By Dr Noel Carroll, Data Lead, ARCH, University of Limerick

The healthcare industry is in the midst of a turbulent global transformation. Coupled with resource constraints, healthcare reform provides a natural environment in which to explore technological innovations to improve healthcare effectiveness and efficiency. Healthcare services continue to face both increased demand from an expanding population of consumer-patients and growth in costly chronic disease management. Thus, technology and software services play an increasingly dominant role in supporting the delivery of healthcare services. As a result, Connected Health has emerged as a field to support the evolution of modern healthcare services and solutions. However, there is an increasing blur between software capabilities and healthcare needs whereby technologists are now providing the solutions to support consumer wellness and provide the connectivity between patient data, information and decisions.

In recent years, there has been significant growth in software companies across the healthcare sector developing new technologies to improve healthcare delivery and services. This has given rise to the emergence of Connected Health – a new model for healthcare management. This also places considerable emphasis on the process of software development in supporting Connected Health. In addition, it highlights the growing reliance and trust we place on software to support healthcare decisions. However, unlike many other sectors, such as business and education, failure to align healthcare needs with software requirements can have devastating consequences on people’s health. Our research and experience with healthcare companies confirms the need to support software developers in clearly identifying healthcare requirements. Recent efforts on an e-pharmacy case study allowed us to examine the impact this approach has within a Connected Health context.

There is an apparent lack of insight on how healthcare requirements are mapped onto software requirements, which, if ill informed, can have a devastating effect on people’s health. For example, we often support technology companies in improving their evidence-based research and identify healthcare needs using technological solutions. However, there is a lack of an established framework to guide software developers in identifying healthcare needs. Our research and experience with healthcare companies indicates the need to establish a Connected Health Innovation Framework to both a) support software developers identify healthcare requirements and b) extend and enrich traditional software requirement gathering techniques. We propose that this should be done using Design Thinking principles.

The Bridge: Design Thinking
Design Thinking provides a formal process to capture people’s various needs or pain-points. Therefore, this is particularly apt to guide our research in identifying healthcare innovation requirements. Such guidance is vital since innovation enabled through healthcare software development has much at stake, most notably patient safety. Our research suggests that Design Thinking moves beyond requirements gathering and being constrained by preconceptions of software solutions in isolation. It supports our ability to gain rich insights on the Connected Health case studies, e.g. e-pharmacy. This worked well for us in a pharmacy project recently completed within ARCH. In fact, Design Thinking adopts five key phases (Figure 1) guiding innovation through: 1) empathising to fully understand the experience of the pharmacists, 2) defining a wide variety of possible e-pharmacy solutions, 3) ideating creative e-pharmacy solutions, 4) prototyping ideas into tangible form, and 5) testing to refine and examine the value/impact of e-pharmacy solutions. This fosters a learning lifecycle through various actions about both the solution and informing how we can bridge our understanding of healthcare needs and the software design process.

As a delivery model for health services, co-production is considered to be a key process for sharing information and decision making between the service users (i.e. patient) and healthcare providers. This led us to examine the promise of Design Thinking and how we can better inform technology innovation in a Connected Health context. This differs from software requirements engineering, which guides the process of eliciting individual stakeholder requirements meaning that once it gets to the user it improves the level of engagement and uptake of the technology. We discovered the need to adopt a new stage in pre-requirements gathering to inform software developers of specific healthcare needs and how software requirements can be best aligned with those needs.

Figure 1. Overview of Design Thinking Phases

To guide our efforts, we adopted Stanford University’s D-School Design Thinking method to initiate the research. This Design Thinking process offers a formal approach for practical, creative resolution of barriers, which can guide improved healthcare software solutions. This approach also supports Connected Health solutions development and can reduce the risks of failure through our framework for healthcare innovation. Through the five Design Thinking phases, we examined the benefit of using the following key activities in software requirements. The development of the Connected Health Innovation Framework was influenced by the need to structure how we gather healthcare needs from Connected Health research developments and bio-design literature in order to support software requirements in healthcare technology innovation.[/imageframe]

The Design Thinking phases provided a bridge to guide both healthcare needs and software requirements for Connected Health opportunities. Focusing on hospital pharmacy services we analysed the various day-to-day operations of the existing system, subsequently identifying opportunities for improvement. We proposed a patient-focused system for timely medicines management (e.g., reduced medicines supply, lead-time from prescription to administration). We argue that, in order to facilitate an e-health eco-system in Ireland, both hospital and community pharmacy will play a pivotal role. We demonstrate this through our e-pharmacy case study, highlighting the need to introduce a new approach through Design Thinking. This supports software engineers in learning about healthcare needs (i.e., intangible factors) and supports healthcare professionals in learning about software solutions (i.e., tangible developments). Noel would enjoy the opportunity to expand on this work and would encourage you to contact us or check our upcoming events to get more insights on our current projects.

Additionally, if you have any questions or wish to collaborate on any specific aspects of Connected Health design and developments, please feel free to contact me at noel.carroll@lero.ie or our Centre Director, Michael O’Shea at moshea@arch.ie to explore other opportunities.

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