The impact of COVID-19 on abortion access: Insights from the European Union and the United Kingdom

Government policies on abortion are a longstanding topic of heated political debates. The COVID-19 pandemic shook health systems to the core adding further to the complexity of this topic, as imposed national lockdowns and movement restrictions affected access to timely abortion for millions of women across the globe. In this paper, we examine how countries within the European Union and the United Kingdom responded to challenges brought by the COVID-19 crisis in terms of access to abortion. By combining information from various sources, we have explored different responses according to two dimensions: changes in policy and protocols, and reported difficulties in access. Our analysis shows significant differences across the observed regions and salient debates around abortion. While some countries made efforts to maintain and facilitate abortion care during the pandemic through the introduction or expansion of use of telemedicine and early medical abortion, others attempted to restrict it further. The situation was also diverse in the countries where governments did not change policies or protocols. Based on our data analysis, we provide a framework that can help policy makers improve abortion access.Accepted Author ManuscriptApplied Ergonomics and Desig

Informing the Product Development of an mHealth Solution for People with Multiple Sclerosis Through Early Health Technology Assessment

The potential of mHealth is enormous for chronic conditions, yet the integration of these technologies into the clinical infrastructures and healthcare pathways remains an ongoing challenge. Digi-HTA has been developed to support health technology assessment activities for novel digital healthcare technologies. The use of Early Health Technology Assessment (EHTA) can help product development. The present study describes the way in which EHTA can guide the development of a product to anticipate future needs and market access.Applied Ergonomics and Desig

Experiences Using Patient and Public Involvement in Digital Health Research for Multiple Sclerosis

Patient and public involvement (PPI) is increasingly used for improving quality of the research. There are many barriers in translating PPI into practice, including lacking examples of good practices. Frameworks that have been developed in one setting do not readily transfer to other settings. In this paper, we examine the implementation of PPI in the context of a digital health research project that explores the design, development and use of mHealth for persons with Multiple Sclerosis taking an iterative user-centered design approach. Methods: Instrumental case study to describe the PPI process on a digital health research project. Results: Overall experience was positive. We found 3 roles for PPI involvement: strategic members; design and development partners; and expert members. Challenges lay on unclear PPI terminology; managing roles and expectations; and ensuring accessibility. Applied Ergonomics and Desig

Health Care Professionals' Perspectives on the Uses of Patient-Generated Health Data

Integration of digital self-management solutions into health care processes requires the involvement of health care professionals in the adoption and use of the solutions as part of the care pathway. We conducted 23 interviews with diverse profiles of health care professionals participating in the treatment of chronic patients in three different countries. Our results indicate that health care professionals appeared relatively motivated at the prospect of having access to patient-generated data. Nevertheless, they appeared less confident in weighing what types of data could be collected efficiently through mobile devices and how it could be presented in ways that would provide value to the care process. Our results identify four broad categories for how patient-generated health data could be useful: monitoring, prevention, research, and transparency of condition parameters. Applied Ergonomics and Desig

Design-Relevant Factors Affecting the Patient Experience in Digital Health: Preliminary Results of an Umbrella Systematic Review

Since Covid-19, digital health interventions (DHIs) have been embraced as never before. The pandemic led to many new challenges, including the patient experience in digital health care delivery. In this literature study, we identified and synthesized factors that impact patient experience in digital health (dPEx), and reviewed the methods and strategies relevant to its design and implementation. We conducted an umbrella review including 15 reviews representing 543 studies. Four themes were identified that describe design-relevant factors that impact dPEx: individual context, content, technical issues, and design features. We propose a preliminary framework to explain the relationship between each factor and support user-centered design efforts. Further research is needed to identify which factors have the most impact.Applied Ergonomics and DesignHuman-Centered Desig

Digital Patient Experience: Umbrella Systematic Review

Background: The adoption and use of technology have significantly changed health care delivery. Patient experience has become a significant factor in the entire spectrum of patient-centered health care delivery. Digital health facilitates further improvement and empowerment of patient experiences. Therefore, the design of digital health is served by insights into the barriers to and facilitators of digital patient experience (PEx). Objective: This study aimed to systematically review the influencing factors and design considerations of PEx in digital health from the literature and generate design guidelines for further improvement of PEx in digital health. Methods: We performed an umbrella systematic review following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methodology. We searched Scopus, PubMed, and Web of Science databases. Two rounds of small random sampling (20%) were independently reviewed by 2 reviewers who evaluated the eligibility of the articles against the selection criteria. Two-round interrater reliability was assessed using the Fleiss-Cohen coefficient (k1=0.88 and k2=0.80). Thematic analysis was applied to analyze the extracted data based on a small set of a priori categories. Results: The search yielded 173 records, of which 45 (26%) were selected for data analysis. Findings and conclusions showed a great diversity; most studies presented a set of themes (19/45, 42%) or descriptive information only (16/45, 36%). The digital PEx-related influencing factors were classified into 9 categories: patient capability, patient opportunity, patient motivation, intervention technology, intervention functionality, intervention interaction design, organizational environment, physical environment, and social environment. These can have three types of impacts: positive, negative, or double edged. We captured 4 design constructs (personalization, information, navigation, and visualization) and 3 design methods (human-centered or user-centered design, co-design or participatory design, and inclusive design) as design considerations. Conclusions: We propose the following definition for digital PEx: "Digital patient experience is the sum of all interactions affected by a patient's behavioral determinants, framed by digital technologies, and shaped by organizational culture, that influence patient perceptions across the continuum of care channeling digital health." In this study, we constructed a design and evaluation framework that contains 4 phases-define design, define evaluation, design ideation, and design evaluation-and 9 design guidelines to help digital health designers and developers address digital PEx throughout the entire design process. Finally, our review suggests 6 directions for future digital PEx-related research.Applied Ergonomics and DesignHuman-Centered Desig

Designing Depression Screening Chatbots

Advances in voice recognition, natural language processing, and artificial intelligence have led to the increasing availability and use of conversational agents (chatbots) in different settings. Chatbots are systems that mimic human dialogue interaction through text or voice. This paper describes a series of design considerations for integrating chatbots interfaces with health services. The present paper is part of ongoing work that explores the overall implementation of chatbots in the healthcare context. The findings have been created using a research through design process, combining (1) literature survey of existing body of knowledge on designing chatbots, (2) analysis on state-of-the-practice in using chatbots as service interfaces, and (3) generative process of designing a chatbot interface for depression screening. In this paper we describe considerations that would be useful for the design of a chatbot for a healthcare context.Applied Ergonomics and Desig

Smart home applications for cognitive health of older adults

The lifespan of older people is growing together with their proportion in the population growth in the older population. This leads to an increasing need for support services for older adults who will inevitably experience a significant decrease in their cognitive capabilities and mental health conditions. Cognitive functions, including memory, attention, sleeping, problem-solving activities, or speed processing, are playing a crucial role in everyone’s independent daily life. Technologies can help maintain their independence and improve quality of life, reducing the care costs. In this regard, Smart home applications (SMAs) offer a solution to the complex needs of older adults and their families, monitoring physiological and functional issues, as well as aiding in emergency detection and response. This chapter provides an overview of current applications reported in the scientific literature, identifies the frameworks proposed for designing these types of applications, and defines evidence-based recommendations for designing SMAs for cognitive health of older adults.Green Open Access added to TU Delft Institutional Repository 'You share, we take care!' - Taverne project https://www.openaccess.nl/en/you-share-we-take-care Otherwise as indicated in the copyright section: the publisher is the copyright holder of this work and the author uses the Dutch legislation to make this work public.Applied Ergonomics and Desig

Designing digital patient experiences: The digital health design framework

Background Digital health (DH) brings considerable benefits, but it comes with potential risks. Human Factors (HF) play a critical role in providing high-quality and acceptable DH solutions. Consultation with designers is crucial for reflecting on and improving current DH design practices. Objectives We investigated the general DH design processes, challenges, and corresponding strategies that can improve the digital patient experience (PEx). Methods A semi-structured interview study with 24 design professionals. All audio recordings were transcribed, deidentified, grammatically corrected, and imported into ATLAS.ti for data analysis. Three coders participated in data coding following the thematic analysis approach. Results We identified eight DH design stages and grouped them into four phases: preparation, problem-thinking, problem-solving, and implementation. The analysis presented twelve design challenges associated with contextual, practical, managerial, and commercial aspects that can hinder the design process. We identified eight common strategies used by respondents to tackle these challenges. Conclusions We propose a Digital Health Design (DHD) framework to improve the digital PEx. It provides an overview of design deliverables, activities, stakeholders, challenges, and corresponding strategies for each design stage.Applied Ergonomics and DesignResponsible Marketing and Consumer BehaviorHuman-Centered Desig

Building Understanding of Experience Design in Digital Health: Preliminary Results Based on Semi-Structured Interviews

Design is expanding its influence on shaping future healthcare. Ideally, designers apply human-centered design and human factors that introduce theory, principles, and methods to design to optimize people’s healthcare experiences in both digital and non-digital environments. To discuss and implement experience design in healthcare, consensus about experience design in healthcare is needed. Objectives: Therefore, the purpose of this study is to investigate designers’ views on experience design in health, and to uncover their understanding about three experience design concepts, i.e., user experience (UX), patient experience (PEx), and digital patient experience (dPEx). We conducted online semi-structured interviews study with convenience samples who met the eligibility. We used ATLAS.ti for an in-depth data coding following thematic analysis. 24 international designers of digital health solutions, either in industry or in academia took part in the interviews. We found the similarities and differences mentioned between healthcare design and non-healthcare design relate to (1) design principles, (2) user attributes, and (3) design contexts. Furthermore, the differences between UX, PEx, and dPEx can be mapped on five dimensions: people, contexts, purposes, means, and usage scenarios. These insights can help designers and human factors specialists build a common design language for experience design in healthcare. Our study can also assist designers and human factors specialists with experience design in digital health by pointing out the areas where design thinking generally is appropriate and the places where particular expertise in healthcare design is needed.Green Open Access added to TU Delft Institutional Repository ‘You share, we take care!’ – Taverne project https://www.openaccess.nl/en/you-share-we-take-care Otherwise as indicated in the copyright section: the publisher is the copyright holder of this work and the author uses the Dutch legislation to make this work public.Applied Ergonomics and DesignResponsible Marketing and Consumer BehaviorHuman-Centered Desig