The coming years, demand for healthcare will increase exponentially, resulting in increased pressure on the decreasing number of healthcare providers. A digital transition of healthcare is needed in order to be able to keep offering widely accessible, quality care.

Unfortunately, the healthcare sector has difficulties keeping up with the trend of digitalization in comparison with other sectors. This project aims to bring to light why the healthcare sector is struggling with the process of digitalization. Through this exploration it endeavors to design a solution with the intention of facilitating the digital transformation of the Reinier de Graaf Gashuis (RdGG). To keep the project scope limited it was decided to focus on digitalization of colorectal cancer care.

The following methods were used during the research phase of the project:

1) Conducting a literature review that explored the current state of affairs regarding digitalization in the context of colorectal cancer care and methods for digitalization of care processes.

2) Observing interactions between healthcare professionals and colorectal cancer patients and observing during meetings with different stakeholders in the RdGG.

3) Conducting interviews with colorectal cancer patients, healthcare professionals and organizational employees.

This led to the creation of a colorectal cancer patient journey map. The map displays the care process and reveals its ‘non-digital state’. The result showed that mapping a complete care process in a clear way is challenging. Most care processes are not linear or fixed; there are different treatment options and exceptional circumstances. It was discovered that there isn’t a journey mapping format available that is simultaneously comprehensive and user friendly.

The research outcomes revealed numerous factors hindering the digital transformation within the RdGG, some of which include:

1) The complexity of hospitals makes it difficult to keep overview over the process of digitalization.

2) Not all digital resources are perceived in a positive light, one reason being that they sometimes clash with existing workflows or care processes.

3) Patient journey maps and care pathways can help to prevent this from happening, but there are problems with the making of, managing and use of journey maps.

4) There are issues in the communication between healthcare professionals and organizational employees.

The following design goal was created:

Design an interactive journey mapping tool for care professionals and organizational employees at the RdGG, that helps to better comprehend care and digitalization processes, by offering overview, knowledge and easy communication.

This led to GoMedFlow. A design created to help hospitals transition into smart hospitals. It utilizes journey mapping as a facilitator for the digital transformation of healthcare. GoMedFlow offers:

1) Overview in the current state of affairs of digitalization of care processes

2) The opportunity to easily and cooperatively form, maintain and analyze care pathways and patient journeys.

3) Aid to effectively implement digital resources in care processes, assuring digital resources fit well within the care processes.

4) Easy communication between different stakeholders in the RdGG; healthcare professionals and organizational employees

Using GoMedFlow results in an efficient deployment of employees and resources in the future.

The human body, although seemingly symmetrical, can in fact be highly asymmetrical. Our bodies are predetermined by our DNA and co-shaped by our environment. This leads to most of the world's population having a discrepancy in leg length either from birth or developed during their life time. It is completely natural and goes unnoticed, as changes are incremental and people get used to it. On the contrary, when undergoing total hip replacement surgery and waking up with one leg longer than the other, the change is almost instantaneous and immediately noticeable. Current surgical solutions do not address this issue in a practical manner within the operating theatre, leading to surgical teams developing their own methods and procedures to evaluate the change in patient's leg length.
 
Introducing new workflows to medical professionals often entails neglecting the protocols they spent years practicing. This thesis identified this bottleneck and instead of introducing new methods and procedures, it was decided to build on existing ones. This was done by exploring common surgical workflows in respect to total hip replacement and determining an approach to enhance surgical team's capabilities in evaluating leg length discrepancy.. Important in achieving this goal it to make any given design solution effortless, reliable and undisruptive to various workflows

In order to do so, user research was performed by joining multiple surgical teams within the OR, thereby observing and evaluating their methods. One method in particular stood out, which is best described as the 'loaded assessment'. During this assessment the surgeon or circulating nurse will centre the patient's feet, apply pressure to the heels and try to evaluate the discrepancy. Although this method being seemingly simple, its execution is difficult to perform by a single person and varying pressure differences may confuse the assessment.

Following the initial research phase, co-creation sessions with technical experts were organised, after which various concepts were developed and tested on the basis of feasibility, desirability and viability. Finally, a functional prototype based on the loaded assessment principle was developed and tested for its functionality and conceptual expectation.

This graduation project has been carried out in the context of the research project ‘Tailored Healthcare through Customer Profiling’ at the TU Delft, in collaboration with hospital Reinier de Graaf Group in Delft, and medical device company Zimmer Biomet. Together we focus in this project on the rehabilitation journey after total hip replacement (Total Hip Arthroplasty, THA).

The central aim of this project has been to find out how different patient profiles benefit from different interaction features in the rehabilitation device ‘BioCoach’, to effectively support them in their rehabilitation process.
This project investigates how a tailored version of the BioCoach could meet the needs and wishes of three different patient profiles: the ‘optimistic’ patient; the ‘managing’ patient; and the ‘modest’ patient.

This thesis describes the design process of a service/tool for the management and prevention of periprosthetic joint infection (PJI) cases. PJI is a complication that follows total joint replacement and is devastating for the patient. It causes physical and mental strain and the patient's health never returns to close to what it was prior to the complication. It furthermore lays a financial burden on hospitals and society. The assignment for this thesis is initiated by Zimmer Biomet, the leading manufacturer for orthopaedic medical devices and joint prostheses. It is expected that providing services and tools that aid in the management and prevention of PJI cases will become a future strategy of Zimmer Biomet. The research in this thesis defines that the biggest problem concerning the management and prevention of PJI cases is the presence of a knowledge gap between guidelines defined by experts and appliable knowledge by staff. The multidisciplinary team (MDT) dashboard is a solution to this problem. This dashboard aids in the diagnosis and decision for treatment method of PJI cases. It is used both prior to and during the MDT meeting, which is a meeting during which a team of physicians from varying disciplines discuss PJI cases to arrive to a just diagnosis and optimal decisions for treatment methods. The dashboard provides visual aids, to help all members communicate their substantiation and to ensure that every aspect is discussed. It furthermore gives a non-binding advice, based on the patient data and guidelines developped by PJI experts. A digital prototype of the dashboard and a strategy are also presented. After validation of both these elements, further elaboration is given on the technical and organisational implementation of the dashboard, into hospitals. It is concluded that the dashboard is feasible, desirable and viable and that it will aid in the management and prevention of PJI cases. Next to aiding surgeons and MDT members, it will improve patient outcome and will serve an economic and societal goal. It is therefore recommended that Zimmer Biomet continues the development and pursues the implementation of the dashboard.