Multiple perspective problem framing in the design of self-administered treatments

Self-administered health technologies can empower patients and reduce health service costs. Whilst clinician-administered (C-A) treatments limit the number of variables by providing a managed process, delivered by experts with specialist equipment in purpose-built environments, self-administered (S-A) treatments must acknowledge the dynamic unpredictability of patient’s daily lives by considering a complex relationship of influencing factors. This article describes a multiple perspective problem framing (MPPF) approach that involves the collection of data from diverse sources and considers its interpretation and influence on design choices. In this MPPF approach, data collection informs the construction of a ‘Value Arena’ from which key framing factors can be agreed through stakeholder discourse. The chosen ‘Cornerstones of Innovation’ describe characteristics that, in combination, define the universal form of potential outcomes. This approach is illustrated through a case study that documents the development of the Noctura 400, a S-A treatment for diabetic retinopathy. The researchers find that the constructed value arena provides an effective foundation for discovery and problem definition and evolves dynamically through development and delivery phases thus underpinning patient empowerment and improved treatment effectiveness.