This paper proposes a categorization of existing approaches to healthcare-related engineering design based on systems thinking principles. Three existing approaches to healthcare-related engineering design are isolated which contribute differently to health systems fundamental purposes and interconnections. The three approaches are labeled as 'silent', 'overt', and 'convergent' health design. Each approach is defined and illustrated through an example. Following, practical advantages and disadvantages of each approach are discussed. A reflection is offered on the expected relevance of the convergent health design approach for present and future societal challenges in the health domain, and specifically on the recently growing field of e-health. Finally, open methodological challenges related to convergent health design are outlined and characterized as opportunities for future research.
Background Remote patient monitoring (RPM) interventions are being increasingly implemented in health care environments, given their benefits for different stakeholders. However, the effects of these interventions on the workflow of clinical staff are not always considered in RPM research and practice. Objective This review explored how contemporary RPM interventions affect clinical staff and their workflows in perioperative settings. Methods We conducted a scoping review of recent articles reporting the impact of RPM interventions implemented in perioperative settings on clinical staff and their workflow. The databases accessed were Embase and PubMed. A qualitative analysis was performed to identify the main problems and advantages that RPM brings to staff, in addition to the approaches taken to evaluate the impact of those interventions. Different themes were identified in terms of the challenges of RPM for clinical staff as well as in terms of benefits, risk-reduction strategies, and methods for measuring the impact of these interventions on the workflow of clinical staff. Results A total of 1063 papers were found during the initial search, of which 21 (1.98%) met the inclusion criteria. Of the 21 included papers, 15 (71%) focused on evaluating new RPM systems, 4 (19%) focused on existing systems, and 2 (10%) were reviews. Conclusions The reviewed literature shows that the impact on staff work experience is a crucial factor to consider when developing and implementing RPM interventions in perioperative settings. However, we noticed both underdevelopment and lack of standardization in the methods for assessing the impact of these interventions on clinical staff and their workflow. On the basis of the reviewed literature, we recommend the development of more robust methods for evaluating the impact of RPM interventions on staff experience in perioperative care; the adoption of a stronger focus on transition management when introducing these interventions in clinical practice; and the inclusion of longer periods of assessment, including the evaluation of long-term goals.
UNSTRUCTURED Patient and staff experience are vital factors to consider in the evaluation of Remote Patient Monitoring (RPM) interventions. However, the current landscape of patient and staff experience measuring in RPM suffers from a lack of methodological standardization, affecting the quality of both primary and secondary research in this domain. In this research, we aim to obtain a comprehensive set of experience constructs and corresponding instruments used in contemporary RPM research and to propose an initial set of guidelines for improving methodological standardization in this domain. A systematic review is conducted on recent articles reporting instances of patient or staff experience measuring in the RPM domain. The obtained corpus of data is explored and structured through correspondence analysis, a multivariate statistical technique. The systematic review shows that the research landscape has seen sizeable growth in the past years, that it is affected by a relative lack of focus on the experience of staff, and that the overall corpus of collected measures can be organized into four main categories (service-system-related experience measures; care-related experience measures; usage and adherence-related experience measures; and health outcomes-related experience measures). In light of the collected findings, we provide a set of six actionable recommendations to RPM patient and staff experience evaluators, both in terms of what to measure and how to measure it. Overall, we suggest RPM researchers and practitioners develop integrated, interdisciplinary data strategies for continuous RPM evaluation.
This contribution explores the potential of lead user research for early-stage designing for intelligent ecosystems through a literature review and a single case study concerning a lead user research initiative on blood pressure monitoring. The results suggest advantages of executing lead user research in early-stage designing for intelligent ecosystems from the points of view envisioning broad initial ecosystem boundaries, developing first intelligence components, and overcoming research challenges related to technical issues.
This thesis presents a research and subsequent design intervention developed in the context of a Design for Interaction graduation assignment called Effortless interactions in Emergency Care.The design process was characterized by a strong focus on analysis, and in particular on user research, which included intense inquiry activities such as direct observation of ambulance shifts. After an iterative conceptualization phase, a final product idea was detailed and its interaction tested with real users. The thesis is concluded with a set of and conclusion and recommendations.
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