Implementing changes to digital health systems in real-life contexts poses many challenges. Design as a field has the potential to tackle some of these. This article illustrates how design knowledge, through published literature, is currently referenced in relation to the implementation of digital health. To map design literature’s contribution to this field, we conducted a scoping review on digital health implementation publications and their use of references from nine prominent design journals. The search in Scopus and Web of Science yielded 382 digital health implementation publications, of which 70 were included for analysis. From those, we extracted data on publication characteristics and how they cited the design literature. The 70 publications cited 58 design articles, whose characteristics were also extracted. The results show that design is mainly cited to provide information about specific design methods and approaches, guidelines for using them and evidence of their benefits. Examples of referenced methods and approaches were co-design, prototyping, human-centered design, service design, understanding user needs and design thinking. The results thus show that design knowledge primarily contributed to digital health implementation with insights into methods and approaches. In addition, our method showcases a new way for understanding how design literature influences other fields.

With the current strain on the healthcare service, wearable technology presents a solution. However, there is a lack of adoption from user groups due to a focus on clinical and financial factors. This study explores the implementation of positive design in medicine, outlining contributing factors to positive emotional experiences. Using a qualitative methodology in the form of semi-structured interviews with users and experts, a construct was defined consisting of five key psychological needs, including control, stimulation, competence, social factors, and purpose & growth.

This study surveyed 190 healthcare professionals to examine attitudes towards reusable surgical gowns, aiming to reduce medical waste. Comfort (scoring 5.32 out of 7) and misconceptions about gowns serving as personal protective equipment (87% hold this belief) are crucial influencers. External motivators, trust, emotions, and workload also impact perceptions. The study recommends enhancing reusable gown design for comfort, multifunctionality, and hygiene trust. It calls for communication strategies to normalise reusables in healthcare and urges a transition to sustainable practices.

Despite technological and medical advances, amputations continue to increase. Amputees face significant challenges when acquiring and using prosthetic devices, challenges which are made worse as their emotional needs, aspirations, mobility, prosthesis requirements and problems change over time. These challenges require custom solutions for each individual amputee, a fact that current amputee centered prosthesis services tend to ignore. The work reported in this paper contributes an AI based Prosthesis Development Service Framework to cater for the current and evolving needs of amputees.

The paper explores the integration of emotional design elements in the development of medical devices to enhance user acceptance and adherence. It emphasizes the importance of a user-centered approach, acknowledging both functional and emotional needs. The study compares two cases within healthcare design, highlighting the impact of emotional design on users' perception of medical devices. Despite the different stages of development in the two cases, both employed a higher level of refflective design, aiming to create a lasting impact on users' identity using the products.

Recent clinical trials have successfully slowed Alzheimer's disease dementia progression, but only in early-stage patients. Society must therefore shift to early diagnosis. By framing this is as an engineering design challenge, we argue that a systems approach will identify solutions by providing the means to validate dementia medical technologies from multiple levels and perspectives: society, government, public health, healthcare, and patient ecosystems. We show that new data-enabled design methods can facilitate these different granularities of thinking and outline the need for designers.

Challenges in implementing digital health in clinical practice hinder its potential. The complexities posed by implementation could benefit from using design practices. To explore the current role of design practices in digital health implementation, designers in the Netherlands were interviewed. The preliminary results indicate that designers contribute to digital health implementation processes, especially in the early stages. Design practices are mainly used for engaging the users, testing concepts, aligning the ideas of stakeholders, and adapting interventions to fit within the contexts.

Wearable devices have some shared characteristics. They should conform to the wearer's size and shape, not interfere with desired activities, perform intended functions, be easily usable and comfortable, among others. Due to these shared characteristics, a common design methodology should be possible for designing wearables that assists designers in taking a systematic approach. We propose a configuration design method for wearables and sketch its elements. An example of a family of passive exoskeleton suits that assists with walking is presented to illustrate the configuration design process.

eHealth development faces the challenge of generating evidence about health effectiveness in real-world settings. Designers can potentially support this challenge but must understand health approaches to evidence generation about health outcomes. This case study investigates how health and care professionals conceptualise health outcomes and their evidence generation in eHealth. Our results identify three key conceptual dimensions: effect, meaning, and collection. We discuss how these inform future design competencies to support evidence generation about health outcomes in eHealth design.

NHS Scotland, one of the keystone healthcare providers in the UK, have recently set a wide variety of sustainability targets in an effort to mitigate waste and the intensive energy demands of healthcare. Medical garment production, management and design is an area in which design researchers can explore and offer solutions. This paper presents a series of co-design explorations to examine design alternatives to single-use theatre caps, the majority of which are currently disposed of routinely. Using a series of probes, major insights into how theatre cap design may be improved is presented.

This study addresses the challenges of the ageing population, focusing on enhancing the life of caregivers and the elderly. It proposes a multifaceted solution that allows dependents to live close to their carers, enabling oversight without a need for constant presence. The paper employs empirical studies to ensure a deep understanding of caregiving, capturing the breadth and depth of challenges. Presenting a novel design solution, Hygge, combines physical and system design with technology integration. This prioritises accessibility, cost, maintenance, and adaptability for diverse needs.

This paper addresses challenges in pediatric urotherapy, focusing on low patient compliance and motivation. Informed by creative sessions with children aged 9-13y, a novel urotherapy ecosystem concept is designed. It includes a smart drinking bottle, context-aware reminder watch, home uroflowmeter, smartphone app, and clinician portal. Interconnected products, embodied interaction, stigma-free design, and a digital training buddy aim to enhance engagement, motivation, and patient experience. This concept showcases the potential of integrating diverse design methodologies in healthcare design.

A wide range of disciplines are directing their methods and tools to help address the challenges of healthcare. Chief among these are design and operational research (OR). Though they have much in common, these two disciplines have existed in isolation for most of their history and there is currently a gulf between the two research communities. In this position paper, we rapidly review the contributions of design and OR in healthcare. We then identify similarities and complementarities between the two disciplines and communities when they consider healthcare systems. Finally, we propose practical steps to enable better collaboration. Our focus is on finding ways in which the two disciplines complement each other. When applying design to healthcare services, designers may wish to learn from OR, which has a long history of supporting improvements in healthcare organisation and services, particularly using quantitative data and analysis and modelling methods. In return, design has distinctive qualities that could augment the OR approach, such as its emphasis on wide and creative search for potential solutions, and iterative co-production and prototyping of solutions with clients. Better collaboration will require a coordinated effort but could yield a more comprehensive and effective approach to improving healthcare systems.

The concept of Health Systems is ubiquitous in the healthcare literature. However, the question ‘what is a Health System’ is not easy to answer. The emerging field of Health Systems Design is by nature multi-disciplinary, involving several disciplines with different ontological commitments and diverse perspectives and interpretations of health and system. To avoid confusions in communication and facilitate engagement between the design and health communities, it is important to begin an open exploration of the fundamental concepts of Health Systems. This paper is a first step in that endeavour

How does change occur in healthcare settings? In this paper, we take a design-based approach to healthcare research. From researcher-patient interactions to information sharing between practitioners, we examine how clinical research can mediate a change of routines and illuminate potential new system structures. Using a hospital-based cognitive care clinic as an example, we demonstrate how the inclusion of new actors, tools and resources was able to shed light on the prevalence of hearing loss among mild cognitive impairment (MCI) patients and lay the framework for new care pathways.

User experiences of atypical conditions leading to adverse events have the potential to discover latent user needs and improve usability in design outcomes. This study introduces atypical scenarios as a design intervention to student designers working on healthcare product design projects. These atypical scenarios are framed from real-world clinical experience related to individual projects. 40 participants from a healthcare product design course comprising of 8 teams were involved in this study. Results indicate a positive influence on design and designers in terms of usability in the design process.

Occupational therapists modify mass-produced and universally-designed assistive technologies (ATs) to fulfill the specific needs of people with disabilities. We interviewed ten occupational therapists with experience in modifying ATs in order to understand adaptation processes. Our findings reveal the reasoning behind adaptation, common ATs that require adaptation, as well as the collaborative nature of adaptation. We propose a new framework called Adaptable Universal Design (AUD) that blends Universal Design with the need to adapt ATs in order to fulfill unique and specific user needs.

This paper presents an open-source novel intravenous cannulation task trainer developed during the Covid- 19 pandemic for unsupervised clinical skill practice. Multiple user errors were uncovered when observing 13 registered nurses using the task trainer during a two-hour unsupervised skill training session. These insights raise the question of how OSH needs to share more than just device descriptions and assembly instructions- as designs are being shared only in its current state of an ongoing project, sharing insights, user errors and test results should be encouraged and prioritized.

Healthcare services have evolved with advances in science, technology and societal needs. Despite being around for two decades, 'X-ray at Home' has seen limited adoption. Understanding its enablers and disablers can lead to insights to develop an accessible healthcare service ecosystem. Healthcare organisations have adopted design thinking to develop new products but healthcare service design is still in its introductory phase. This qualitative study describes the current state of home X-ray services in Mumbai and proposes touchpoints for raising awareness, acceptance and patient experience.

The use of serious games is more and more popular in the medical filed, mainly for home-based rehabilitation therapy. In this context, some design principles were already proposed. Designing serious game for evolution diseases assessment is challenging and necessitates a new approach of this principles. Working with physiotherapists at the origin of the Motor Function Measurement assessment scale, the development of a dedicated serious game is proposed based on new contextual principles.