Engineering value-effective healthcare solutions : a systems design perspective

Our modern healthcare systems commonly face an important dilemma. While they depend on innovation to provide continuously greater healthcare value, they also struggle financially with the burden of adopting a continuous flow of new products and services. Although several disruptive healthcare models, i.e. decentralised, personalised, pervasive, connected, and stratified, promise to relieve some of this tension, they do not per se guarantee optimal value generation. We argue that systems thinking and engineering design can remedy this limitation. We support this claim by making the case of Design for Evolvability and by elaborating on two examples: MRI systems and Point-of-Care in-vitro diagnostics solutions. We specifically argue that Design for Evolvability can realign the agendas of various healthcare stakeholders, serving both individual and national interests. We finally acknowledge the limitations of current engineering design practices and call for new theoretical and empirical research initiatives taking a systems perspective on healthcare product and service design