An ageing population leading to more chronic disease is straining healthcare systems. This paper makes two core contributions to healthcare systems design research: Firstly, a systemic techno-behavioural approach is presented to support intervention design with value-effective health outcomes. The systemic techno-behavioural perspective takes into consideration the interaction between three angles: The current healthcare system in place, the technological opportunities for addressing an issue and a broader and deeper understanding of the behaviour of those involved. The purpose of considering these three angels is to create interventions that are more robust. This will help inform healthcare systems design researchers and other stakeholders. Secondly, it is proposed that interventions should be grounded in behavioural theory, a collection of theories are presented to be incorporated in the design process of interventions. The systemic techno-behavioural approach is applied to dementia care highlighting the need to understand the dynamic relationship between the context of the current healthcare delivery system, technology, and behaviour to improve quality of care during the progression of the disease.
Current healthcare delivery challenges are multi-faceted, requiring multiple perspectives to be addressed using a systems approach. However, a significant amount of healthcare systems design research work is carried out within single disciplines or at best a few disciplines working together. There appears to be little deliberate attempt to draw together a wide range of disciplines committed to working together to overcome differences and tackle some of the complex challenges in healthcare delivery. In this paper, we report on the initial outcomes of such an international initiative that, in the form of a workshop held at the University of Cambridge, brought together researchers and practitioners from a wide range of disciplines to explore the foundations of a community for Healthcare Systems Design Research and Practice.
Healthcare systems are under strain, this creates a challenge for designers to develop solutions for better health and care delivery. This paper presents a sandbox of illustrative design themes used to improve health systems based on state of the art research projects. These were collated from presentations at The Second International Meeting on Healthcare Systems Design Research, held at DTU-Technical University of Denmark. Attending groups were mapped based on their research keywords, target journals and methodologies in order to gain insight on the communities research landscape.
This paper presents a systematic literature review aimed at assessing how well current technology-based interventions that focus on dementia and other cognitive impairments align with the principles of the P4 vision for healthcare: Predictive, Preventive, Personalised and Participative. A search of the SCOPUS database yielded 887 articles, of which 48 were ultimately selected for analysis. Looking at whether and how each intervention implements each "P"-principle, our results suggest a partial and non-systemic embrace of the P4 vision.Reasoning on possible explanations for this state-of-the-art, we propose that our findings represent an opportunity for the engineering design community to engage with P4-based healthcare delivery models through the development of design frameworks, new indicators for assessing the success of such healthcare delivery models, as well as tools and methods.
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