The integration of digital technologies and design thinking is reshaping the healthcare industry, necessitating tools that can support designers in navigating complex, multi-stakeholder environments. This thesis presents the development of a toolkit specifically designed for digital health designers to facilitate shared design goals among diverse stakeholders. The toolkit addresses key challenges identified through case studies of 14 existing toolkits, as well as structured interviews with healthcare designers.

The research began by classifying current design toolkits, revealing that many focus primarily on ideation while offering limited support for earlier stages such as stakeholder alignment and goal definition. Existing toolkits often take a card-based format, though there is a growing trend towards digital tools, particularly in response to the shift towards remote collaboration.

Structured interviews with both novice and experienced digital health designers highlighted critical challenges in stakeholder engagement. These included difficulties in creating a common understanding, managing conflicting values, and setting realistic goals. The need for toolkits to facilitate clear communication, organize complex insights, and align expectations was emphasized. Participants also expressed preferences for toolkits that are easy to use, adaptable, and reusable, with many advocating for a digital version.

In response, this thesis developed a toolkit that addresses the complexities of coordinating multiple stakeholders in digital health design projects. The toolkit features a Honeycomb diagram structured around seven key dimensions, guiding designers through the process of defining clear, achievable design goals. It aids in co-creation and brainstorming sessions, organizes thoughts, and serves as a visual communication tool for tracking project progress and reviewing stakeholder alignment.

The toolkit was evaluated by six design students with digital health experience, who tested its usability and usefulness. Feedback indicated that the toolkit effectively facilitated collaboration, structured the design process, and improved confidence in managing stakeholder relationships. However, participants also suggested areas for improvement, including the development of a digital version and clearer instructions. In response, a final digital version of the toolkit was created, offering greater flexibility and enhanced support for remote collaboration. This toolkit aims to empower digital health designers in achieving cohesive, stakeholder-aligned design goals.

Hemophilia, a bleeding disorder, is divided into types A and B, resulting from coagulation factors VIII and IX deficiencies. The levels of these clotting factors in the body determine the severity of hemophilia. The classification includes severe, moderate, and mild hemophilia. Managing hemophilia involves options like on-demand and prophylactic treatment. A key part of managing this condition involves Hemophilia Treatment Centers (HTCs) as the primary healthcare providers for patients.

The HTC at Erasmus MC is one of the six centers in the Netherlands. It offers comprehensive care for adults and children with hemophilia and other rare bleeding disorders. In the pediatric department of Erasmus MC's HTC, children with hemophilia attend multiple outpatient clinic visits annually. During these visits, patients and their caregivers receive education about the bleeding disorder, its treatment, and potential consequences. However, grasping the information during these visits can be challenging, especially as most of it is conveyed verbally. This poses a particular difficulty for patients and caregivers with lower literacy levels.

To enhance the information provided to hemophilia patients and caregivers, HTCs must offer comprehensive support to ensure patients understand the information communicated during outpatient clinic visits. Improving information provision in these contexts aims to make significant progress towards a future where patient information and education are improved, resulting in better outcomes for those living with hemophilia.

This graduation project involved conducting research through literature reviews, analyzing materials, observing HTC's operations, and interviewing healthcare professionals, patients and their caregivers, and relevant stakeholders. The findings revealed several pain points regarding the current information provision. These areas include the information exchanged during outpatient clinic visits and the accessibility of provided information outside of these visits. Consequently, two solutions were developed: an information tool named "Samen Spraak," designed to enhance information exchange between healthcare professionals and parents by introducing interactivity and structure during consultations. This tool is then detailed in a strategy outlining a digital solution's implementation roadmap.

Based on this developed tool and strategy, it is advisable to classify it under the Dutch Association for Hemophilia Patients (NVHP) for further implementation and testing. Future research could explore expanding the approach to other blood clotting disorders across all age groups.

Patients who are admitted to the Intensive Care Unit (ICU) are extremely ill and at high risk of organ failure and death. Being admitted to the ICU is known to cause long lasting physical, cognitive, and physiological symptoms, which is called Post-Intensive Care syndrome (PICS). To provide better management of PICS, early recognition and intervention are required. Two LUMC intensivists are exploring methods to increase ICU involvement in follow-up care for ICU patients, and thereby improve outcome related to PICS. Home monitoring may provide a method feasible for the ICU. To better assess feasibility, a pilot study, called "The ICU-Recover Box", was conducted. Additionally, since patients admitted to the ICU vary widely, it is essential to determine which patients are most likely to benefit from increased ICU involvement in follow-up care. An attempt was made to determine whether measurements recorded during ICU admission contain valuable information to predict ICU mortality. When this data contains valuable information, it may also be used to predict which patients should receive the ICU-Recover Box.

Fifteen patients who were admitted to the ICU received a weight scale, blood pressure monitor and smartwatch at hospital discharge. During the twelve week follow-up period, these patients would monitor their health status, which could be monitored remotely. Based on the preliminary results of six patients, a list of recommendations for large-scale clinical research and eventual implementation of the ICU-Recover Box into standard ICU practices, was formulated. The most important recommendations were to reduce the dependency on third parties and to substitute the home monitoring devices for devices that are medically CE-marked and have better ergonomics.

One recommendation was to assess which patients are most likely to benefit from home monitoring before implementing the ICU-Recover Box into standard ICU procedures. An attempt was made to predict ICU outcome using a machine learning approach. Data of 1364 patients, admitted to the LUMC ICU in 2017 and 2018, was collected and labeled "Survivor" or "ICU-Death", based on the ICU mortality. Features consisted of patient characteristics, hemodynamic status, and medication administrations. An Extreme Gradient Boosting (XGB) classifier was selected and optimized. Training and testing of this classifier was iterated 100 times. Mean AUC over all iterations was 0.809 with a standard deviation of 0.036. Mean sensitivity was 0.298 and mean specificity was 0.964, with standard deviations of 0.067 and 0.011 respectively. The mean corresponding F1 score was 0.851 with a standard deviation of 0.020. These results indicated that data recorded on the ICU seems to contain valuable information to predict ICU mortality. To identify whether this data could be used to determine which patients should receive the ICU-Recover Box, further research is required.

Post-mortem interval estimation (PMI) is a key part of forensic investigation. Accurately obtaining a PMI early in the investigative process improves the reconstruction of events, directs follow-up research and narrows down suspects in case of homicide. Currently, PMI is determined using Henssge’s nomogram requiring ambient temperature, rectal temperature, an estimated body weight and an estimated correcting factor to account for the clothing of the deceased. These body weight and correcting factor estimates are subjective and can lead to errors of up to 14 hours from the actual PMI.
To improve the accuracy of the PMI Academic Medical Centre (AMC) in Amsterdam, TU Delft, the Dutch Forensic Institute and the Dutch police initiated the Therminus project. Using the Wilks Model [1]with specialised equipment can increase the accuracy of the PMI by up to a 15-minute margin of error under ideal circumstances and up to 3.2 hours under non-ideal circumstances.
For the Wilks model, the weight of the deceased remains an important input and the QuickScale was developed as a specialised tool to provide this information to forensic investigators at the crime scene. This report contains the development of the second iteration of the QuickScale, the QuickScale 2.0. Objectives of this development were:
1. To Finish the QuickScale prototype, design the modules needed for building in the electronics and for adding user-friendly, intuitive controls.
2. To design and conduct usability studies with forensic investigators and use the obtained information to further improve the QuickScale construction, electronics and usability.
Using a design analysis and usability engineering approach for the QuickScale design and user interface respectively. The QuickScale design was calibrated, and validated and possible improvements were identified. Three different user interfaces were developed and usability studies were conducted for groups of students and forensic investigators. New design requirements were derived from both the design analysis and usability studies.
The resulting QuickScale 2.0 design incorporated the user interface that resulted in the least user errors. It met 27 out of the total 30 design criteria and contains:
• An ambidextrous user interface.
• Correcting springs for the non-linearity of the load cell when measuring weights below 20kg.
• Handlebars with improved grip which can easily be extended to accommodate more users.
• Safety labels with an abbreviated guide on the field use and stickers indicating the controls

The un-met design criteria were an indicator of remaining battery life and the possibility that both units can display a difference in weight larger than 0.5 kgs, especially at the start of weight measurements. As this design still needs to be produced, it needs to be tested and evaluated. Special care should be taken when calibrating the QuickScale 2.0 and altering the calibrating method might be necessary. Furthermore, it is recommended to integrate the QuickScale 2.0 with other Therminus equipment in future evaluations.

All in all the QuickScale 2.0 is a user-oriented step toward more accurate post-mortem interval estimation.

This graduation project focused on reducing the environmental impact of syringes on the Intensive Care Unit (ICU) of Erasmus University Medical Centre (MC) by designing solutions based on circular economy.

The ICU of Erasmus MC produces an excessive amount of waste and initiated the transition towards a circular ICU. Syringes and their packaging are defined as an impact hotspot product at the ICU, due to the product properties, extensive use (24 per patient per day), and the fact that it is a single-use disposable product. The underlying problem of the high environmental impact of syringes is the current linear life cycle. This needs to be transformed into a more circular system by design, to limit the amount of waste and to reduce the use of natural resources.

The goal of this project was therefore to redesign the syringes, their packaging and their use, according to circular design strategies suitable for medical products, to decrease the environmental impact. The use of syringes should remain convenient and safe for the healthcare staff and patients.

Research was executed to understand the context. This consisted of literature, user and product research. Furthermore, a waste audit and a life cycle analysis were performed. It showed that decreasing the impact of syringes is not only about the product itself. Manufacturing, preparing, using and disposing of all contribute to the environmental impact of the syringe. Various possible interventions were derived from this research.
Firstly, adapting the infection prevention protocol and behaviour of the staff could lead to a decrease in unused disposed syringes.
Secondly, separating infectious waste from general hospital waste properly could result in opportunities for recycling.
Thirdly, the syringe itself can be redesigned to reduce the impact by changing the material to a sustainable alternative and redesigning the shape for (partial) reuse.
Lastly, the impact of the filling process could be reduced. It was concluded from research that prefilled sterilised syringes (PFSS) are more environmentally friendly than manually filled syringes because they are produced in large batches and, therefore, have fewer by-products per syringe. However, a life cycle analysis of the filling process of PFSS showed various impact hotspots in this filling process, such as the sterilisation phase, materials used, and left-over medication.

The final design is a process optimisation for batch-produced PFSS, based on circular strategies such as reduce, reuse, rethink and repurpose. Interventions include: eliminating the first sterilisation phase, reduce left-over medication and change from steam to gamma sterilisation. The proposed interventions have been evaluated by discussion.

In the end, the environmental impact of syringes is reduced by optimising the filling process, which resulted in decreasing the amount of waste, material, energy and water usage, while remaining safe and without increasing the workload of the staff of the ICU.

Background
The healthcare sector is one of the most polluting sectors in the Netherlands. To limit the environmental impact of the medical sector, Erasmus MC collaborated with Metabolic to conduct a Material Flow Analysis (MFA) and Impact Assessment for the Intensive Care Unit (ICU). The research revealed the hotspots of the ICU, contributing to this polluting sector. Based on the hotspots The Convergence, a cooperation between the Erasmus University, Erasmus MC, and TU Delft have set up the first three design projects.
Project aim
This graduation project aimed to make a start towards greener ICUs. In the ICU care is delivered to critically ill patients. The number of gloves used is high because of the intensity of care and high standards. Due to its resource-intensive production and frequency of use, the use of nitrile disposable gloves was found as a hotspot. The question to be answered was; How could the environmental impact of gloves in the ICU be reduced, while remaining quality of care? Research
Extensive research is done with different focuses; product-centred, human-centred and material centred. Furthermore, the waste from the PICU was analysed for one week. The research revealed the importance of the procurement department and the Unit Infection Prevention.
Design direction
Together with the nursing staff, it was decided to go for the design direction of reducing the number of unused gloves. The scope was set to the current situation in the ICU and the idea should be implementable in the short term. The research resulted in five building blocks for the design that need to be incorporated; (1) infection prevention, (2) zero-risk, (3) ease of use, (4) efficiency and (5) technology.
Ideation
Ideation was done by involving people in creative sessions. Restrictions were excluded in the creative sessions, to come up with a wide range of ideas. Three ideas were chosen based on their short-term implementation possibility and incorporation of the building blocks. The ideas were presented to the Green Team of the ICU and it was decided to go on with an addition of the current box and applying a different way of dispensing gloves.
Prototyping and testing
Prototypes were made to quickly verify the functioning of the ideas. While testing the prototypes, iterations were applied. A user evaluation was performed and resulted in a preference for the vertical dispensing design.
Final design
The final design is GloVe, a vertical dispense system. By incorporating the five building blocks, the design can provide benefits for multiple stakeholders. It reduces the environmental impact of gloves in the ICU by dispensing one glove at a time. Furthermore, the gloves are dispensed at the cuff, which comes in little contact with the patient. The vertical movement is pleasant to the user. The use of colour for different sizes makes it clear to the care assistant which box should go in which holder. Also, nurses will see at a glance, which size gloves they are dispensing. The small V-shaped opening makes the undesirable behaviour, of placing gloves back, almost impossible.
Transformation towards greener ICUs The design thinking approach has yielded a design, insights, and recommendations for subsequent projects. Furthermore, the project has drawn a lot of attention to making healthcare more sustainable. The project has been a necessary start towards more sustainable ICUs.

Many people living in low-middle-income countries (LMICs) are affected by injuries that develop into chronic wounds and, without adequate treatment, may lead to disabilities or even cause death. Negative Pressure Wound Therapy (NPWT) is currently a highly suitable manner to treat complex and chronic wounds. NPWT uses controlled negative pressure to stimulate wound healing and requires a vacuum device that is connected to a sealed vacuum dressing by a tube system. However, due to lack of resources in money and medical equipment, this treatment is still inaccessible to marginalised patients in LMICs,
The context of this research is the Green Pastures Hospital (GPH) in Nepal. This test location is typical for LMICs. In GPH a converted aquarium pump (AquaVAC) is currently used as a NPWT device. There are a multitude of complications in relation to this equipment. Therefore, the following design goal is formulated: ‘Treat chronic and complex wounds in LMICs with a device that is affordable, safe and reliable and made out of widely available, replaceable components.’

In order to design such a device, extensive context analysis, literature and expert review has been done in Phase I. It was found that international guidelines for treatment, as well as design standards and safety regulations, assume a western context or high-resources setting, and do not comply with the needs of end-users at GPH. This led to a new set of requirements and design guidance for the WOCA Wound Pump in Phase II.
Analysis of the market shows that NPWT systems are unnecessarily costly, due to the complexity of the devices and reliance on specific wound dressings. Low-cost solutions, such as the AquaVAC, show good results, however, these devices lack reliability, safety and ease of use. The design proposal of the WOCA contributes to solving these issues in several ways. Hence, the design proposal that was developed in Phase III, is based on availability, compatibility and simplicity.
The WOCA Wound Pump is a simple, cheap and robust NPWT device. The battery powered vacuum pump is portable and can be made completely from locally sourced components. The product can be disassembled with standard tools and all individual components are replaceable, which ensure a long lifespan. Special features of this design are 1) automatic pressure control, 2) compatibility with self-made dressings and standard canisters, 3) portable design with a battery that lasts for 15 hours, 4) simple interface for smooth operation and monitoring, 5) easy to repair and made from widely available components. Even so, the WOCA is affordable, the main components are purchased and produced for less than 100 USD.

To conclude, the WOCA Wound Pump has much potential in LMICs. After the evaluation of the final design, it turned out that in therapy most requirements set for a NPWT used in LMICs, were met. However, future steps have to be taken in order to fulfil its potential and make an actual contribution to the healing of chronic and complex wounds in LMICs. Firstly, the prototype needs to be finished. Design iterations should be made in order to fulfil the current dissatisfiers from the requirement list still, such as noise production, shockproof design and cleaning possibilities. Subsequently, the prototype should be validated with end-users and collaborations should be set up for funding, distribution and education. This process would probably take years, but it has the potential to profoundly improve the healthcare for chronic and complex wounds in low-resource settings.

Skin cancer is the most common form of cancer in the Netherlands, often caused by having too much exposure to UV radiation from the sun. An effect of this is that the part of the body that is exposed the most to the sun is also the body part where skin cancer is seen more often; the head. When the skin cancer gets removed surgically, the defect is sometimes so big that reconstructive surgery has to take place. This treatment is impactful for patients, since their face can abruptly change, impacting their social interactions.

This project explores the patient experience that facial skin cancer patients have throughout their treatment and how augmented reality (AR) could contribute in this treatment, to ultimately bring about a better quality of life (QoL).

In the first phase of this project qualitative research was conducted. Interviews with healthcare professionals (HCPs) and observations in the hospital helped to understand the context for patients. Contextmapping interviews with patients gave insights on the patient journey they went through. It was found that this journey can best be explained as an emotional roller coaster with a long recovery phase.

In the second phase of this project the final concept “Face it” came about through experimentation with AR software and co-creation with HCPs using the patient journey as a basis. A final interactive mock-up was created and tested with ex patients to evaluate the concept as a whole.

The final concept Face it is a tool that helps patients to look at themselves in three different ways during the recovery phase of their treatment; the current selves, back in the past and the future selves. This is done by taking photos, keeping track with photos and looking to the future phases of the recovery in AR. The final concept was evaluated as a good example of digitalization to evoke patient engagement in their own care and with that patient empowerment.

This design research showed that there is a need and opportunity for more digitalization in healthcare. Furthermore, the project has shown that solutions in healthcare can benefit from taking a more holistic approach to a problem. Taking this a different perspective offers interesting opportunities for future projects on AR in healthcare, as does this project, offering a glimpse into the future.

The Intensive Care Unit (ICU) of the Leids Universitair Medisch Centrum (LUMC) focuses on vitally threatened patients, who cannot survive without daily intensive treatment. As the patients in this department could easily deteriorate and (potentially) pass away, the staff members of LUMC’s ICU often need to act rapidly and make decisions within a short period of time, while they experience severe (time) pressure. This pressure causes stress and increases the chance of human errors by the staff members, which eventually could lead to adverse events (incidents that caused irreversible damage to patients). In order to minimise the human errors made by the staff members and thereby, the amount of adverse events, the ICU physicians and nurses of the LUMC currently need to participate with two training exercises, called Advanced Life Support+ (ALS+) and Crew Resource Management (CRM). Despite the fact that they are encouraged to reflect on- and expand their non-technical skill set, the (ALS+/CRM) trainers still notice that the non-technical skills of the staff members differ with their expectations. Initially, they believed that the difference in desired behaviour (by the trainers) and shown behaviour (by the staff members) is caused by the current set-up of the ALS+ and CRM training. However, it was found that this difference is mainly caused by two other factors. First, although they need to participate with the ALS+ and CRM training, the staff members still have little awareness about their behavioural impact on acute procedures, meaning that they do not precisely know how they can stimulate effective teamwork. Second, the staff members are barely triggered to reflect on their behaviour or to apply their learnings/action points (in practice) once they participated with the ALS+ and CRM training. As a result, (sustainable) behavioural change is not established and the staff members continue to show their old behavioural patterns. Based on these two factors, I developed the iCare-initiative. The iCare-initiative consists of four product solutions: an application, renewed (digital) patient boards, pocket cards and debriefing-flyers.
In the short term, the staff members can reflect more structuredly on their behaviour with the use of the debriefing-flyers. Next, they are reminded of their action points and other important behaviours (during acute procedures) via the pocket cards. In the long term, once the staff members feel more comfortable to think about- and reflect on their behaviour (in teams), the application and renewed patient boards will be launched. The application offers a platform to the staff members to individually develop/train their non-technical skill set and reflect more consciously on their behavioural impact. Furthermore, the patient boards aim to create continuous awareness amongst the staff members to reflect on their behaviour, but also to encourage them to share useful insights via a convenient (accessible) platform. Although the iCare-initiative consists of four separate product solutions, they all work together in one integrated system. This system mainly aims to prepare the staff members for acute procedures, to expose which non-technical skills they should improve, and to allow the staff members to individually develop their non-technical skills. Eventually, these new opportunities will accelerate the transition towards desired behaviour in LUMC’s ICU.

Microcatheters are used for endovascular diagnosis and treatment purposes. Variations of this minimally invasive instrument, accompanied by guidewires, are manipulated through the vasculature towards the target of the intervention. The human vascular anatomy can however present complex pathways towards a target, for example a distal tumor. Interventions are challenged by limited 2D imaging, and a limited degree of motion and control of the instruments. This thesis therefore focuses on developing a novel endovascular microcatheter with a steerable tip, a project commissioned by Mencius Medical BV. It elaborates on the theoretical substantiation of the designed distal steering mechanism, that is developed based on an existing patent. It covers part of the design process and documents the development from patent to working prototype. The design process commences with observations in the operating theatre and specialist interviews, allowing for thorough understanding of the clinical need. Based on this need, the catheter tip is designed with a unique mechanism, enabling controlled tip deflection while inside vascular environment. A user-centered approach enabled fast and efficient convergence of design choices. The concept is evaluated on its technical feasibility, producibility, and functionality. A thorough mechanical and computational (FEA) analysis evaluates the material choice and feasibility of the design by simulating the system’s behavior in context of use. This analysis confirms a theoretical proof of principle. A user test with various prototypes in pre-clinical environment provides the first step towards practical proof of principle. A recommendation is done for further in-vivo validation for final proof of concept. The device potentially allows the interventionalist to take the entire route through the vascular roadmap with one device, eliminating a trial and error process and the need for exchanging multiple instruments during the procedure. Consequently, operation time, radiation, frustration, vessel trauma, and equipment waste are minimized. Lastly, it might increase the accessibility of more distally located tumors, which is groundbreaking for tumor treatment and interventional radiology in general.

With the introduction of the Quadruple Aim at Philips, healthcare staff experience is recognized as an important health system performance indicator. Engaged healthcare employees are related to retention, patient-centered care, high patient safety and improved quality of care provided. However, burnout seems to be a common phenomenon among healthcare personnel. Especially employees from radiology departments are prone to developing burnout symptoms. This does not only have negative consequences for the individual’s well-being and the organizations’ performance, but also negatively affects the quality of patient care. As Millennials are the least engaged generation but will take up 75 per cent of the workforce in 2025, this thesis proposes solutions on how Philips might support Millennial healthcare employees within radiology departments to enhance engagement in 2030. This has been done by extensive research on how to create an employee experience that enhances engagement, how this looks like for Millennials at radiology in the future and exploring the opportunities for Philips to support this. Field research revealed that technologists mainly value involvement in the workflow, department and hospital. This can be enhanced by giving them more responsibility based on interests, experiences and knowledge that they build up during their job. This means that in the future, technologists will have tailored roles (e.g. management-expert, patient care-expert and technology-expert) and could take over tasks of radiologists and residents. Residents mainly value staff equality that creates an open and safe learning environment. This can be enhanced by structuring the supervision and assessment and by tailoring their learning pathway. This means that in the future, they will have personalized learning pathways which are tailored to their needs and learning preferences. Radiologists mainly value being result-driven to define diagnoses as soon as possible. This can be enhanced by technology support in the workflow and in the interpretation of scans and images. This means that in the future, technology will take over simple tasks and will enable a more efficient workflow for radiologists who will have more time to focus on complex cases and collaboration with other physicians. Based on these findings, five service propositions are designed on how Philips might support the Millennial employees at radiology in the future to enhance their engagement. Four service propositions are created during a creative workshop with Philips employees. As confidential information was used in this workshop, these four service propositions are considered confidential. One service proposition is created based on an individual brainstorm and insights from the project and is applicable to all roles within radiology: As the roles of radiology employees will change into becoming more visible and specialized based on preferences and technology support, it is necessary to have a clear overview of all employees to sustain the employee engagement within the employee, department and hospital workflow. This can be supported by “a personalized planning that helps radiology employees who want to define diagnoses as soon as possible, be involved in the workflow, department and hospital, and want to learn in an open and safe learning environment by allocating employees correctly based on their tailored tasks and managing the workflow efficiency.” All findings of this thesis are presented in the format of a roadmap where the design innovation elements are visualized: the changing role of radiology in the future, the employee values, the future scenarios and the service propositions. These propositions will serve as inspiration for projects or research initiatives for Philips to continue with. However, the next steps for Philips are to validate these service propositions with radiology employees to explore the desirability. Besides, these service propositions need to be validated based on feasibility and viability within Philips and should be benchmarked to other health technology companies as well as companies that provide educational services within healthcare.

This report presents a design proposal of a product-service system that is supposed to facilitate cardiologists in their auscultation responsibilities. Auscultation today is usually still performed with an acoustic stethoscope, in which the cardiologist tries to recognize abnormalities concerning the patient’s heart through attentive listening.

The efficiency driven practices of modern healthcare have forced cardiologists and other medical professionals to become even more economical with their time. Currently, doctors only have a timeframe of 600 seconds to see a new patient. Since the stethoscope is almost always the first tool used for diagnosis, it can be seen as the first factor that determines if the patient reaches the “further testing threshold”. Therefore it is paramount for the general quality of healthcare that auscultation is performed in the best way possible, since this can determine whether further testing is done on the patient, or the patient is sent home. The relevance of this auscultation success is backed up even more by the fact that heart-disease is responsible for 45% of European annual deaths alone.

The problem, which is a concoction of the efficiency driven practices in healthcare combined by the neglect of auscultation in medical education and the available tools at hand, was attempted to be improved and solved by the design proposal in this report.

Together with doctors, a product-service system was created that makes use of Artificial Intelligence, seamless automation, improved ergonomics and feedback loops in order to facilitate the cardiologist during auscultation.

The design proposal aims to increase medical effectiveness and diagnostic potential, facilitating cardiologists in their auscultation responsibilities by creating a new and improved diagnostic tool in the form of an electronic stethoscope that harmonises with the efficiency of the auscultation process in an unobtrusive way; benefiting both the cardiologist and the patient.


The main part of the design consists of a physical product in the form of an electronic stethoscope supported by a system consisting of a simple Bluetooth Forwarding Application and Desktop Application.

The design proposal was qualitatively evaluated with several cardiologists during a presentation at Maasstad Hospital. It was received with great positive response on the fronts of both appearance and presented functionality.

In order to substantiate the promising outlook the design proposal elicits, long term testing with a 0-series product- service system will need to be done.