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Social innovation by design in mobile healthcare forsleep disorders

Marie-Julie Catoir-Brisson

To cite this version:Marie-Julie Catoir-Brisson. Social innovation by design in mobile healthcare for sleep disorders. De-sign as a catalyst for change, Design Research Society, Jun 2018, Limerick, Ireland. pp.2324-2333�10.21606/dma.2018.264�. �hal-01841771�

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SocialinnovationbydesigninmobilehealthcareforsleepdisordersCATOIR-BRISSONMarie-Juliea*

aAssociateProfessorofDesignandCommunication,UniversityofNîmes,ProjektLab(EA7447)*Correspondingauthore-mail:marie-julie.catoir@unimes.frdoi:10.21606/dma.2017.264

This project-grounded research aims at answering a need for research on sleepdisorders and connected objects, through an interdisciplinary dialogue betweenhumanandsocialsciences,medicalsciencesanddesign.Theobjectiveofthisarticleistoanswerthefollowingquestions:howcansocialinnovationbydesignsustainthedevelopmentof innovativemedicaldevices?Howcandesignwork tooptimize theprevention, the support and the follow-up in sleepmedicine? The project aims atcreating a digital platform optimizing the circulation of the data, the customer’sjourney and the communication between patients and care professionals. Theresearchhashadadoublescientificchallenge,carryingontherapeuticeducationinsleep and digital health literacy, especially in the field of medical computing andmobile devices for chronic diseases. First, the scientific roots andmethodology isexplained. Then, the methods of inquiry and the results are reported. Finally, acontribution todesign research forhealthcare isproposed, focusingon the roleofdesign in promoting sleep’s hygiene through the creation of suitable services,products,experiencesandhealthcareenvironments.

Keywords:m-Health;insomnia;servicedesign;digitalliteracy

1. IntroductionThisarticledealswithaproject-groundedresearchcurrentlybeingdevelopedatthePROJEKTLabattheUniversityofNîmes,onservicedesigninmobilehealthcare(especiallysleepdisorders),incollaborationwiththeUniversityHospitalinNîmes1.Basedonaninterdisciplinarydialoguebetweendesignsciences,informationandcommunicationsciencesandmedicalsciences,thisresearchinvolves,atthesametime,interactiondesign,servicedesignandsocialinnovationbydesign.Usingexperimentationsandprototyping,theobjectiveistoshowthatadigitalservicecanbeusefultoeducateandtofollowinsomniacpeopleup,ifitisintegratedinacarenetworkandsupportedby

1Theresearchisco-managedbyDrBeatrizAbril,NeurologistandSleepdisorderspecialist,DrGauthierBrisson,General

careprofessionals.ThefinancialcontributionoftheUniversityHospitalinNîmes(SecondawardwoninOctober2016attheInnov’actionsTrophy)hasmadethisone-yearstudypossible,toassessthefeasibilityoftheprojectandtomakeinquirieswithlocalstakeholders.Researchisneededonchronicinsomniaandconnectedobjects.InFrance,insomniaisapublichealthproblemthataffectsalmost20%ofthepopulation.InspiteoftherecommendationsoftheHAS(HauteAutoritédeSantéwhichisFrenchHealthHighAuthority),patientscareislimitedatanylevel:accesstohealthcare,availabilityoftheprofessionals,lackofeducationalkittools,reimbursementforhealthcare,andadversedrugreactions.Moreover,connectedobjectsandappsdedicatedtosleeparegrowingfasterandfaster.Theyareusedbythecitizens,withoutanymedicalsupervision,andareoftengivenupafterafewmonths(Kebs,Duncan,2015).Buttheiremerginguseimpliesthedevelopmentofhealthdigitalliteracy.Thesetechnologicalinnovationsandthesocialchangesaccompanyingthemmaketheparticipationofhealthprofessionals,designers,researchersandcitizensinthefieldofmobilehealthcareforsleepdisordersnecessary.Problematicsinthisstudyaimtoanswerthefollowingquestion:Howthedesignofmobilehealthtechnologiesinthefieldofinsomnialeadstorethinkthecooperation’smodelsbetweenhealthcareprofessionalsandpatients,thecarejourneyofthepatientsandtheroleofthedifferentstakeholders?Thisarticleconsistsinthreepartstocopewiththiscomplexissue.Inthefirstpart,thescientificrootsandthemethodologyarepresented.Inthesecondpart,thefirstresultsoftheresearcharediscussed.Inthethirdpart,acontributiontodesignresearchforhealthcareisproposed.

2. Scientificrootsandmethodology:socialinnovationbydesignanddigitalsocialinnovation

Tostartwith,let’sintroducethedifferentconceptandvaluesofthedesignresearch,inordertodefinethespecificityofthemethodology.

First,thisproject-groundedresearchispartofaspecificmethodologycalledrecherche-projet(Findeli,2003),characterizedbythefactofarticulatingaresearchprojectandaservicedesignproject.Itisakindofaction-research2(Rapoport,1973)tomaketheexperienceoftheparticipantsbetter.Consideredatthesametimeasexpertsoftheirownexperienceandbeneficiariesoftheproject,theyareinvolvedinthesearchforsolutions.

Tobemorespecific,themethodologyisbasedonaninterdisciplinarydialoguebetweenmedicalsciences,socialandhumansciences(inpeculiarinformationandcommunicationsciences)anddesignsciences,aswecanseeinthediagrambelow.

Figure1–Interdisciplinarymethodologyoftheproject-groundedresearch

2AccordingtoRobertN.Rapoport(1973,p.115),«action-researchaimsatmakingacontributionatthesametimetothepracticalconcernsofpeoplebeinginproblematicsituationsandtothedevelopmentofsocialsciences,byacollaborationthatconnectsthemaccordingtoamutuallyacceptableandethicalplan.»

Secondly,itisimportanttoexplainthemeaningofsocialinnovationthroughinthisresearch.Socialinnovationbydesignisatopicalissueinhumanandsocialsciencesespeciallyinthedesignsciences.Nevertheless,itisnotreallynewandthistrendtakesupwiththeoriginsofdesignhistory(forinstance,theworksoftheBauhaus,thenV.Papanek,A.Findeli).Designsciencesmayseizetheproblemofsocialinnovationtodaybecausethesetwofieldshaveincommontostudytheproblematicofuses,andtrytostandoutfromtechnologyandproduct-centeredinnovation.Thisapproachgivesthepatientsapowertodesignandact,besidehealthcareprofessionalsandadministrations.Thus,digitalproductsandservicescanbedesignedforsocialchange,asfarastheyaredesignedtocreateusesandbehavioursdedicatedtosocialinnovation(Tromp,Hekkert,Verbeek,2011).Itisimportanttounderlinetheimplicationofbothpatientsandprofessionalsinthisproject,toexplainhowitispossibletoreframepatientsaspersonswithactiveparticipationintheirownhealthcare.Theobjectiveoftheprojectistobuildahumananddigitalnetworkinwhichthepatientscandeveloptheirhealthcareanddigitalskillsbasedontheexpertiseoftheirownexperienceofpatients.Inaddition,healthcareprofessionalscandeveloptheirknowledgeinthefieldofinsomniaaswellastheirdigitalliteracy,bytakingpartintheservicenetwork.

Thespecificityofthisproject-groundedresearchisalsobasedonhuman-centered-design(Buchanan,2001).Theobjectiveistogofurthertotheproblematicofusetoreachsocialissuesinvolvingthedesigner’sresponsibility3.Human-centered-design“isanon-goingsearchforwhatcanbedonetosupportandstrengthenthedignityofhumanbeingsastheyactouttheirlivesinvariedsocial,economic,political,andculturalcircumstances.”Asaconsequence,“thequalityofdesignisdistinguishednotmerelybytechnicalskillofexecutionorbyaestheticvisionbutbythemoralandintellectualpurposetowardwhichtechnicalandartisticskillisdirected.4”Inthisperspective,theobjectiveoftheproject-groundedresearchistodevelopacreativeethicsoftechnologythatisclosetoethicsbydesign,basedontheresponsibilityoftheactofdesignintheproposalofanexperience-à-vivre(Vial,2015)fromfivekeystepsinthedesignprocess:understandingtheexperienceoftheusers,usingparticipativemethods,relyingonasystematicapproach(tocreateasynergybetweenalltheactors),makingworkshopsinordertopracticeideation,co-creationorco-designservicesandprototypeswiththebeneficiaries,inaniterativewayofthinking.

Atlast,digitalsocialinnovation5isalsopartofthemethodologyofthisproject.Thisapproachoftechnologymakesthemovementfromtechnological-centeredinnovationtosocialanddigitalinnovationpossible,inwhichdigitaltechnologyisputintheserviceofthecommongoodforpublichealthinterventions.

3. Methodsofinquiry:aqualitative,participativeandcreativeresearchThefirststepofthedesignprocesswasdedicatedtoinquiry,inthefieldofthepublichospitalinNîmesbutalsoinofficepractice(generalpractitioner).Thismethodologywasusefultounderstandandthentomakemanyactors(patients,healthcareprofessionalsandadministrations)takepartinthehealthcareproject.Itcanbeconsideredasacontributioninbothresearchandpracticeoninsomniabecause“nostudywasfocusedonthecross-personalviewsoftheseactors.6”Thequalitativemethodswereusedtocollectdataontherepresentations,thepracticesandtheexpectationsoftheparticipants.

3TrompN.,HekkertP.,VerbeekP-P.,«DesignforSociallyResponsibleBehavior:AClassificationofInfluenceBasedonIntendedUserExperience»,DesignIssuesVol.27,N°3,2011,p.3-19.4BuchananR.,«HumanDignityandHumanRights:ThoughtsontheprinciplesofHuman-CenteredDesign»,inDesignIssues,Vol15,n°3,2001,p.35.5OurresearchleadsonthevaluesdevelopedintheEuropeancommunityresearchofDSI:https://digitalsocial.eu6GaboreauY.,PricazF.,Cote-ReyA.,RoucouI.,ImbertP.(2017)«Consensus,controversesetdissensionsentremédecinsgénéralistesetpatientsautourdel’insomniechroniqueprimaire»,RevueExercer#130Volume28,CollègeNationaldesGénéralistes,février2017,p.52.

Figure2Observationperiodsandinterviews

Theinquirywasbasedonthreesteps:observationperiods,interviewsandworkshops,fromFebruarytoJune,in2017.ObservationsofspecializedconsultationsintheSleepMedecineUnityoftheUniversityHospitalinNîmeswereundertakenwiththeagreementofthedoctorsandfifteenpatients.Then,semi-structuredindividualinterviewsandfocusgroupbasedonvisualandcreativemethodswereorganisedinthepublichospitalandintheofficeofageneralpractitioner(withdoctors,patients,medicalsecretaries,andalsolocalpublicadministrations(ARSOccitanie,CPAMduGard).Thisstepwasusefultounderstandthelimits,constraintsandthespecificitiesoftheconsultationinmedicalcityofficeandinthepublichospital.Itwasalsohelpfultovisualisethepatient’sjourneyinordertounderlinetheproblemsbetweenthepatientsandthetouchpointsoftheirhealthcarejourneybetweenpublichospitalandmanyhealthcareprofessionalsinthecity).TheanalysisofthedatacollectedduringtheobservationsperiodallowedustodesigntwoworkshopsinAprilandJunebasedoncreativemethodandco-design.

Thefirstworkshopwascomposedoftwelvehealthcareprofessionals(psychologist,generalandspecialistpractitioners)inordertocometogetherthemainactorsandtounderstandtheiractualproblemsintheinsomniacpatient’sjourneyandtheirusesofdigitaltoolsandmobiledevices.Visualandcreativemethodswereusedtomaketheexpressionoftheparticipantseasier.Visualmaterialscamefromtwodifferentsources.Theparticipants-especiallythegeneralpractitioners-wereinvitedtosendsomephotographsofthedigitaltoolstheymayuseintheireverydayprofessionalpractice.Forexample,twogeneralpractitionerssentusascreenshotoftheirmobilephonerepresentingthehomepageofKlepios(anappfordoctorswithasyntheticmedicalindexofthemainpathologies;seehttps://www.klepios.com)andUnivadis(freemedicalappandwebsitewithmedicalinformation,especiallyondruginteractions;seehttps://www.univadis.fr).Wealsogaveboardsandvisualcardsrepresentingvariousdigitaltoolsusedinmedicalcityoffice,madebythesocialservicedesigneroftheproject.Thevisualmethodsusedinthisinvestigationwerebasedatthesametimeontheparticipants’,thedesigner’sandtheresearcher’sproductions.Welettheparticipantsfreetocovertheboardswithnotesinordertorepresentthedigitaltoolsforwhichtheydidnothaveanypicture.Withthismethodology,wecollectedinformationontheindividualpracticesoftwelvehealthcareprofessionals.

Figure3Workshop#1April2017

Thesecondworkshopofco-designatthebeginningofJunewasmadewithpatients,healthcareprofessionalsandadministrators.Differentmethodscomingfromgamestormingwereused,basedonactivitiesmadetousespaceasanexpressionofopinions,andalsovisualandcreativemethods.Theparticipantswereinvitedtoworkinsmallgroupsofthreeorfourpeople,andeachteamhadtomixpatientswithdoctors,andasecretaryoranadministrator.Visualmaterials(suchasgameboard,cards,personas,patientcarejourney,map-tools,mapofthenetworketc.)werepreparedbythedesignerandresearcherandproposedtotheparticipantstosupporttheirexpressionbyplayfulandparticipativematerials.

Theresultsofthisco-designworkshopwereveryuseful,asthreemapsofthecareprofessionalsandinsomniacpatientsnetworkweresketched,inordertoexpressdifferentvisionsofthesleepinstituteimaginedbytheparticipants.Inaddition,morethantwentydigitaltoolsattheserviceofthehumannetworkwereproduced,allowingtoimaginethedigitalandhealthcareservicesoftheinstitute,thefunctionsofthewebsiteandtheconnectedobjectusedtooptimizetheprevention,thesupportandthemedicalfollow-upinsleepmedicine.

Figure4Workshop#2June2017

Thevisualmethodswererelevanttomakethevoicingofopinionseasierandtoincreasetheimplicationoftheparticipantsintheworkshops.«Thisimplicationcanbeexplainedbythefactthatvisualmethodsofferparticipantsthepossibilitytoexpressthemselvesfromseveralmaterialsthattheycanmobilizeinafreeway.7»Allthevisualandphysicalmaterialswereusedasmediation’ssupportintheworkshops,attheserviceofthemethodologyofthisproject-groundedresearch.Relyingonco-designandinclusivedesigncanbeausefulwayofleadingorganizationalchange-makingbasedonamethodtoinvolveparticipants,whocanbecareprofessionals,patientsandrelatives.Thissystemicdesignpracticeandresearchisnecessaryinthefieldofhealthcarebecausethisspecificfieldisacomplexfield,whichcombinestheinterventionsofmanydifferentstakeholders.

Theobservations,theinterviewsandthetwoworkshopsallowedtodrawandtoproposesomesolutionsthatcanbeusefultotheresearchandtotheproject.Themainresultsaccentuatedthenecessityof1/creatingapatientsandhealthcareprofessionalsnetworktodeveloptherapeuticeducationandtooptimizethepatient’scarejourney;2/improvethecommunicationbetweenhealthcareprofessionals,patientsandadministrations.Thisnetworkwouldbebasedonadigitaltoolallowingtocollectdataonthepatient,whichwouldservetodeveloptheresearchonsleepingdisorderswithinalivinglab8(ENoLL,2008).Thedatawouldbevisualized,afteraworkofinformationdesign,toinformthepatientsontheirownmechanismsofsleepandimprovetheunderstandingandthefollow-upoftheirpathology.Ahumancareprofessionalnetworkinthelocalcommunitywouldsupportthedigitalnetwork.Theseresultsinviteustothinkaboutthewaythedigitaltechnologyre-configuresthemedicalpracticeandthecommunicationbetweendoctorsandpatients.Theyalsoopenthereflectiononthemutualcontributionsbetweeninformationandcommunicationsciencesanddesignsciences.

Moreover,wecanlistthevariousprojectdeliverablesthatweproducedduringthisfirstyearofstudy.Abook-includingtheresultsoftheenquiry,somerecommendationsforthedesignoftheinstitutededicatedtoinsomnia,morethantwentydigitalandeducationaltoolsforpatientsandcareprofessionals,andusersscenarios-wasprinted.ApedagogicalprojectwasalsomanagedwiththestudentsoftheMaster’sprogramme“DesignInnovationSociety”(MasterDIS)intheUniversityofNîmes,fromOctober2017toJanuary20189todevelopthepossibledeliverablesoftheproject.Theobjectiveofthepedagogicalprojectwastomakestudentsunderstandthecomplexityofthefieldofhealthcare,andimaginesolutionsabletochangecustomer’sjourney,landscapeandexperienceinhealthcarethroughsocialinnovationbydesign.Thestudent’spropositionswereusefultogiveformtothehumannetworkthatcanimprovethepatient’scarejourneyandtodeveloptheinteractiondesignbetweenthedigitalnetworkandtheconnectedobjectdedicatedtothedatacollectiononsleep(includingaprototypeofthewebapplication).Ashortdocumentarywasproducedtoexplaintheprojectmethodologybasedonsocialdesign.Awebsiteisalsoproposedtofollowthecurrenteventsoftheproject(see:https://projetsomhealth.org).

Itisimportanttofinishwiththemainlimitsofthisexperienceofproject-groundedresearchinthefieldofhealthcare.Wecanlistthreelimits:1/politicallimitsbothinthelocalandnationalcontextaschronicinsomniaisnotconsideredasapriorityinFrenchhealthpolicyduringthisone-yearstudy;2/limitsinrelationwiththestakeholderssuchasrepresentationsofpatientsandcareprofessionalsoninsomniaanditstreatment,fearsofchangeandoftechnology,accesstoprofessionals;3/limitations

7Catoir-BrissonM-J.,JankeviciuteL.,«Entretienetméthodesvisuelles:unedémarchederecherchecréativeensciencesdel’informationetdelacommunication»,Sciencesdelasociété,92,2014,p.125.8AccordingtotheEuropeanNetworkofLivingLabs(http://openlivinglabs.eu):“aLivingLabisaboutexperimentationandco-creationwithrealusersinreallifeenvironments,whereuserstogetherwithresearchers,firmsandpublicinstitutionslooktogetherfornewsolutions,newproducts,newservicesornewbusinessmodels.”9ThispedagogicalprojectwassupervisedbyMarie-JulieCatoir-Brisson,incollaborationwithLucileHauteandSandrinePirolles.Participatingstudentswere:YounesGzouli,MarylouPlanchon,EmelineTiteux-Flores,TiphaineRosier,AlanShammas,CamilleSoulier.

ofthemethodology,inpeculiarfortheparticipativeaction-research:difficultytomakecareprofessionals(especiallydoctorsandhealthadministrations)participateintheworkshops.

4. AcontributiontoDesignResearchforHealthcareInthisthirdandlastpart,acontributiontodesignresearchforhealthcareisproposed.Ourproject-groundedresearchcanbestudiedtodemonstratehowdesigncanimprovethepreventionandthepromotionofsleep’shygienethroughthecreationofservices,products,experiencesandhealthcareenvironments.Moreprecisely,themethodologybasedonsystemicdesignallowsustoopentheprojectfromaservicefocusedonmobiledevicestoaprojectofinstituteconsideredasacomplexofsystemsandservicedesigndedicatedtoinsomniapreventionandtreatment.Ahumananddigitalnetworkofpatientsandprofessionalscansupporttheinstitute.Inaddition,mobiledevicesandconnectedobjectscanbeusedtoservevariousstakeholders.Theglobalsolutionincludesoptimizingthepatientcarejourneyandthecommunicationbetweenpatientsandcaringprofessionalsthroughsecureinformationsystemsanddatabase.Accesstothepatient’sdatashouldbeco-definedbypatientsandcareprofessionals.Thispeculiarityisveryimportantfortheethicvalueoftheproject.Buttheaccesstothepatient’sdatawillalsoneedtoconsidertherecommendationsoftheFrenchHealthHighAuthority(HAS10)andthelegalregulationsondataprotectionintheEuropeanUnion.Theminimalequationofthedigitalplatformiscomposedofprofessionals+data+patients.Andthefinalformofthedigitalnetworkshouldbesuitabletotheconstraintofinformationsystem’sinteroperability(inpeculiarbetweenthesoftsusedinpublichospital,cityofficeandpublicadministrations).Thistechnologicalchallengewillbepossibleonlyifthesocialinteroperabilitybetweenthevariousactorsismadepossiblebythelocalandnationalpublichealthauthorities.Thisprojectofconnectedobjectsandsleepmedicineaffectshealthpublicpolicies.ThissupportedneedtoimprovethedevelopmentoftheprojectwasalsorecommendedbyoneofthegeneralpractitionersinthefirstAprilworkshop.Henoticedtheimportanceofa"politicalsupport"todevelopa"nationalinformationcampaign"onchronicinsomnia,tostrengthenourinitiativeofnetworkonthefieldwork.Thisiswheredesigncanbeusefultodevelopinformationandeducationalkittools,tosustainsleephygieneandpatients’andcareprofessionals’digitalhealthliteracy.

Theresultsofthisone-yeardesignresearchleadustothinkaboutmutualcontributionsbetweeninformationandcommunicationsciencesanddesign,andtofocusonthecontributionofdesigntothefieldofhumanandsocialsciences.

4.1Mutualcontributionbetweeninformationandcommunicationsciencesanddesign

Ontheonehand,wecanemphasizethelinksbetweenthesetohumanandsocialsciences.Indesignsciences,theprojectisseenas“theactofdesign”andtheactofdesignisan“actofcommunication”(Vial,2014).Itcanbeanalysedfrombothperspectives:conceptionandreception,thatistosay“thedesigngesture”and“theeffectofdesign”(Vial,2015).Theactofdesignreferstotheactofcommunicationinherenttoanymediadevice.Inthisproject-groundedresearch,thelinkbetweenthetwosidesoftheco-constructionofthemeaning(bydesigneranduser)isanalysedwiththreemainapproachesthatbuildthespecificityofthemainresearcher’sprofile:semiotics,communicationandanthropology.

Moreover,itisnecessarytoputthedesigner’sandresearcher’srolesinaproject-groundedresearchintoperspective,especiallyinthefieldwork.Ourexperienceofthisprojectmakesusthinkthatthesetwoapproachesarecomplementary.Withtheresearcher,thedesignercontributestothecreationofmediationdevicesthatarehelpfultothetransmissionandthecollectionofinformationbetweentheparticipants.Thevisualmaterialscanbeconsideredas“transitionalobjects”,usefulina“potentialenvironmentofskillsdevelopment11”.Thesematerialsbuildupanenvironmentallowing

10SeetheFrameofreferenceofthebestpracticesonhealthapplicationsandconnectedobjectspublishedin2016:http://webzine.has-sante.fr/portail/upload/docs/application/pdf/2016-11/has_ref_apps_oc.pdf11BertenA.,(1999),«Dispositif,médiation,créativité:petitegénéalogie»,Hermès25,Ledispositif,CNRS,p.41.

todevelopthenecessaryconditionstodevelopthecreativityoftheparticipants.Inaddition,thedesignercandrawvisualsynthesisoftheenquiry,whichcanenlightensomecharacteristicsofthequalitativeanalysis.

Ontheotherhand,themediationtoolsproducedinandfortheprojectcanbeconsideredascasestudiesininformationandcommunicationsciences.Thesecreativetoolsbasedonvisualmethodologycontributetotherenewalofthequalitativeinquiriesinhumanandsocialsciences,withdifferentobjectivesaccordingtothedifferentstepsoftheproject.Intheperiodsofobservation,thevisualmaterialscaneasethevoicingandtheexpressionoftheparticipants.Theyareusefultocollectrepresentations,experiencesanddataco-producedbystakeholders,designersandresearchers.Intheworkshops,thesemediationtoolscanbeusedtohelptheparticipantsgiveformtotheirideasandsolutions.Inthedevelopmentphaseoftheproject,visualmaterialscanbehelpfultocommunicatethesolutionstothebeneficiaries,andtosketchuser’sscenariostoexplainthefunctionsofthecomplexsystemofservicedesign,relyingonastorytellingfocusedonapatientexperience.

4.2Specificcontributionofdesigntohumanandsocialsciencesinthefieldofhealthcare

Attheendofthisone-yearstudyondesignandmobilehealthinthefieldofsleepmedicine,wecanunderlinetheadvantagesofourmethodologybasedonsystemicandinclusivedesign:implicationoftheparticipantscommittedintheco-designprocess,appropriationoftheprojectandthevaluesoftheproject,andempowermentintheprevention,thecareandthefollow-upofchronicinsomnia.

Theparticipativedesignpracticeandresearchalsoallowedtheparticipantstoseizetheprojectandtobecomesomecontactpersonsineachcommunityofthelocalterritory.Theyparticipatedinthedistributionoftheprojectintheirownnetworks.Tous,thisistheminimalconditiontomakeaprojectdedicatedtosocialinnovationinhealthcaresuccessful.Indeed,co-designcanimproveacceptabilityandadoptionofthesolutionsbythebeneficiariesasfarastheycantakepartinthedesignprocess.

Thequalitativeapproachallowedustoseizethefears,theexpectationsandtheaspirationsofthestakeholders,tobeabletoproposethemostadaptedsolutions.Thecontributionofdesigntohumanandsocialsciencesinthefieldofhealthcareistotaketime,withqualitativeandparticipativemethodstounderstandtheconstraintsandtherepresentationsofthestakeholders.Thisapproachisrelevanttoidentifytheirreluctanceandtofindsolutionstogowiththeculturalandsocialchange.Byunderstandingthefearsandthereluctancesoftheactors,andputtingoneselfinthemainbeneficiaries’shoes-whosometimesliveinnovationasanorder,thequalitativemethodologiescanaccompanytheinnovationinthefieldofhealthcaretoacculturatetheprofessionalsandthepatientsinthecollectiveintelligencebasedoncreativemethods,butalsointhedigitalhealthliteracy.

Atlast,wecandistinguishfivefiguresofthedesigner’smediationroleinaproject.Thedesignercanalsobea“competenceconnector”(Deni,2014),acoordinator,acommunicator,afacilitatorandatranslator,abletomanagetheinter-professionalandinterdisciplinarydialoguebetweenthemultiplestakeholders.Newrolesforthedesignercanbeidentifyinthecomplexfieldofhealthcare.Sleepmedicine,asanewcross-disciplinarydiscipline,offersgreatchallengesfordesignerstoleadmultidisciplinarygroupsandmakemajordecisionsthatwillinfluencebehaviourcontributingtolong-termpreventionandbetteroverallpopulationsleep’shygiene.

5. ConclusionToconclude,thisproject-groundedresearchondesignandm-Healthdedicatedtosleepdisorderscanbeconsideredasanattempttocontributetothedesignresearchonhealthcareandwellbeing.Thespecificcontributionisaboutthesystemicdesignoftheproject,includingmanystakeholdersandsomedigitaltoolsattheserviceofthepatientsandcareprofessionalsnetwork.Thesystemic

approachisusefultounderstandhowitisnecessarytore-designthewholeexperienceofthepatient’scarejourney,andtodesigneducationalkittoolsforpatientsandcareprofessionals,includingtelemedicineserviceandmobilehealth.

Thespecificityoftheprojectandofthecomplexfieldworkleadustobuildupamethodologybasedonsocialinnovationbydesign,togivesuitableanswerstothequestionsweidentifyonthefield.Inthisperspective,thisproject-groundedresearchgoesforwardtoobjectorservicedesigntoreachtosystemicdesignofsystemsandservicesbasedonsuitablesolutionsforthemainstakeholders.Thescientificrootsoftheresearch,basedonhuman-centered-designleadustoworkonsocialinteroperabilitybetweentheactors.Thesolutionsaredesignedtooptimizethecommunicationbetweeninsomniacpatientsandcareprofessionals,toimprovethepatient’scarejourney,todevelopthetrainingofprofessionalsinsleepmedicineandtherapeuticeducation,andtodevelopdigitalhealthliteracy.Theobjectiveoftheprojectisthustoconsiderthebenefitsformdesigningadigitalservicededicatedtoinsomnia,whichisintegratedinapatientandprofessionalnetwork,toimprovetheimplicationandsustaintheempowermentofinsomniacpatientsintheirownpathology.

Inaddition,wecansaythatfurtherresultscouldbepresentedtotheDRSCongressinJune2018,asthecurrentdevelopmentphasehasledthescientificteamtomeetpotentialpartnerstodevelopaprototypeofthedigitalnetworkandtheconnectedobjectsinthefollowingtwoyears.

Tofinishwith,thesetwoinitiativescanalsobeconsideredasanattempttounderlinetheroleofdesigninpreventionandwellbeinginsleepmedicine.

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AbouttheAuthor:

Marie-Julie Catoir-Brisson works on mHealth and social innovation. Her recentworks deal with digital interfaces, connected objects, information and interactiondesign, which she approaches on a critical perspective, from several knowledges:design,semiotics,intermediality,communication’santhropology,visualmethods.