Journal of Design, Business & Society - Design for Medicine and Healthcare, Oct 2020

This article explores how co-design was used to engage young people in the design of a new brand identity and online platform for the Auckland District Health Board’s Peer Sexuality Support Programme (PSSP). Unlike conventional branding practices that do not generally engage users as co-creators in the early discovery stages of the design process, in this research young people were brought into the design process as informants and co-designers. This drove both brand strategy and touchpoint design, positioning the brand to be better accepted by the young people involved in the programme. A series of discovery and evaluation co-design workshops, with a diverse range of PSSP youth leaders, offered game-like interactive activities and the opportunity for open discussions. Engaging young people in fun and meaningful ways helped them uncover and share insights that could only be possible by directly involving them in the design process. The outputs of this co-designed brand – FRANK – incorporated a full visual identity and a proposal for an online platform. The final brand design elicited strong positive responses from PSSP youth leaders, highlighting the importance of involving young people in the design of products and services that address issues affecting them.

Advanced three-dimensional (3D) design and engineering technologies have revolutionized patient-specific implants, prostheses and medical devices, particularly in the cranio-maxillofacial and oral medical fields. Lately, decreasing costs, coupled with the reported benefits of bringing design and production technology closer to the point of healthcare delivery, have encouraged hospitals to implement their own 3D design and engineering services. Most academic literature reports on the factors that influence the sustainable development of such services in high-income countries. But what of low- and middle-income countries where demand for custom craniofacial devices is high? What are the unique challenges to implement in-hospital services in resource-constrained environments? This article reports the findings of a collaborative project, Co-MeDDI (Collaborative Medical Device Design Initiative), that brought together a UK-based team with the experience of setting up and running a hospital-based 3D service in the United Kingdom with the Maxillofacial Department of a public hospital in the Uttar Pradesh region of India, which had recently received funding to establish a similar capability. We describe a structured design research approach consisting of a series of exchange activities taking place during the lifetime of the project that compared different aspects of the healthcare innovation ecosystem for 3D services in India and the United Kingdom. Based on the findings of the different activities, we identify key factors that influence the adoption of such services in India. The findings are of relevance to healthcare policy-makers and public hospital managers in resource-constrained environments, and to academics and practitioners engaging in collaborative export of healthcare initiatives.

Translational design is an increasingly important objective for universities as research institutions are seeking to play a more active role in the commercialization of fundamental medical research. Practice-based designers working within these academic contexts have a skill set that positions them to make a contribution to translating fundamental research into real-world applications. Real world applications of research that are informed by the needs of end-users and actioned through the creation of medical device prototypes. The translational designer’s toolkit includes a range of methodologies, frameworks, procedures and processes to identify problems, conceptualize ideas and create functional prototypes. Progressing research towards commercialization through prototyping is one of the most important skills leveraged by translational design researchers. This article details two case studies of practice-based design research within a large Australian university. It discusses the role of design prototyping as a key part of a lean and integrated development process that relies on accumulative rounds of iteration and interdisciplinary collaboration mediated through artefacts. Design prototyping is used within these projects to bring ideas to life and enable more effective communication between diverse stakeholder groups spanning across academia and industry, and across the boundaries of research and application. This article unpacks the key role of prototyping as a translational tool to iteratively test, refine and conceptually verify ideas, while additionally providing boundary objects for effective communication. This discussion addresses the benefits and limitations of prototyping as a translational tool, including the ability of prototyping to save time and development costs, explore constraints and trade-offs, and communicate with industry partners and end-users through tactile objects and/or real experiences. Design prototyping is an efficient and effective process that embraces failure in early stages of development, where the consequences are limited and the benefit substantial. The article explores how prototyping can provide the backbone to industrial design researchers working in translational contexts to drive development to real-world application and to effectively engage with research end-users.

Purpose/audience: this study targets designers, clinicians and biomedical engineers who are involved in digital surgical planning and patient-specific medical device design, either in hospitals, universities or companies. A commonly accepted, standardized design process does not exist in this specialized but highly variable field, and this can make regulatory compliance via the implementation of quality standards more difficult. Methodology/approach: an article-based design pro-forma was created based on needs identified in previous work. It was structured in order to broadly standardize the design process; consolidate planning and modelling behaviours into discrete clusters; anticipate decision-making on key product requirements; facilitate focused discussion with clients (surgeons); create a pleasurable experience for the designer; and encourage detailed reporting of design decisions and therefore to lower barriers to Quality Management System (QMS) implementation and adherence. The performance of the pro-forma was verified using observation, simultaneous verbalization and semi-structured interviews. Three participants across two contexts were observed designing without and then with the pro-forma. Their behaviours and comments were recorded, their designed outcomes evaluated and their quality compliance assessed. Findings: The design workflow was shown to be segmented and contained within distinct and repeatable steps when using the pro-forma. Reported participant confidence increased and stress decreased. Contact time between participants and clients was consolidated. Designed outputs and documented records successfully complied with generalizable aspects of the International Organization for Standardization (ISO) 13485 standard. However, it did not, and by definition could never, wholly implement a complete certifiable QMS, which must be tailored to a specific organization. Implications for practice, society or research: as demand for patient-specific devices continues to rise, and as regulatory requirements about QMS adherence extend to cover all contexts, organizations will need to react accordingly. This pro-forma offers a clear direction for how to introduce evidence-based best practices, and a starting point for full QMS certification. Originality/value: this research marks the first attempt to standardize this highly specialized design process across users, tools and contexts.

Gestational diabetes mellitus (GDM) is the fastest growing type of diabetes in Australia, with the needs, barriers and challenges of women managing GDM being well recognized in the literature. Despite these recent advances in knowledge, mobile-based offerings designed to assist women with their management do not holistically address users’ needs. This study therefore aims to answer how the features and functionalities of a mobile-based application could be designed to better address GDM patient needs. We undertook a co-design session with four GDM stakeholders and identified eleven overarching issues across four main themes that encapsulate the requirements of women with GDM: (1) tracking and monitoring, (2) physical activity, (3) community support and (4) dietary interventions. The results were synthesized into key design considerations for the future design of mobile applications in the GDM context. These considerations include unobtrusive care, support through connection, increasing capability and personalization of information. Each consideration is accompanied by design recommendations for features and functionalities to be implemented in future app developments.