Designing Technology and Healthcare Delivery Systems to Support Clinician and Patient Care Experiences: A Multi-Stakeholder Systems Engineering Co-Design Methodology

Healthcare technology significantly improved human health for historically predominant acute conditions of infection and trauma. Today, over 78% of healthcare expenditures address chronic conditions. Healthcare services organically emerged to address acute conditions and formed decentrally by specialty as different departments across many different geographic locations. However, today's chronic conditions require the utilization of decentralized services with no centralized source. The patient is left to coordinate their care, introducing safety concerns. The effect of technology on patient health outcomes is mediated by how these tools are integrated into the healthcare delivery system. Thus, patients experience poorly coordinated care, while clinicians experience increasing operational burden. Therefore, suboptimal care experiences suggest a need to evaluate healthcare technology and system design, developments, and implementations. To address the issue of technological integration across a decentralized socio-technical system, this paper presents a design methodology that combines principles from engineering systems, axiomatic design, healthcare systems architecture, coproduction, and user-centered design to develop healthcare delivery systems designed to enhance clinician and patient care experiences. This multi-stakeholder co-design process uses a systems thinking framework to incorporate technology that addresses stakeholder human values, universal access to technology and services, and designs for rather than reacts to the impact of technology.