Involving users/patients in our product development

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Why this is important to us

Since the DiGAV came into effect in 2020, new "digital health applications" (DiGAs) have been continuously coming onto the market. In the area of "psyche", 14 DiGAs are already listed by the Federal Institute for Drugs and Medical Devices (BfArM) (as of May 2022). The companies must prove that their products are well positioned in terms of user-friendliness in addition to their efficacy for the respective disorder and/or positive effects on care. The inclusion of patients is also mandatory. Digital health products that want to adequately meet the needs of patients must also develop a deep understanding of these needs and allow patients to actively participate in the development process of the health product. How can this be achieved?

Developing products with patients

The diagram below outlines an ideal (digital) product development process (based on the "Double Diamond" model; British Design Council, 2005). In each phase of product development, the role and possibilities of involving patients are presented. In addition to "classic" methods from psychological research, numerous methods from the fields of user experience design and user experience research can also be used to involve patients in the development of digital health products. (Semi-)structured interviews, online surveys and behavioral observations can be supplemented by usability tests or joint ideation workshops, for example, and patients can be directly involved in the creative process of finding ideas and solutions (co-creation).

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1. Discover – Understanding needs and problems The first step in the development of a digital health product is to immerse ourselves in the lives of patients. In doing so, we take part in the everyday lives of those affected and gather insights into their central needs, burdens and problems. Only when we develop a profound understanding of these can we design tailored solutions and products.

Examples of patient involvement

  • We accompany patients in their daily lives, get to know their environment, daily routines and routines without intervening (observation, shadowing).
  • In interviews, we gain insights into disease trajectories, treatment paths, and existing coping strategies (open and semi-structured interviews), among other things.
  • We collect insights in public reports of affected persons (literature, online research).
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2. Define – define the Problem focus In this phase we find our focus. To do this, we analyze the insights we have gained so far. From this, we develop concrete hypotheses and clues for further research, which we can then review, concretize and prioritize together with those affected. In this way, we find out which central problem area our future product solution should address.

Examples of patient involvement

  • We conduct further targeted interviews with stakeholders to complement and sharpen previous findings (semi-structured and structured interviews).
  • By means of (online) surveys, we can test specific hypotheses on the basis of a larger sample and obtain more representative assessments, e.g. on frequencies and distributions of certain variables in a larger sample of affected persons. We can also obtain prioritizations (e.g. card sorting).
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3. Develop - Finding the best solution

Based on the previous findings and the defined problem focus, we first develop a wide range of possible solutions together with those affected. We evaluate and prioritize this collection of ideas, and develop initial product ideas and rough product sketches (wireframes). We discuss and test these with patients. Finally, we select the most promising product concept.

Examples of patient involvement

  • Patients are involved in the development of solution ideas in joint workshops. They can develop and discuss ideas together with the team, and question and evaluate solution approaches (co-creation).
  • Concrete solution ideas can be presented to and evaluated by a large, representative sample of patients in online surveys.
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4. Deliver – Implementing the solution in a product The next step is the concrete implementation of the product concept. This includes, for example, the creation of texts, video or audio material, illustrations and the user interface, as well as programming. The involvement of patients ensures that we stay on the right track and that the needs, wishes and preferences of those affected are also taken into account in the design of the product. Examples of patient involvement
  • In a group, patients freely discuss various product features (focus group).
  • Patients test the future product on the basis of detailed prototypes and evaluate e.g. the user-friendliness, usability, possible obstacles and misunderstandings in the use (usability testing).
  • Some patients receive the product before its final completion and test it (beta testing).
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5. Distribute – Test and evaluate the product Especially after the product has been released, we need regular feedback from patients. The users of the product show what benefits they derive from the product, e.g. which functions or contents they find helpful, which components they miss. Their feedback is a decisive factor in the further improvement and development of the product. Examples of patient involvement
  • In regular online surveys, users provide feedback on their satisfaction, suggestions for improvement and new product ideas
  • In workshops or interviews, the team directly exchanges information with patients about their experiences with the product.
  • Through public product reviews and feedback via e-mail, the team continuously collects feedback for further development.

Conclusion

Patients are an integral part of digital health product development. From initial exploration to product release and beyond, they should be involved at every stage. Methods from psychological research and the field of user experience design and research offer a wide range of tools for this purpose. This results in products that offer patients true added value and enable them to become active players in the digital transformation of healthcare.

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PS: this topic is actually super important to us, so we advocate for it, for example, in cooperation with the Spitzenverband Digitale Gesundheitsversorgung e.V. (German Digital Health Association). We’ve also previously presented this during the Deutscher Psychotherapie Kongress (German Psychotherapy Congress) in a poster (German only):
DGPs_Poster.pdf6479.9KB