From Framework to Practice: Designing a Real-World Telehealth Application for Palliative Care
Wei Zhou, Rashina Hoda, Andy Li, Chris Bain, Laura Bird, Emmy Trinh, Peter Poon, Teresa O Brien, Mahima Kalla, Olivia Metcalf, Wendy Chapman, Joycelyn Ling, Sam Georgy, David Bevan
TL;DR
The paper tackles the challenge of designing telehealth software for palliative care that is technically robust, ethically aligned, and deployable in real-world health systems. It proposes an integrated socio-technical framework spanning quality, human values, and real-world feasibility, applied to the ETHC Patient Consultation Summary add-on. Through co-design, prototyping, and staged evaluations (think-aloud, simulation, feasibility study), it demonstrates the creation of a secure, equitable, and practical telehealth solution integrated with a national platform. The work offers a transferable design model for digital health that emphasizes participatory development, real-world testing, and institutional collaboration to bridge research prototypes to practice.
Abstract
As digital health solutions continue to reshape healthcare delivery, telehealth software applications have become vital for improving accessibility, continuity of care, and patient outcomes. This paper presents an analysis of designing a software application focused on Enhanced Telehealth Capabilities (ETHC) for palliative care, integrating across three socio-technical dimensions: quality, human values, and real-world. Designing for quality attributes -- such as performance, maintainability, safety, and security -- ensured that the system is technically robust and compliant with clinical standards. Designing for human values -- empathy, inclusivity, accessibility, and transparency -- helped enhance patient experience, trust, and ethical alignment. Designing for real-world -- through a multidisciplinary, experience-based co-design approach involving clinicians, patients, and carers that guided iterative cycles of prototyping, usability testing, and real-world evaluation -- ensured continuous refinement of features and alignment with clinical practice. The resulting telehealth software solution demonstrated that our socio-technical design framework was successful in producing a secure, equitable, and resilient digital health application. Our design approach can assist others designing software in health and other domains.