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This paper proposes a categorization of existing approaches to healthcare-related engineering design based on systems thinking principles. Three existing approaches to healthcare-related engineering design are isolated which contribute differently to health systems fundamental purposes and interconnections. The three approaches are labeled as 'silent', 'overt', and 'convergent' health design. Each approach is defined and illustrated through an example. Following, practical advantages and disadvantages of each approach are discussed. A reflection is offered on the expected relevance of the convergent health design approach for present and future societal challenges in the health domain, and specifically on the recently growing field of e-health. Finally, open methodological challenges related to convergent health design are outlined and characterized as opportunities for future research.

The research question of this doctoral thesis is: What can be the future impact of design (activities) in digital health, given the rise of data collection and analysis technologies? I answered this question on three knowledge levels: design vision, knowledge-generating approach, and design tool. In Chapter 1, I envision design activities for the collective computing era (an upcoming modern computing era with complex systems of massive social interaction through various connected computing devices) that data collection and analysis technologies are a part of. Based on the literature review and informants’ interviews, I developed a design vision that demonstrates the changes posed in design activities (design tasks, processes, and the designer’s role) due to the upcoming collective computing era, and provides guidance for adopting the changes. Consequently, the vision proposes that design tasks in the collective computing era move towards designing ‘complex system(s)’ and testing these within ‘society as a lab’. The vision’s guidance states that designers can approach these tasks by addressing communities and engaging with their data. In terms of the design process, the vision claims the ‘coexploration’ of the design problem and solution spaces. To tackle such change, the guidance suggests designers: the flexible combination and analysis of mixed data, working on social forces at a system level, and developing through multiple soft launches with modular designs. Finally, the designer’s role becomes conducting an ‘accountable implementation.’ The vision recommends approaching accountable implementation by incorporating a transdisciplinary vision of the value and control of the design output....

Digital health is a vibrant and dynamic field, encompassing subsets such as mobile health, health information technology, wearable devices, telehealth and telemedicine, and personalised medicine. While digital health adoption has been markedly accelerated by the covid-19 pandemic (Inkster et al., 2020), an evolving body of research has focused on describing and addressing specific challenges related to the design and evaluation of digital health technologies (Pagliari, 2007; Murray et al., 2016; Blandford et al., 2018; Marvel et al., 2018). This research articulates a need for novel, interdisciplinary design approaches to digital health innovation, integrating disparate sets of requirements such as clinical soundness, user-centeredness, technical interoperability, and cost-effectiveness (Cornet et al., 2019). In this complex domain, design and health disciplines are called not only to collaborate with each other, but also to learn to work with digital data as the raw material fueling digital technologies. This dissertation explores such challenges through a series of exploratory research efforts at the intersection of design, healthcare and digital data. These explorations are conducted within the context of the Cardiolab, a Delft Design Lab born out of a partnership between Philips Experience Design and Delft University of Technology. Throughout the dissertation, knowledge in this domain is gained through a mix of literature reviews and project-based action research (Somekh, 2005). In this way, the relevant scientific literature is connected and put in dialogue with real-life digital health design practice.