Solving pain points in guideline development and implementation using human-centered design

Abstract

Guidelines International Network North America expanded on ‘Adapting Clinical Guidelines for the Digital Age’, an initiative to innovate guideline development and implementation leveraging technology. The objective: solve pain points ̶ problems occurring at different levels of the customer experience ̶ in guideline development and implementation using human-centered design (HCD). In HCD, customers are people who would use the product or system being designed and are at the center of the design process. HCD builds empathy to understand challenges facing different customers. HCD has three phases: inspiration, ideation, and implementation. Inspiration phase: Semi-structured interviews collected multiple perspectives within guideline development and implementation and determined key pain points (38 participants). Ideation phase: HCD workshop ‘Bringing Guidelines to the Digital Age’ defined design goals, determined design criteria, and developed ‘prototype’ solutions for each pain point with feasibility testing during the workshop (35 participants). Implementation phase: Postworkshop participants continued developing and testing solution designs, tracked progress, and created products to be further tested, iterated, or published (44 participants). Interviews revealed five pain points in implementation stemming from issues in guideline development: (1) lack of clarity of ‘how’ to apply recommendations; (2) inadequate or nonexistent feedback and testing; (3) unclear language; (4) incomplete information; and (5) lack of informatics expertise. Each workshop group produced prototypes – early models of products built to test a concept or process – that were consolidated into five solution categories and refined through post-workshop teams focusing on: (1) patient preferences in recommendations (2) real-world testing and feedback, (3) standard operating procedures for computability and better implementability, (4) artificial intelligence approaches, and (5) connecting informatics with guideline development. HCD provided a user-centered, iterative approach to design solutions leveraging technology to solve paint points and improve implementation of guidelines into patient care. This is a blueprint for using HCD in guideline development.