Introducing User-Centred Design: a Longitudinal Study of a Healthcare Informatics Organisation

Information System designers report increasing difficulties applying User-Centred Design (UCD) techniques effectively due to the growing complexity of the domains in which they work and the techniques’ prescriptive nature. The rapid growth of “Big Data” and associated analytical tools thus demands closer investigation of UCD activities and processes within the complex and rapidly-changing work domains in which they are designed, developed and used. This thesis reports a longitudinal case study from inside a commercial organisation, through a six-year Action Research collaboration to introduce and embed UCD techniques in the design of health informatics tools in the UK. An assessment of the initial modus operandi is followed by the development of personas with data from interviews, user-generated screen captures and database server log files; these informed the redesign, evaluation and testing of the organisation’s flagship product. Finally, stakeholder interviews explore the wider impact of UCD techniques. In so doing, this thesis shows the value of auto-ethnographic documentation, based on being embedded in a design team and collaborative reflection, for practice-led research; it found the organisation’s culture around UCD was dynamic and design practices can change this culture through, for example, training opportunities and fostering customer relations. Individuals and extrinsic factors played strikingly key roles in reshaping the organisation’s culture; the commitment and resilience of individuals was important for sustaining UCD activities across several reorganisations and changes in business strategy. Finally, this thesis comprehensively presents and evaluates an innovative approach for grounding personas in database server and user-generated content. These findings concern both research and practice by informing the scope of the designer’s role, educational programmes and Action Research collaborations. They call for further attention on the compatibility of design and development processes and suggest that design practice can not only be tailored to organisations, but organisations can be fitted to design practice with the reassessment of the value of some UCD activities. Finally, this thesis can inform approaches to practice-led research, and more effective and efficient strategies for the introduction of UCD techniques to other organisations from the base of their hierarchy