User-centered design, but for which user?
When developing new solutions, we must consider how changes affect the entire ecosystem, rather than just a single user group.
Systemic design is about creating holistic solutions within complex systems involving multiple stakeholders, needs, and technologies. In healthcare, this means understanding the interplay between patients, healthcare professionals, regulations, and technological systems.
A complex design challenge
Developing effective systems often starts with the most difficult questions. Design processes are user-centered, meaning we build solutions based on the needs of those who will use them. But what happens when it is not obvious who the primary user is? This was the challenge the Norwegian Directorate of Health faced when developing a new system for managing health data. To ensure a solid foundation for the system, we first had to understand how data could be collected with the highest possible quality – before we even began building the system.
Technology
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The challenge: Simple navigation in a complex universe
Health data: Critical insights for a well-functioning healthcare system.
Collecting health data is a cornerstone of healthcare development. Every day, thousands of healthcare professionals report information to various registries. This data is analyzed, researched, and used to improve services, procedures, and decision-making within the health sector. However, for the data to be valuable, it must be reported in a structured way that enables precise sorting and analysis.
The challenge? Healthcare systems are in a state of constant change. To manage this dynamic, we needed to develop a system that not only records data but also makes it easy for users to navigate complex and constantly updated guidelines.
Ever-growing documentation
The documentation describing how data should be reported is extensive. At any given time, it consists of approximately 400 pages of instructions for around 4,000 healthcare workers across the country. These guidelines are updated twice a year, but before the project, there was no way to search for changes.
This led to challenges: healthcare personnel had to find and understand for themselves which changes were relevant to their work.
A lack of updates could affect data quality and, in the worst case, weaken the decision-making basis for the healthcare system. Significant variations in technological capacity and resources between large health trusts and smaller clinics made it difficult to find a one-size-fits-all solution.
The solution: Design sprint and user testing
To address this challenge, we brought together developers, systems experts, and managers from the Norwegian Directorate of Health for an intensive design sprint.
The goal was to create a digital prototype that could:
- Make documentation changes searchable and more accessible.
- Tailor information to the specific needs of individual healthcare workers.
- Reduce the time healthcare personnel spent finding the correct documentation.
The prototype was tested on specialists in health trusts and integrated into the two major health systems currently in use – Helseplattformen and DIPS.
Results and lessons learned
The sprint revealed several key insights regarding the challenges of large-scale systems:
User differences: While large health trusts have extensive resources and technical capacity, a dental office in a rural municipality may have completely different needs and limitations. The system therefore had to be adapted to different users.
Simplification is key: To ensure high data quality, we had to remove as many obstacles as possible in the process of finding and understanding updated documentation.
Adapting to user needs: Users have different needs for seeing dependencies in the system, and we tested how they would navigate to information in a way that was useful for their specific context.
Adapting to workflow: Users must be able to easily integrate the system into their daily workflow without creating unnecessary friction.
The way forward
Systemic design must be flexible and responsive to adapt to changes in technology and framework conditions. By putting the user at the center—and clearly defining who the user actually is—the Norwegian Directorate of Health has taken an important step toward a more efficient and user-friendly health data system.
The project demonstrates how crucial it is to start with insights before developing technology.
The result? A system that provides better conditions for quality-assured data collection, simpler workflows for healthcare personnel, and a stronger basis for decision-making in the healthcare sector.
With this approach, we are not just building technology—we are building solutions that truly work for those who need them most.
