“Inclusive design is an approach to designing and delivering services that ensures everyone can access NHS services regardless of their background or life experience.” Human centred design puts real people at the center of the development process, staring with the people you’re designing with and ending with new solutions that are purpose-built to suit their needs.
Taking these two concepts together, inclusive human centred design is an approach that places people at the heart of the design process to create products, services, and environments accessible to the widest possible range of users.
The Double Diamond Design Process
The Double Diamond design process was highlighted by the UK Design Council as a visual representation of the design and innovation process. Since its publication in 2005 it has been used as a way to understand and explore the design process for non-designers such as digital intervention researchers. The process can be used irrespective of the type of methods and tools used so is suitable for different disciplines. This was then updated in 2019 to take into consideration the iterative nature of the design process with organisations or researchers learning something new about the problem while working through the diamond method. This means that early testing phases can form part of the discovery section of the diamond. This has been called the Framework for Innovation.
This process is very helpful to incorporate the principles of human-centred design and the Design Council has proposed this approach to describe the steps taken in any design and innovation project, irrespective of methods and tools used.
Inclusive Human Centred Design for the Development of Digital Interventions
The four stages of the double diamond method are used in an inclusive human centred design approach for digital approaches
Discover the problem
This stage involves understanding the problem. This includes speaking to and spending time with the end-users (stakeholders). In our case this is people with mental health conditions, their carers or healthcare professionals. During this period of time it is vital to explore the context and peoples’ experiences, to identify needs.
Define the problem
This stage involves summarising the users’ needs, with both researchers and stakeholder involved in this process, to define opportunities for improvement and define an evidence-based solution.
Develop solutions
This involves the collaborative creation of multiple possible digital designs focusing on content and user experience and end-users are recruited to begin testing the possible solutions during this phase.
Deliver a solution
During this stage the best solution is selected by the collaborative team and a higher quality prototype of the digital therapy is developed. Pre-clinical usability testing is conducted with stakeholders. User feedback informs future design changes and research. In non-digital therapy interventions the solution may well be initially delivered as part of this stage due to a lack of regulations where an intervention is not defined as a medical device.
More evidence is needed in the Double Dimond method when designing a digital therapeutic product prior to clinical implementation which would require a Notice of no objection from the MHRA (link to relevant webpages here). For example in the development of SloMo based on the 2005 Double Diamond method the end stage “Deliver” only initial resulted in the minimal viable product. This is the point at which for digital therapies a Notice of No objection would need to be sought from MHRA to test the product with patients in a clinical setting. As the 2019 Double Diamond amendments have shown this would then lead a renewed need to discover the problem, define the solution, develop the solution and deliver the solution based on the chosen setting (e.g. if it were NHS Hospital specialist service or community based services).
Resources
A paper that describes the use of the Double Diamond process to develop one of the NIHR Maudsley BRC supported Medical Devices SloMo which is a psychological intervention for psychosis : How Inclusive, User-Centered Design Research Can Improve Psychological Therapies for Psychosis: Development of SlowMo
A paper providing an overview of evidence-based co-design, using the example of SloMo, a blended digital therapy for paranoia: Co-designing technology to improve psychological therapy for psychosis: SloMo, a blended digital therapy for fear of harm from others
Short animation to explain co-design and co-production
