DesignforNext
12thEADConference
SapienzaUniversityofRome
12-14April2017
EmergingTrendsandtheWayForwardin
DesigninHealthcare:AnExpert’s
Perspective
EmmanuelTseklevesa*,RachelCoopera,
a
Imagination@Lancaster,LancasterInstituteforcontemporaryArts,LancasterUniversity,UK
*Correspondingauthore-mail:[email protected]
Abstract: In this paper the authors provide a new perspective on the emerging
trendsandwayforwardfordesigninhealthcare.Thearticleisbasedonananalysis
of 20 chapters and 26 case studies contributed by design research experts for an
internationalbookinDesignforHealth(currentlyinpress1)editedbytheauthors.
Thepaperaimistoprovidedesignresearchers,withaninterestedinhealth,with
newinsights.Focusingonthefiveidentifiedemergenttrendsindesignforhealthe
theauthorsdiscusshowdesignerscancontributetodifferentdimensionsofhealth
(in public, acute, chronic healthcare and in ageing well), as dictated by several of
the healthcare challenges and opportunities created by design research and the
advent of digital technology. The analysis reveals that design has the capacity to
contribute significantly to future healthcare. It has also revealed that the key
agenda going forward and requiring immediate attention is that of preventative
healthcare.
Keywords: Design in healthcare, challenges, emerging trends, design
research
1.IntroductionandBackground
EversincetheKingsFundHospitalBedprojectbeganin1962(Campbell-Preston,1967)designers
havebeenundertakingprojectsforhealth,architectshaveofcoursebeendesigninghospitalsever
sincetheseinstitutionswereestablished.Thesedesignprojectshave,however,remainedwithinthe
differentprofessionaldomainsindesign,forinstanceinproduct,communication,architecture.Itis
onlyrelativelyrecentlywehaveseenagreaterbodyofworkfromdiversedesignworkandan
increaseindesignresearchfocusingonhealthandhealthcareissues(Chamberlainetal,2015).
Traditionallydesignershavepaidparticularattentiontoacuteandchroniccare,throughnewmedical
products,prostheses,hospital,clinicandcarehomedesign(Jones,2013;Tosietal,2016);for
1
E.Tsekleves(2017)andCooper,R.,eds.DesigninHealthcare.Gower.(DesignforSocialResponsibility).Routledge.InPress
ForalistofthebookchaptersoftheDesignforHealthbookseetheAppendix.
2
3
Comorbidity refers to index chronic diseases are coexisting with other diseases, whereas multimorbidity refers to any co-occurrence of
medical conditions within a person. Based on definitions by van den Akker, M., Buntinx, F. and Knottnerus, J.A., 1996. Comorbidity or
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EmmanuelTseklevesandRachelCooper
exampletheyhavefocussedonrestorationofhealth,throughdesignandtechnology(Mawsonetal.,
2013;Ludonetal.,2014).Morerecentlythecomplexpictureofmaintainingpopulationwellbeing,of
health(illbeing)preventionhasbeguntoemerge,andthustheroleofdesignersindirectlyin
supportingthepromotionofhealthylifestyleorintheircontributiontoillbeing(AUTHORS,2011).
Thisresponsibilitymeansdesignersperhapsnowneedtoconsidermorallyandethicallyhowthey
canensurethatthey‘donoharm’andthattheymightdeliberatelydecidetopromotehealthy
lifestylesandthereforepreventillhealth.
Designofcoursehasnowbroadeneditsskillbaseanditsapplication.Servicedesign(Meroniand
Sangiorgi,2011)hasintroducedanewopportunitytoaddresstheimproveddeliveryofproductsand
servicebothwithinandoutsidethehealthcaresystem(BateandRobert,2006;Lee,2011;
Hugentobler,2015).Behaviourdesign-groundedinpsychologyandbehaviourchangetheory-has
enableddesignerto‘designout’barriersfoundacrossobjects,services,spaces,environments
(Nieddereretal.,2014)andtoinfluenceand/orshapehumanbehaviour(Michieetal,2011).
The‘DesigninPolicy’fieldisintroducingnewapproachestodevelopingpolicyandaidinginnovation
inorganisational,local,regionalandnationalgovernance(Bason,2014).Designinteractionsisanew
wayofconsideringhowwecanimprovetherelationshipbetweenpeople,products,placesand
servicesandofcoursetechnologytrends,suchasthe‘internetofthings’,offergreatopportunitiesin
providingnewwaystoconnectpeoplewithservicesandproductsthatcancontributetohealthier
lifestylesandmechanismstosupportpeoplewithacuteandchronicconditions.
Furthermorethestrengthinuser-centreddesignhasledtoparticipatorydesign,co-designandcocreation(Sanders,2002;SandersandStappers,2008;CouvreurandGoossens,2011),wherebya
muchcloserrelationshipisdevelopedbetweenthedesignprofessionalandtheindividualsand
communitieswhohaveastakeintheoutcomeofanydesignactivity.
Inlightoftheabove,thecontributionandfuturepotentialofdesignforhealthcanbeexplored
throughthelensoftraditionaldesigndisciplines,suchasarchitecture,communication,product,
service,policy,interactionsandbehaviourdesignwhilstspanningkeyhealthcareareas,suchasin
public,acute,chronichealthcareandageingwell.Itiswithintheaforementioneddesignand
healthcareareaswehaveexploredthechallenges,opportunitiesandemergingtrendsfordesignin
healthcare.
Havingpresentedthebackgroundondesignforhealth,thenextsectionfocusesonthemethodology
employedforthedataanalysisandapresentationofthekeyresults.Thisisfollowedbyadiscussion
section,whichpresentsandexploresinmoredetailtheemergingtrendsindesigninhealthcare.This
discussioninprecededbyasmallsectionthatprovidesbackgroundonthekeyhealthcarechallenges
thathelpunderstandbettertheemergenceoftheidentifiedtrends.Lastlyweconcludeby
presentingthewaysforwardfordesigninhealthcare.
2.MethodologyandResults
Thematicanalysiswasemployedfordataanalysis(Gibbs,2007),wherealldatacollectedareinvolved
inaprocessofidentifyingthemesthroughoutcoding,indexing,andcategorizingtowardsdrawing
themes.Moreprecisely,thecodegenerationwasdonebylookingateachparagraphofeachchapter
oftheDesignforHealthkookandcodingdata,bywritingnotesthroughtheuseofstickynotesand
electronicnoteswithintheelectronicversionofthegook.Afterthedatacodingandcollation,we
startedtolookforoverarchingthemesbasedontheareaofinterestandinvestigation.Forinclusion,
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EmergingTrendsandtheWayForwardinDesignforHealth:AnExpert’sPerspective
athemeshouldhavebeendiscussedinlengthbyatleasttwoormorechapters2.Inourinitialtheme
search,severalmoresub-themeswereidentified,whichinthereviewofthemainthemeswere
integratedintolargerthemestoallowforclarityandconsistency.Thisprocessproducedanumberof
themes,whichwerereviewedamongtheteamandthenconsolidatedandupdatedtoprovidethe
themes,showninFigure1.
Basedonof20chapters(ofaproximatelly8,000wordseach)and26casestudiesatotalof18themes
haveappearedacrossdifferenthealthcaresettings(public,acute,chronichealthcareandageing
well)anddesigndisciplines(architecture,communication,product,service,behaviourdesign).Closer
analysisandfurthercategorisationofthethemesrevealedthreemaincategoriesunderwhicheach
oneofthethemescanbegrouped.Thesearechallenges,opportunitiesandemergingtrendsfor
designinhealthcare(seeFigure1).Althoughthispaperfocusesontheemergingtrends,weoffera
briefoverviewofthethemesthatourthematicanalysisrevealedinrelationtotheresearch
challenges,opportunitiesindesigninhealthcare.
Long-termhealthcare
Ageing
Socialinteracton&support
Challenges
Environment&lifestyle
Non-communicablediseases
Wellbeing&mentalhealth
Acivelife/living
Healthcommunicaion
Prototyping
Co-design
DesigninhealthcareThemes
Evidence-baseddesign
Opportuniies
Digitaldesign
Salutogenicdesign
Holisicdesign
Self-managementhealthcare
Person-centrichealthcare
EmergingTrends
Holisichealthcare
Communityhealthcare
Healthpromoing/preventaivecare
Figure1.Mainthemesandtheirgroupingfollowingthematicanalysisofthebookchapters.
Morepreciselythethematicgroupingof‘challenges’referstocurrentandemergingdemandsand
issuesthathealthcareisfacinganddesigniscalledupontorespondto.Underthisgroupsevenmain
themeshavebeenidentified,namelylong-termhealthcare,aging,socialinteractionandsupport,
2
ForalistofthebookchaptersoftheDesignforHealthbookseetheAppendix.
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EmmanuelTseklevesandRachelCooper
environmentandlifestyle,non-communicablediseases,wellbeingandmentalhealth,active
life/living.ThesethemeshaveeitherbeenhighlightedexplicitlybyauthorsintheDesignforHealth
bookaskeychallengesorhaveimplicitlybeendiscussedacrossseveralofthebookchapters.
Movingon,underthethematicgroupof‘opportunities’seventhemeshaveemerged,namelyhealth
communication,prototyping,co-design,evidence-baseddesign,digitaldesignsalutogenicdesignand
holisticdesign.WithinthecontextoftheDesignforHealthbookthethematicgroupofopportunities
referstomethodologiesandapproacheswheredesignoffersvalueandbenefitswithinhealthcare,as
identifiedanddiscussedbyauthorsacrossseveralchapterstheaforementionedbook.Thevalueand
importanceofseveralofthese,intermsoftheircontributiontoproblem-findingandproblem-solving
acrossdifferentsectorsofhealthcare(public,acute,chronic)canbemoreexplicitlyfoundinthecase
studiespresentedintheDesignforHealthbook.
Asitsnamesuggests,thethirdthematicgroupof‘emergingtrends’referstoemergingandfuture
directionsofhealthcarepractices,servicesandprovisionasdictatedbyseveralofthechallenges
identifiedanddiscussedinthisbook(seeFigure1)aswellasopportunitiescreatedbydigital
technology.Underthisthematicgroupfivethemeshavebeenidentified,namelyself-care/health
management,person-centrichealthcare,holistichealthcare,communityhealthcareandpreventative
healthcare.
• Long-termhealthcare
• Ageing
• Socialinteracion/
support
• ...
Challenges
Emerging
Trends
• Self-care/
management
• Person-centric
healthacre
• ...
• Health
communicaion
• Prototyping
• Co-design
• ...
Opportuniies
Figure2.Mainthemesandtheirgroupingfollowingthematicanalysisofthebookchapters.
Figure2illustrates,howthethreethematicgroupsareinterconnected.Moreprecisely,the
challengesinhealthcareareinfluencingtheemergingtrends,whilsttheopportunitiescreatedby
designcancontributeinaddressingthehealthchallengesandemergingtrends.Weexploreindetail
themesrevealedundertheemergingtrendsthematicgroupinthefollowingsection.
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EmergingTrendsandtheWayForwardinDesignforHealth:AnExpert’sPerspective
3.Discussion
3.1KeyChallengesinDesigninHealthcare
Priortodiscussingindetailtheemergingtrendsinhealthcareitismosthelpfultopresentsomeof
thekeychallengesinhealthrevealedbyourthematicanalysisandechoedbytheliterature.
Furtheranalysisofthethemesunderthethematicgroupofchallenges,indicatedacasual(although
oftennotproven)relationshipandasphereofinfluencesbetweenthese,asdepictedinFigure3.
Startingfromtheinnercircleofthenestedcirclediagrambelow,wecanseethattheenvironment
andlifestyleaffectourpersonalhealthataholisticlevel,influencingourwellbeingandmental
health,ouropportunitiesforsocialinteractionandtheextentofhowactiveourlivesare.Thesein
turnhaveanimpactonourageingprocessandtheprevalenceofnon-communicablediseases.The
riseofthosealongwithanageingpopulationposeamassivechallengeandstraintolong-term
healthcareaccess,provisionandmanagementaffectingeachindividual.ItisthefirstthreeinFigure3
thatwepresentanddiscussbelowastheyrelatethemosttotheemergingtrends.
Long-term
healthcare
Ageingpopulaion|Noncommunicablediseases
Wellbeing&mentalhealth
|socialinteracion&
support|Aciveliving
Environment
&lifestyle
PERSON
Figure3.Casualrelationshipsbetweenthechallengesindesigninhealthcare.
Morepreciselylong-termhealthcareemergedintheDesignforHealthbookasoneofthemain
challengesfacedindesigninhealthcaretoday.Thethemewasdiscussedinseveralchaptersacross
allfourhealthcaresettingspresentedintheaforementionedbook.Long-termconditionsfitwellto
the‘wickedproblem’definitionofHorstandRittel’s(1973).Asthenumberofpeoplewithlong-term
(orchronic)healthconditionsincreasesthroughlivinglongerandwithchanginglifestylesamassive
challengeinmaintainingpresentlevelsofhighqualitypatientcareatanaffordablecostemerges
(Daar,2007).Thephysical,socialandsocio-economicenvironmentsinwhichpeopleliveshapetheir
behaviouranddirectlyaffectpopulationhealth.InfacttheMarmotreportdrewalinkbetween
betterhealthandhighersocioeconomicpositioninsocietyprovidingsixpolicyrecommendationsfor
reducinghealthinequalities.Accordingtothereportthereisasocialgradientinhealth–thelowera
person’ssocialposition,theworsehisorherhealth(Marmotetal.,2010).Thisisfurtherexacerbated
bytheriseofnon-communicablediseasesandthenumberofpeoplewithtwoormorelong-term
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EmmanuelTseklevesandRachelCooper
conditions(comorbidityandmultiplemorbidity3)(Barnettetal.,2012;Uijenetal.,2008).The
challengescreatedbycomorbidityandmultimorbidityrequireapersonalizedapproachtothedesign
ofinterventionsandtotheservicedesignofpatientpathwayswithintheexistingchronichealthcare
system.
Non-communicablediseases(NCDs)refertonon-infectiouschronicdiseases,lastingforlongperiods
oftimeandprogressingslowly.AccordingtotheWHONCDskill38millionpeopleeachyear,with
eightoutoftendeathsbeingpreventable(Alwan,2011).Tobaccouse,physicalinactivity,excessive
alcoholuseandunhealthydietsallincreasetheriskofdyingfromanNCD.Challengesunderthis
themeincluderaisingawarenessandengagingthepublicinunderstandingtheriskfactorsof
developingNCDs;shapinghealth-promotingbehavioursthroughdesignthatminimisetherisk
factors;designinginterventionsformanagingNCDswhilstimprovingqualityoflifeandreducing
deathrates.
ThethemeofanageingpopulationisoneofthemostwidelydiscussedchallengewithintheDesign
forHealthbook.Weliveinanageingworld.TheUnitedNationsestimatethat1.4billionpeoplewill
beover60yearsoldby2030(UnitedNations,2016).IntheUKtherearecurrently11.4million
peopleover65andby2040,24.2%willbeagedover65(AgeUK,2016).Thechallengesthatan
increasinglyageingpopulationbringsintohealthcareareseveralandmultifaceted.Thechangingage
demographicsmeanthatthelikelihoodofacquiringachronicdiseaseisontheincrease.Ontopof
thatanincreasednumberofolderpeoplearesufferingfrommultipleandcomplexhealthconditions
(Marengoni,2011;Salive,2013)placinganadditionaldemandontheexistinghealthcareandin
particularchronichealthcareservices.Thischangingagestructuremeansdiminishingworkforceto
sustainpublichealthcareraisingchallengesonthefundingandexistenceofpublichealthcare
provision.Withinthecontextoflivinglongercomesthechallengeofstrategicallyplacingresearch
focusonpreventativeservices,interventionsandsupportmechanismsthatfavourandplace
emphasisonlivinghealthierintoolderyears(disease-feelifeexpectancy)ratherthansolelyfocusing
onlifeexpectancy.Currentlythoughoneofkeychallengesdesignersandhealthcareprofessionals
needtoaddresswithinthiscontextistheincreasingdemandforsupportingindependencyand
independentlivingathomeandincommunitysettings.Theemergingtrendspresentedbelowshed
lightonwaysdesigncanaddresssomeofthechallengesdiscussedabove.
3.2EmergingTrendsinDesigninHealthcare
Thethematicanalysisrevealedanumberofemergingtrendsinthefieldofdesigninhealthcare,
whichhavebeendepictedinFigure4.Withafocusontheperson(startingfromthecentreofthe
diagram),person-centrichealthcareappearsfirst,followedbytheemergingtrendofself-healthcare
management,communityandholistichealthcare.Preventative/healthpromotingcareissituatedat
theouteredgeofthecircleofhealthcarediagram.Weexaminetheseinmoredetailbelow.
Person-centrichealthcareformsoneofthekeyemergingthemesintheDesignforHealthbook,
havingbeenencounteredacrossseveralchapters.Themoveformpatient-centredtoperson-centric
healthcareisstartingtoemergeintheliteratureandrelevantreports(Royenetal,2010;Peeketal.,
2007;Price,2006;Eatonetal.,2015;Raleighetal.,2015;TheHealthFoundation,2014).Withinthis
contextthechallengeandopportunityfordesigninhealthcareistoplacethepersonasanactive
3
Comorbidity refers to index chronic diseases are coexisting with other diseases, whereas multimorbidity refers to any co-occurrence of
medical conditions within a person. Based on definitions by van den Akker, M., Buntinx, F. and Knottnerus, J.A., 1996. Comorbidity or
multimorbidity: what's in a name? A review of literature. The European Journal of General Practice, 2(2), pp.65-70.
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EmergingTrendsandtheWayForwardinDesignforHealth:AnExpert’sPerspective
agentinallaspectsofhealthcare,fromthepromotiontothedeliveryandtreatment.Thefocushere
isdesigningforapersonratherthanforapatientaimingatimprovingaperson’squalityoflifealong
withhealth.
Servicedesignhasanessentialroletoplayherebyplacingthepersonattheepicentreofthedesign
anddevelopmentprocess,leadingtoaserviceresponsivetotheneedsoftheindividual.Co-design
willcontributeactivelyinthisprocessbyempoweringtheindividualintheprocessofredesigning
healthcareservicestowardstheirneedsbutalsorecognisingthevalueofhealthcareontheperson
(Robert,2013).Intermsofbehaviourdesign,person-centrichealthcarewillplacefocusonaperson’s
internalandexternalbehaviour,wheretheinterests,needsandmotivationswillbeatthecentreof
thedesignprocess.Insteadofexplicitlychangingaperson’sbehavior,person-centrichealthcare
designwillseektominimizeoreliminate(designout)theproblemsandbarriersthatpreventhealthpromotingbehaviours.Forarchitecturedesign,person-centrichealthcaredesignwillcreateamore
directlinkbetweentheplace,personandhealth,placingtheperson’shealthattheforefrontofthe
environmentdesign.Salutogenicdesigncanactivelycontributetowardsthis.Salutogenicdesign
referstotheembeddingofpreventativecarestrategiesinourbuiltenvironment,byplacingfocuson
factorsthatsupporthumanhealthandwell-being(Rao,2007;Codinhoto2009),ratherthanon
factorsthatcausedisease(DilaniandArmstrong,2007;Golembiewski,2012).Although
predominatelyarchitecture-focusedsalutogenicdesignhasalsoapplicationsinotherdesign
disciplineswithinpublichealthandageingwell,suchasinbehaviourandservicedesign.
Withinproductdesignthecorevalueofperson-centricityinhealthcarewillbereclaimedand
reflectednotonlyontheproductoutcomes,butalsotheprocess.Person-centrichealthcaredesign
teamswillplaceempatheticdesignanddeepethnographicinsightsattheheartoftheprocess
combiningtheirqualitativefindingswithevidence-baseddesign.
Theimplicationsandimpactofperson-centrichealthcarearetwofold.Ononehanditwillprovide
moreperson-agnosticservicesandontheotherhanditwillpartlyshifttheresponsibilityofcare
fromtheserviceprovidertotheserviceuser.Thisleadsintothenextemergingthemeofselfmanagementhealthcare.
Person-centric
healthcare
Self-management
healthcare
Community
healthcare
Holisichealthcare
Preventaive/health
promoingcare
Figure4.Circleofemergingtrendsindesigninhealthcare:hierarchicaldepictionofemergingtrendsrevealedbythe
thematicanalysiswithafocusplacedontheindividualperson.
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EmmanuelTseklevesandRachelCooper
Self-managementhealthcareprogrammesarebeingincreasinglyintroducedacrosstheworld
(Ouwensetal.,2005;Beagleholeetal.,2008;Brady,2013)asaresponsetothehigheconomic
burden,placedbyanageingpopulationandtheincreasedprevalenceofchronicdisease.Inlightof
theincreaseandpenetrationofdigitaltechnologiesacrossboththehomeandthehealthcare
setting,thereistheexpectationthatpatientswiththesupportoftechnologyandinparticular
personalmedicaldevices,maybemotivatedandempoweredtomonitorandmanagetheirown
healthstatus.Thereareseveralexamplesintheliteratureofprojectsthathavefocusedonthe
designofpersonalmedicaldevicesfortheself-managementofdifferenthealthcareconditionsfor
publicaswellaschronichealth(Bitterman,2011),suchasweightmanagement(Abraham,2012),
diabetesmanagement(ClarkeandFoster,2012)andstrokerehabilitationmanagement(Mawsonet
al.,2014).Althougheachprojectandpersonalhealthdevicepresentedisdifferent,theyallagreein
thattoenableself-management,thepersonwiththechronicillnessandhealthprofessionalneedto
worktogetherwithinaparticipatorynetworkofrelatives,friends,andserviceorganisations.This
presentsopportunitiesfortheapplicationofco-designintheshapingofself-managementproducts
aswellasservices,sincewithinco-designliekeycharacteristics,suchasempowerment,controland
motivationthatallowthisgoaltoberealised.
Particularlyforservicedesign,self-managementofhealthcareposesachallengeandopportunityat
thesametime.Asinordertofacilitateeffectiveself-managementofchronichealthconditionsata
nationalhealthcarescale,radicalrethinkingisrequiredabouthowpublichealthservicesare
organisedanddelivered,includinghowtechnologiescanbeintegratedintohealthcaresystemsto
promoteandsupportself-management.Ontopofandwithintheredesignofself-management
healthcarethereareopportunitiesfordesignresearchandpracticetocreatethenecessary
conditionsrequiredtoprovidepeoplewithchronichealthconditionsnotonlywithpersonalhealth
productsbutalsotherequiredskillsandknowledgetomanagetheirownconditionmoreeasilyand
efficientlyinordertomaintainorenhancetheirhealth,emotionalandsocialwell-being.
Embracingandimplementingaself-caremanagementmodelwillundoubtedlyhaveimplicationson
servicedelivery,shiftingmoreservicesintothecommunityandpatients’homes.Community
healthcareis,hence,anotheroftheemergingtrendsourthematicanalysisrevealed.Communitybasedhealthcareservicesareexpectedtoincreaseononehandplacingpersonalhealthwithina
socialcontextandontheotherhand,facilitatinghealthcareoutsidetheenvelopeofprimaryand
secondaryhealthcareprovision.Withinthiscontextofservicemigrationintothecommunitythere
aredesignopportunitiesintermsofcommunity-locatedservicedesign,productsandbehaviour
designwithincommunityhealthcareservices,aswellasdesignofbuiltenvironmentsthatpromotea
moresocialandcommunity-basedhealthcaredeliverysystem.
Withinthetopicofdesigninhealthcare,thethemeofholistichealthcareemergesfromthe
literature(Kolcaba,2003;Wade,2009;Royenetal.,2010)andthethematicanalysisoftheDesignfor
Healthbookasakeytrend.Morepreciselyseveralchaptersinthebookhighlightedtheneedfora
holisticapproachandmindsetinthedesignofproducts,services,builtenvironmentsandbehaviours
withhealthcare.Inthiscontextholisticreferstoeveryaspectofaperson’slifeincludingphysical
functioning,mentalwellbeing,socialandprofessionalaspectsoftheirlives.Itiswithintheenvelope
ofholistichealthcarewherethechallengesofwellbeingandmentalshouldbeaddressedbydesign.
Independentresearchreviews,suchastheNationalPreventionResearchInitiative(NPRI)report
haveindicatedthatthereneedstobebetterunderstandingofthecomplexinteractionbetween
individualbehaviourandriskfactors,andsocial,cultural,health-careandotherdeterminantsof
health(NPRIScientificReviewGroup,2015).Ourcurrentenvironmentandadoptedill-health
lifestyleshascontributedtoanincreasinglyhighnegativeimpactonourmentalhealthand
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EmergingTrendsandtheWayForwardinDesignforHealth:AnExpert’sPerspective
wellbeing.Wellbeingcanbethoughtofinthecontextofanindividual,communitybutalsonational
wellbeing.In2010aMeasuringNationalWellbeingProgrammewaslaunchedintheUKaimedat
providingabetterunderstandingofnationalwellbeing.Amongstotherfindingthereportconcluded
thatthebiggestchallengeistoturntheevidenceonwellbeingintoaction,sothatpoliciestruly
reflectourqualityoflife(Self,2014).
Salutogenicdesign(DilaniandArmstrong,2007)canalsoplayakeyroleintheemergingtrendof
preventativeandhealthpromotingcare.Similarlytothetrendofself-managementhealthcare,this
trendisalsonecessitatedbytheeconomicchallengesandtheprevalenceofchronicdiseases.The
environmentandlifestylearecatalystfortheincreaseofill-healthpromotingriskfactors,such
physicalinactivity,unhealthydiet,anxietyandstress.Shiftingthefocusofhealthcaredeliveryand
provisionfromchronichealthcareintopublichealthcarewillrequiretheredesignofourcurrent
servicesaswellasbuiltenvironmentanditwillbealong-termstrategy.Howeverthebenefitsfrom
suchchangewillbeinvaluableforpeople’shealthandwellbeing.Communicationandbehaviour
designcansignificantlycontributetowardstherealisationofhealthpromotingandpreventativecare
too.
Preventativeandholistichealthcareshouldbeviewedincombination.Theimportanceofthishas
beenhighlightedbythenationalpreventionresearchinitiative(NPRI)report.TheNPRIreportwas
createdbasedonascientificgroupestablishedtoreviewtheoutputsfrom70+projects(receiving
£34millionoffundingby16researchfundersintheUKbetween2005-2014),aimedatreducingthe
burdenofchronicnon-communicablediseasebyinvestigatingtheroleofhealth-relatedbehaviour,
particularlyalcoholconsumption,smoking,dietandphysicalactivity.Basedonthereporttoachieve
greaterreductionsinthepopulationillnessorhealthriskcouldresultfromapplyingthese
interventionsatmultiplelevels(individual,group,communityand/orpopulation-level)(NPRI
ScientificReviewGroup,2015).
4.Conclusions:theWayForwardforDesignin
Healthcare
Wehavepresentedanddiscussed,followingathematicanalysisoftheDesignforHealthbook
chapters,fiveemergenttrendsdesignersarecalledupontoaddresswithinthecontextofhealthcare
(self-care/healthmanagement,person-centrichealthcare,holistichealthcare,communityhealthcare
andpreventativehealthcare).
WhattheanalysisoftheDesignforHealthbookchaptershasrevealedisthatthekeyagendagoing
forwardandrequiringimmediateattentionisthatofpreventativehealthcare.Weknowthatthecost
ofhealthcaredeliveryisincreasing(Appleby,2013;ThomasandWise,2015).Weknowthatwehave
anincreasingandageingpopulation(Ortiz-OspinaandRoser,2016;Deloitte,2016).Theissueishow
toreducethecostandburdenofdisease,particularlyofnon-communicabledisease,byfocusing
moreresearchworkaroundpreventionandlookingathowdesigncanworkinprevention.
Figure5illustratesthecontributionoflifestyletodiseaseandprovidesexamplesofdesigndisciplines
andtheattentiontheycanpaytohealthpreventionandcare.Thereofcoursemanymoreareasin
healthpreventionandhealthcarethatdesignerscanfocustheirskillsandattentionon,geneticand
childhoodhealth,ageingsocietyandthegrowthofdementiaarejusttwoexamples.Indeed
designer’smightbenefitfromassessingtheircontributionagainstthelife-coursefromprenatal,
childhood,adulthoodthroughtoolderlifeanddeath,lookingattheindividualandtheircommunity
9
EmmanuelTseklevesandRachelCooper
inthecontextofvariousenvironments,suchascities,variousgeographiesandcontinents,various
socioeconomicsituationsandvariousbehaviourconditions.Inthesamewaymulti/interdisciplinary
teamsthatembracenotonlytheuserbutalsoallthediverserangeofskillsandexpertiserelatedtoa
specificchallengeareacommonfeatureofprojectteams,theopportunityisfordesignerstotakea
leadandfacilitatethatcollaborativeapproach.
Figure5.TheRelationshipBetweenthePhysicalEnvironmentandNon-communicableDisease.(AdaptedfromAUTHORS,
2011).
However,ifdesignersaretoplaytheleadingrolethatwehaveseentheycando,therearesome
imperativestoaddress,firsthowtowetraindesignersforafuturerolewheretheynotonlyapply
designforhealthchallenges,butareabletoleadmultidisciplinarygroupsandmakemajordecisions
thatwillinfluencebehaviourcontributingtolongtermpreventionandbetteroverallpopulation
health.Thisraisesasecondimperativehowdodesignersworkwithdifferentsectors,howdothey
providetheevidenceoftheimpactofdesign,howdotheyinfluencethesesectorsandindeedwho
shouldtheybe,forinstancehowcantownplannersorhealthcareprofessionalsorpolicymakers
understandthevalueofbringingadesignperspectivein.Weneeddesignerstrainedtounderstand
thesediverseperspectivesandbeableconverseinamannerthatthespecialistsinotherareascan
understand.
Designerswillstillcontinuetodesignproductsandservicesforhealthbutifwearetoreducethe
costofhealthcareandimprovethequalityoflifeinandbeyondwesternsocieties,weneedtolookat
howtoensurethatdesignersarekeypartofteamsidentifyingtheproblemsanddesigningthe
solutions.
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EmergingTrendsandtheWayForwardinDesignforHealth:AnExpert’sPerspective
Appendix
ListofDesignforHealthbookchapters:
1. AbriefhistoryofWesternmedicineandhealthcare
2. Challengesandopportunitiesfordesign
Theme1Designforpublichealth
3. Services:softservicedesignaroundtheenvelopeofhealthcare
4. Behaviours:behaviour-changeinterventionsforpublichealth
5. Architecture:thebenecialhealthoutcomesofsalutogenicdesign
6. Communications:thecontributionoftypographyandinformationdesigntohealth
communication
Theme2Designinacutehealth
7. Architecture:healingarchitecture
8. Products:productdesigninacutehealth
9. Communications:designingcarebundledocumentationtosupporttherecognitionand
treatmentofacutekidneyinjury:aroutetoqualityimprovement
Theme3Designinchronichealth
10. Behaviours:designandbehaviourchangeinhealth
11. Communications:communicationdesigninchronichealth
12. Services:servicedesigninchronichealth
13. Products:designingproductsforchronichealth
14. Architecture:urbandesignandwellbeing
15. Designinnovation:embeddingdesignprocessinacharityorganisation:evolvingthedouble
diamondatMacmillanCancerSupport
Theme4Designforageingwell
16. Services:exploringhowaservicedesignapproachcanfacilitateco-designofsupportive
communitiesandserviceframeworksforolderpeople
17. Products:negotiatingdesignwithinscepticalterritory:lessonsfromhealthcare
18. Communications:visualinformationaboutmedicinesforolderpatients
19. Architecture:workplacehealthandwellbeing:cangreaterdesignparticipationprovidea
cure?
20. Behaviours:behaviouralstrategiesofolderadultsintheadoptionofnewtechnology-based
products:theeffectsofageingandthepromisingapplicationofsmartmaterialsforthe
designoffutureproducts
11
EmmanuelTseklevesandRachelCooper
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EmergingTrendsandtheWayForwardinDesignforHealth:AnExpert’sPerspective
AbouttheAuthors:
DrEmmanuelTseklevesisSeniorLecturerinDesignInteractionsatLancasterUniversity
andleadsresearchattheintersectionofdesign,health,wellbeingandtechnologyat
[email protected]’sresearchworkhasbeenpublishedextensivelyand
featuredbyseveralnational/internationalmedia.EmmanuelblogsfortheGuardianand
TheConversationondesignforhealth.
RachelCooperOBEisDistinguishedProfessorofDesignManagementandPolicyat
LancasterUniversity,wheresheisChairofLancasterInstitutefortheContemporaryArts
[email protected],design
management,designpolicyandacrossallsectorsofindustry.Shehaspublished
extensivelyandistheserieseditoroftheAshgateseriesDesignforSocialResponsibility.
Acknowledgements:wewouldlikethankallauthorswhohavecontributedchaptersto
theDesignforHealthbook.
15