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Ethical Considerations and Relation Centered Design for mHealth Applications

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Ethical Considerations and Relation Centered Design for mHealth Applications presented in the Medical Devices Track: Strategies for Successful Implementation of mHealth in Low Resource Settings …

Ethical Considerations and Relation Centered Design for mHealth Applications presented in the Medical Devices Track: Strategies for Successful Implementation of mHealth in Low Resource Settings chaired by Walter Karlen, PhD, Grand Challenges Canada grantee and post-doc at University of British Columbia and Stellenbosch University.

Presented June 6, 2014, at UNESCO Technology for Development 2014, theme: What is Essential?, hosted by EPFL and CODEV in Lausanne, Switzerland. For more information: http://wiki.epfl.ch/opentech4dev

Published in: Healthcare, Technology, Business

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  • 1. ETHICAL CONSIDERATIONS & RELATION-CENTERED DESIGN FOR MOBILE HEALTH APPLICATIONS UNESCOTech4Dev Lausanne, 2014 Kate Michi Ettinger, JD @k8ethics integritybydesign.org Ethical Considerations & Relation-Centered Design for Mobile Health Applications
  • 2. WHY ISTHE ADOPTION OF HEALTH CARE IT SO CHALLENGING? Kate Michi Ettinger @k8ethics integritybydesign.org Challenges Ethical Considerations & Relation-Centered Design for Mobile Health Applications CC Wikimedia
  • 3. Kate Michi Ettinger @k8ethics integritybydesign.org Ethical Considerations & Relation-Centered Design for Mobile Health Applications CHALLENGE # 1 Failure culture of tech meets reality of health care delivery. PRODUCT DESIGN CLINICAL BIOETHICS Challenges Flat Tire by Luis Prado & Pulse by TNS (The Noun Project)
  • 4. Flat Tire by Luis Prado; Pulse by TNS; Patient by Wilson Joseph Kate Michi Ettinger @k8ethics integritybydesign.org Ethical Considerations & Relation-Centered Design for Mobile Health Applications CHALLENGE # 1 “When we fail, we fail real people.” - Christie George Impact Investor New MediaVentures PRODUCT DESIGN CLINICAL BIOETHICS Challenges
  • 5. TECH CHALLENGE #2 Kate Michi Ettinger @k8ethics integritybydesign.org Ethical Considerations & Relation-Centered Design for Mobile Health Applications For technologists: success = working product SOCIAL ENTREPRENEUR Challenges Mountain Climber by Juan Pablo Bravo from The Noun Project
  • 6. FUNDER CONSULTANT CHALLENGE #2 Kate Michi Ettinger @k8ethics integritybydesign.org Ethical Considerations & Relation-Centered Design for Mobile Health Applications For funders: success = product & users SOCIAL ENTREPRENEUR Challenges Mountain Climber by Juan Pablo Bravo & Team by Jon Prepeluh
  • 7. CHALLENGE #2 Kate Michi Ettinger @k8ethics integritybydesign.org Ethical Considerations & Relation-Centered Design for Mobile Health Applications For clinicians: success = data that shows improved clinical outcomes SOCIAL ENTREPRENEUR CLINICAL MEDICINE Challenges Mountain Climber by Juan Pablo Bravo & Patient by Wilson Joseph
  • 8. TECH CHALLENGE #2 Kate Michi Ettinger @k8ethics integritybydesign.org Ethical Considerations & Relation-Centered Design for Mobile Health Applications Different metrics for success result in differing views on product value. CLINICAL MEDICINE Challenges Mountain Climber by Juan Pablo Bravo; Patient by Wilson Joseph & Team by Jon Prepeluh
  • 9. Kate Michi Ettinger @k8ethics integritybydesign.org Ethical Considerations & Relation-Centered Design for Mobile Health Applications CHALLENGE #3 User-centered design: meets one set of needs at the expense of the clinical relationship Challenges PRODUCT DESIGN CLINICAL BIOETHICS
  • 10. Kate Michi Ettinger @k8ethics integritybydesign.org Ethical Considerations & Relation-Centered Design for Mobile Health Applications Scaffold HOW CAN MHEALTH APP DEVELOPERS NAVIGATETHESE CHALLENGES?
  • 11. RELATION CENTERED DESIGN Kate Michi Ettinger @k8ethics integritybydesign.org Ethical Considerations & Relation-Centered Design for Mobile Health Applications RCD Build products in service to our relationships. addresses the relational aspect of user interactions
  • 12. How does your mHealth app impact the clinical relationship? RELATION CENTERED DESIGN Kate Michi Ettinger @k8ethics integritybydesign.org Ethical Considerations & Relation-Centered Design for Mobile Health Applications RCD mHealth by Edward Boatman from The Noun Project
  • 13. RELATION CENTERED DESIGN Kate Michi Ettinger @k8ethics integritybydesign.org Ethical Considerations & Relation-Centered Design for Mobile Health Applications RCD mHealth by Edward Boatman from The Noun Project Respect for Persons Benefit/Harm (Beneficence/Non-maleficence) Privacy Quality | Reliability | Safety Transparency
  • 14. PRODUCT DEVELOPMENT Stages Kate Michi Ettinger @k8ethics integritybydesign.org Ethical Considerations & Relation-Centered Design for Mobile Health Applications Scaffold Research & Development Deployment & Maintenance Prototype & Usability
  • 15. PRODUCT DEVELOPMENT For Each Stage: Kate Michi Ettinger @k8ethics integritybydesign.org Ethical Considerations & Relation-Centered Design for Mobile Health Applications Scaffold Research & Development Deployment & Maintenance Prototype & Usability 2 Parts to Inquiry: Technical Development | Clinical Application
  • 16. SCAFFOLD Research & Development Research & Development Prototype & Usability Prototype & Usability Deployment & Maintenance Deployment & Maintenance Ethical considerations Technical Clinical Technical Clinical Technical Clinical Respect for Persons Beneficence Non-Maleficence Justice Research Ethics - Risk-Benefit - Informed Consent - Harm from research Privacy Quality | Reliability | Safety Transparency Relation-centered design Kate Michi Ettinger @k8ethics integritybydesign.org Ethical Considerations & Relation-Centered Design for Mobile Health Applications Scaffold
  • 17. Kate Michi Ettinger @k8ethics integritybydesign.org Ethical Considerations & Relation-Centered Design for Mobile Health Applications Applied
  • 18. Research & Development Kate Michi Ettinger @k8ethics integritybydesign.org Ethical Considerations & Relation-Centered Design for Mobile Health Applications R&D Tech developers build clinical decision support tools that enable people with lower levels of training to provide higher levels of care.
  • 19. Research & Development Kate Michi Ettinger @k8ethics integritybydesign.org Ethical Considerations & Relation-Centered Design for Mobile Health Applications R&D Current regulatory approaches are mismatched to tech’s iterative development Photo: Richard Holder
  • 20. Prototype & Usability Kate Michi Ettinger @k8ethics integritybydesign.org Ethical Considerations & Relation-Centered Design for Mobile Health Applications P&U mHealth by Edward Boatman from The Noun Project
  • 21. Deployment & Maintenance Kate Michi Ettinger @k8ethics integritybydesign.org Ethical Considerations & Relation-Centered Design for Mobile Health Applications D&M SystemicPressures Personal/Family Pressures mHealth by Edward Boatman from The Noun Project
  • 22. Kate Michi Ettinger @k8ethics integritybydesign.org Ethical Considerations & Relation-Centered Design for Mobile Health Applications To respond to the challenges: 1.Address the clinical reality of technical failure from the outset of design 2. Include all metrics of success 3. Strengthen the clinical relationship 4. Build apps with integrity by design Research & Development Research & Development Prototype & Usability Prototype & Usability Deployment & Maintenance Deployment & Maintenance Technical Clinical Technical Clinical Technical Clinical Respect for Persons Harm/Benefit Privacy Quality/ Reliability Transparency Relation- centered design SCAFFOLDWHEN? WHAT? HOW? WHY? Conclusion
  • 23. “THE DIFFERENCE BETWEEN WHAT WE DO AND WHAT WE ARE CAPABLE OF DOING WOULD SUFFICETO SOLVE MOST OFTHE WORLD’S PROBLEMS.” - GANDHI Kate Michi Ettinger @k8ethics integritybydesign.org Ethical Considerations & Relation-Centered Design for Mobile Health Applications Conclusion
  • 24. SystemicPressures WHAT IS ESSENTIAL FOR MHEALTH? Research & Development Research & Development Prototype & Usability Prototype & Usability Deployment & Maintenance Deployment & Maintenance Technical Clinical Technical Clinical Technical Clinical Respect for Persons Beneficence Non- Maleficence Justice Research Ethics Privacy Quality | Reliability | Safety Transparency Relation- centered design Kate Michi Ettinger @k8ethics integritybydesign.org Ethical Considerations & Relation-Centered Design for Mobile Health Applications Snapshot Personal/Family Pressures Apps that strengthen the clinical relationship Build products with integrity by design Create technology in service to our relationships mHealth by Edward Boatman from The Noun Project