Thoughts on ‘Designing a Healthcare Revolution’ in Ireland

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Yesterday evening I went to NCAD to hear Richard Corbridge CIO of eHealth Ireland, talk about the 10-year plan for improving the Irish health service. The event was billed as; “How to Design a Healthcare Revolution”, supported by IxDA Dublin and UX Ireland. Great work has been done to date such as the implementation of GP e-referrals across all of Ireland, this a major step in digitising healthcare. The implementation of a fully integrated eHealth system within the next 10 years in Ireland certainly seems to hold several challenges.

I’m a pragmatic designer and having carried out research for my MA IxD dissertation, which focused on the needs of Nurses and how they access information and knowledge in their workplace, I am at odds with how this is going to pan out. eHealth Ireland already have buy-in from the clinicians and administrators (Doctors and Nurses) who have their finger on the pulse of technology and social media. From the primary research I have carried out during my M.A., it shows there is a significant portion of H.S.E. Nursing staff who have limited access to information and knowledge in their workplace. Additionally, Gerrish et al (2006), state that ‘Nurses tend to use colleagues rather than on-line sources of information as a primary source for answering their clinical questions’. The authors ascribe this to nurses’ lack of confidence and infrequency in using medical databases to inform their decision-making. This research suggests that IT is generally not seen as being part of Nursing culture.

Being a designer I fear there is little empathy for the non-technically orientated people who work on the frontline in our hospitals. These are people who bear the brunt of the stresses and strains of the HSE system. From what I gather a lot of the collaboration that is going on between eHealth Ireland and the ‘Clinicians and Administrators’ is with a certain cohort who are tech-savvy and active on Twitter. The question I now ask eHealth Ireland is how are the Nurses with limited access to tech in their daily working lives, going to integrate with the new systems and become engaged in how it works? As advocated by eHealth Ireland, stakeholder engagement (as opposed to ICT alone) is at the core of their strategy for change, however, engagement is needed from the frontline staff who are not already engaged – these are the people who need to be ‘bought in’ to successfully address integration in order to partake the flow of knowledge and information – to get the system working on a practical level.

There were lots of questions from the audience about the Persona Project that’s being run by eHealth Ireland. The primary need of persona creation is where there is no access to real end-users. Person creation is a designer’s tool to imagine future users. However, the HSE does not seem to be short on end-users (patients/doctors/nurses). I believe that primary research based on real users’ experience is paramount in addressing the current problem. Because of a Designer’s perspective and training, they can help resolve the problems from an ethnographic design research perspective. A primary user-centered design principle is to; ‘work with those affected by the product or service’, and iterate, iterate, iterate, in a continuous collaborative environment.

When asked how many UX Designers work for eHealth Ireland? Richard Corbridge replied “not enough”, he also reported there’s not enough Design Thinking going on in his office either. It was inspiring to hear directly from him about how eHealth Ireland plan to implement a new system and it’s heartening to hear their approach is a ‘people-led’ one, rather than an IT one. However, it seems Designers’ involvement in changing the health service still has a long way to go, and as recently advocated by Frontend at ‘Pixels to Policy‘, it’s up to designers to make it happen. While I certainly do not advocate that designers are the solution to all the problems of the Irish Health Service, what I do believe is that designers with their design process and unique perspective can help facilitate change through collaboration with other health professionals.

Richard Corbridge invited designers who would like to get involved in eHealth Ireland’s project, so hopefully this invitation is a step in the right direction that is needed to reform healthcare provision in the public service.

Imagine a day when Interaction Designers and UX Designer positions actually exist in the public service?