Requirements and Design for Smart Healthcare Applications

When developing a "smart healthcare" application that takes the participants beyond their experience of the conventional analogue of that application, a challenge is to gather the requirements for the application and to map those requirements onto a successful design. Some requirements will come from the conventional way of delivering the healthcare service. Some will come from the domains of the technologies that have been used to create the smart healthcare application. Some requirements, however, particularly for point-of-care applications, will emerge from the interplay of the actual clinical situation and the novelty of the smart healthcare application. This paper draws on a case study of the development and clinical trial of a point-of-care telehealth application at a tertiary level of healthcare to illustrate the process of requirements elucidation and the mapping of those requirements onto the design of the telehealth system. The telehealth application supports outpatient consultations for postoperative paediatric surgery patients. The consultations involve multiple participants, each with different requirements for the application. They engage in a complex dialogue supported by many shared sets of patient data. They bring differing points of view to the consultation and have differing criteria for a successful outcome. The case study highlights that, at this complex level of healthcare, important requirements for the ongoing success of a smart healthcare application may be uncovered during early clinical trials. While these early clinical trials need to focus on clinical outcomes, they also need to not be bound by rigid trial protocols. Unforeseen events and behaviour may occur during the trials. These should be accommodated, in the interests of the patient, and properly recorded, so that they can contribute to a wider understanding of what is needed for the healthcare application to be successful.