Applying Experienced-Based Co-Design principles to improve digital health demand management processes in a large metropolitan multi-hospital health system

Abstract

Objective

This study describes the application of Experienced-Based Co-Design (EBCD) principles with an embedded implementation technology framework for improving digital health and informatics demand management processes in a multi-hospital healthcare system. The study identified barriers and enablers within the existing demand management system, proposed interventions to address these challenges and engaged in collaborative co-design with stakeholders.

Methods

A multi-method qualitative approach aligning with EBCD principles was used. Framework mapping (Non-adoption, Abandonment, Scale-up, Spread, Sustainability) was applied to barriers and enablers associated with baseline practices. Reflexive thematic mapping and process charts were used to inform stakeholder priorities and co-design. Prototyping was iterative using feedback for continuous improvement with ongoing monitoring.

Results

Fragmentation of information was a technological barrier, decentralized processes and service duplication were organizational barriers, and opportunities to improve clarity of governance policies were identified. Solutions were co-generated and prioritised by stakeholders. The co-design and prototyping phase followed an iterative approach which generated two interventions. For centralizing intake and management, a new workflow process was devised. For improving project portfolio visibility and developing a weighted scoring criterion, a single tool to track projects across the lifecycle and a scoring model based on prioritization techniques were created.

Conclusion

A novel application of an EBCD approach was used to improve demand management processes in a digital health and informatics service context in a large health system. It highlights the value and agility of EBCD to generate flexible and modular solutions for this digital health context and compares favorably to analogous approaches.

Public interest summary

In today's fast-paced digital age, it is vital for hospitals to manage health information innovation efficiently. This study used an Experienced-Based Co-Design design (EBCD) approach to improve how a multi-hospital health system handles and prioritizes digital health projects. We listened to stakeholders, identified challenges, including fragmented information and unclear processes, then co-created solutions. The EBCD produced an implementable streamlined method for managing digital health project requests, including prioritizing and tracking projects from start to finish. This outcome of the exemplar EBCD process is likely to ensure that the most critical health projects are prioritized. For the public, this means better, faster, and more efficient digital health services in the future.