallelly considering the 3 core pillars of health care quality: clinical effectiveness, patient safety, and patient experience. This requires multidisciplinary teams to design interventions that both adhere to medical protocols and achieve the tripartite goals of effectiveness, safety, and experience. Objective In this paper, we present a design tool called Integrated Patient Journey Mapping (IPJM) that was developed to assist multidisciplinary teams in designing effective HIT solutions to address the 3 core pillars of health care quality. IPJM is intended to support the analysis of requirements as well as to promote empathy and the emergence of shared commitment and understanding among multidisciplinary teams. Methods A 6-month, in-depth case study was conducted to derive findings on the use of IPJM during Learning to Evaluate Blood Pressure at Home (LEANBH), a connected health project that developed an HIT solution for the perinatal health context. Data were collected from over 700 hours of participant observations and 10 semistructured interviews. Results The findings indicate that IPJM offered a constructive tool for multidisciplinary teams to work together in designing an HIT solution, through mapping the physical and emotional journey of patients for both the current service and the proposed connected health service. This allowed team members to consider the goals, tasks, constraints, and actors involved in the delivery of this journey and to capture requirements for the digital touchpoints of the connected health service. Conclusions Overall, IPJM facilitates the design and implementation of complex HITs that require multidisciplinary participation.

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Boundary objects are physical and abstract artefacts which support team interactions across diverse knowledge domains. Despite their relevancy, research into the effectiveness of boundary objects in agile distributed ISD remains nascent. In this paper, we develop a framework to theorize their effectiveness in generating cohesion within distributed teams. Our indepth case study finds that their effectiveness is influenced by the nature of the boundary objects themselves but also by team members' willingness to address differences in contextual factors. We identify three contextual factors -structure, identity, and culture -that are critical to supporting team members crossing knowledge boundaries within distributed teams. Furthermore, findings suggest that while boundary objects can indeed foster team cohesion in agile distributed ISD, there are other less explored aspects to their role. For example, we find that boundary objects can be useful for enabling constructive team conflict.