Table 1 Design problems and solutions in the public health context

Incomplete Problem Description

Problems in system design rarely make their conditions clear early in the design process

Few formal needs assessment studies[35]

Needs assessments conducted in coordination with participatory design to clarify problems by learning from their users, users' goals and users' data needs[36]

Unclear Design Pathway

While there are many possible steps that a designer can take while clarifying a problem description, the best path is not obvious

Need to understand the work practices of public health practitioners[36]

Participatory design[37] to create design specifications so a Public Health Informatics solution is incorporated into an optimized workflow and environment

Impact of Design Solutions are Hard to Predict

Although the general type of problem may be understood, the solution to the problem can exceed the problem itself

Public health systems are designed and deployed without complete knowledge of the working environment system[38]

Create a representation of an intentional future[12] by using Human-Computer Interaction, Interaction Design, User-Centered Design and Contextual Design to understand the public health context.

Trade-Offs Due to Competition Among Resources

Project components compete for resources, some elements of the project constrain the design of other elements, and these competing interests challenge resolving conflicts between the design elements

Limited resources mean not all system requirements can be met

Documented design knowledge that allows for comparisons between competing solutions

Balancing competing characteristics such as sensitivity and false negatives[39, 40]

Integrated and Interdependent Needs

Collaboration is needed between designers and users to pool knowledge

Diverse work and diverse information systems[14]

Participatory design that includes a mixture of representative public health work roles and teams

Create scenarios that include a mixture of representative public health work roles and teams

Unintended Consequences

Unintended consequences can have a significant impact on users and those outside the originally conceived group of stakeholders

Data produced by public health systems is used for different purposes by a diverse set of individuals

Use scenario-based design to describe the tasks and activities necessary to deliver essential services

Health practitioners have complex roles and workflows[41, 42]