Digitalisation is regarded as an essential factor in solving the challenges facing healthcare
systems today and enabling more efficient patient-centred care. This graduation project aimed to create a mapping tool to help professionals in the healthcare sector evaluate the fit between context and service when implementing digital health services. Service design mapping methods can make the impact of these changes visible and actionable for all stakeholders, but professionals in healthcare lack specific tools and design expertise.

The project combined a literature review, stakeholder interviews and iterative prototyping to create a functional tool and conceptual roadmap detailing the adoption journey of the tool within the healthcare setting. Interview and user test participants included design researchers in healthcare, implementation managers, and clinicians, primarily from the Leiden University Medical Centre. Insights from these activities shaped the functionality, usability, and collaborative potential of the tool.

The outcome is an online implementation tool centred on a shared service map. It enables future service users to analyse their current and future workflow with a focus on their evolving roles and responsibilities. By embedding service design principles into the process, it addresses one of the key barriers to digital health implementation: uncertainty about the real-world impact of change.

This project focuses on the often-overlooked role and requirements of family members who care for patients with cardiovascular diseases (CVD), particularly those recovering from myocardial infarction (MI) or having open-heart surgery (OHS). While cardiac rehabilitation (CR) programs are beneficial in improving patient outcomes and lowering risk factors, they are often centered around patients. However, family members play an important role in maintaining lifestyle changes and supporting rehabilitation at home, despite receiving minimal to no support.

The project proposes the Family Box, a personalized, digitally enabled support system based on the Leids Universitair Medisch Centrum's (LUMC) modular "Box," as a solution to this issue. The Family Box provides personalized support relevant to a wide range of family members. The research uses literature reviews, focus group data, qualitative interviews, and surveys, all of which are based on the human-centered design methodology ("Hear, Create, Deliver"). In addition to recognizing possibilities to empower family members through personalized support, this approach highlights important problems, including managing caregiver burden, understanding medical information, balancing household tasks, and addressing emotional needs.

The project states that personalization is important because a one-to-all solution can not meet every family member’s diverse needs and preferences. Through the development of a framework for personalization, a personalization strategy is designed for the Family Box. By considering a set of four personas (Protector, Adaptor, Talker, & Observer) based on dimensions like involvement, care approach, and emotional coping strategies, the system can personalize educational modules, goal-setting tools, and progress-tracking features. Using data from wearable devices and other health measurements, family members can receive meaningful updates, reassurance about the patient’s condition, and relevant lifestyle advice without becoming overwhelmed.

Early findings suggest that a Family Box can improve family member well-being, foster better collaboration between family and patient, and ultimately improve adherence to rehabilitation guidelines. Furthermore, by creating a scalable, modular system, the design can scale beyond MI and OHS to other care paths and eventually to preventive applications. However, ethical risks, such as protecting user privacy and preventing over-reliance on constant monitoring, must be carefully managed.

In conclusion, this project shows how personalized support can improve the involvement of family members in CR, leading to the improved well-being of both family members and patients. For further development, the project provides a roadmap for developing such a platform and highlights areas for further research, including the refining of data-driven personalization and larger-scale implementation studies. Additionally, the framework for personalization is discussed for application in other projects, using this project as a case study.

The Dutch healthcare system is under increasing pressure from rising patient numbers, administrative burdens, and staff shortages. These challenges are felt throughout the healthcare sector, including academic hospitals such as the 'Leids Universitair Medisch Centrum' (LUMC). The cardiology department at the LUMC, in collaboration with TU Delft, has initiated a project to optimise their current care journey. This is done by improving workflow efficiency, reducing workload, and enhancing the wellbeing of healthcare professionals while maintaining high-quality patient care.

The project applies a strategic design approach with mixed methods. This includes qualitative research through interviews, observational studies, and Thematic Content Analysis (TCA). It identifies key problems in the current workflow, including administrative overload, fragmented communication, and a lack of transparency between internal systems, people, and technology. The findings indicate a misalignment of expectations patterns between internal healthcare professionals, patients, and external healthcare providers. This leads to decreased wellbeing, reduced collaboration, and professional burnout.

A strategic design framework was developed to address these challenges. This includes interventions for future implementation, such as a redesigned patient portal, a digital collaboration platform for interprofessional communication, and a knowledge data bank for medical and lifestyle information. The interventions aim to increase transparency, facilitate collaboration, and empower patients to engage in their care journey. By implementing the interventions, the cardiology department can improve workflow efficiency, enhance the wellbeing of internal healthcare professionals, and improve patient experience.

The project contributes to a wider discussion on healthcare system transformation and serves as a model for optimising care journeys. Future research should focus on evaluating the long-term impact of the interventions and their scalability across departments and other healthcare organisations.