Digital NHS needs to take the lead from design
Mark Curtis, chief client officer at service design consultancy Fjord, discusses why design should be top of the agenda when creating digital healthcare products
In an increasingly paperless world ruled by screens and devices, digital innovation has become integral to the management of our daily lives. Why should healthcare systems be any exception? It’s time for the managed healthcare sector to pick up the pace in terms of the service it offers its patients. It's clear that digital can – and will – revolutionalise the health and wellness sector, from the advent of wearable technology and digital diagnosis, to the digitisation of health records and treatment models. The UK government’s recent plan to invest £260m in the NHS for hospitals to replace paper patient notes and prescriptions with online systems is just one part of the huge leap by healthcare professionals towards digital. However, it’s not enough to simply digitise; in order to create a service that will be successful for Britain’s growing population, the government will need to consider innovative design at the crux of its strategy.
With today’s data revolution in full swing, many organisations are now compiling information about our bodies; from fitness apps like Nike Fuelband to scales such as BodyTrace, our data is quantified and delivered to us like never before. However, the flip side of this is that it can lead to data fatigue. To minimise this effect we need to design services for ‘the glance’, making information easier, quicker and clearer to interpret. This can be achieved through effective visual design. For example, at Fjord, we have recently worked with a Harvard Medical School-funded SMART Project to redesign North American paediatric growth charts, as research had revealed that many doctors and parents found current tools to be unclear. Growth charts are present in nearly every paediatric appointment and yet existing models did not suit because they had failed to consider doctor and patient needs in their design. In approaching the growth chart’s redesign, we sought to find ways to explain the importance not just of each measurement, but how these measurements related to each other. We relied on visuals to aid the conversation between doctor and parent around a child's development. By taking a design-led approach we were able to create an interactive paediatric growth chart app that can be easily read, understood and shared between doctors and parents.
Likewise, in undertaking a full digitisation of the health system, it is imperative that the NHS places the actual needs of healthcare practitioners and patients at the heart of its design. Recent reports have shown that healthcare professionals feel disconnected with today’s electronic health records (EHRs) because currently, they are not optimised to help doctors get a quick and accurate overview of patients’ health patterns. The new NHS digital records service should ensure that the information is presented in a way that is well suited to doctors’ needs – most importantly, the need to easily share and explain information to patients using clear data visualisations. When designing the new digital system, the NHS will have to take careful steps to avoid the service from becoming a disappointing, ineffective repeat of existing EHRs.
Changing relationships
Today’s digital tools allow us to quantify behaviour, from the food we eat to the exercise we take. These tools enable us to understand our own bodies in more detail and gain useful insight into our health patterns, yet this inevitably alters the doctor-patient relationship. It raises the question: if all personal health records and diagnostic tools are available online, will we even need to visit the surgery? New technologies that provide detailed insight into our bodies will also provide doctors with an informed view, but equally run the risk of upsetting the balance of patient consultation if not implemented correctly. As patients’ medical data moves online, doctors will need to adapt to a new type of consultative role. Technological advances may be able to help doctors to maximise their time and provide more efficient diagnoses, but this can only be achieved if the digital service is clear and easy to use, both for doctors and patients.
As new technologies equip doctors with the tools to more effectively interpret the increasing amount of available patient data, it is no longer enough to design a digital system for a sector in isolation. To create effective medical software, doctors, engineers and designers must all be consulted throughout the development process in order to fine tune what is required to make the service usable and capable of addressing health practitioner and patient needs. By interviewing doctors and incorporating their feedback into the design process, healthcare organisations can create services that truly meet the needs of their staff and the patients they serve. Traditionally, the development of medical software has been led by engineers, with design nearly always an afterthought. However, in order to better fulfil the needs of patients and doctors with emerging digital technologies, the NHS must consider design at the centre of the service, or risk ending up with an ineffective and alienating service. After all, fundamental access and understanding of our health and treatment is something we all deserve.
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