Together, academic design research and design education form the foundations of our design discipline. Much has been discussed about design research and its relationship with, and impact on, design practice. As a design academic who transitioned into design practice for nearly a decade and is now active in healthcare, I believe this year’s exhibition, cases, and design debates can benefit from a traditional design critique.

Design critique, rooted in the renewed Bauhaus tradition, was a fundamental practice in design studios to enhance the quality of the designer’s work. It might feel contradictory, however strong design critique encourages collaboration and boosts a positive culture towards improving ideas and solutions. As a designer, putting your work out there and openly engaging in such a critique is a valuable way to grow and improve your work. As the challenges designers face are becoming more complex, as in the healthcare setting, it is essential to extend the critique process beyond the design profession.

This directly links to the two main points of this design critique. The exhibition pieces provide food for thought and propose new, inspiring realities. However, (1) the design solutions do not grasp true reality. The holistic, multi-perspective approach of the designers has to reach deeper. When reviewed separately, I see useful and relevant design proposals. Nevertheless, (2) healthcare can no longer afford additions to care pathways; we need to change these pathways to support affordable, accessible care.

The projects in this exhibition, the solutions from medical technology companies, and their applications in healthcare have one thing in common: they commonly result in additions to healthcare rather than transforming care pathways. Given the current status of our healthcare systems,  additions no longer help: the key is to redesign care pathways in ways that fundamentally challenge existing methods of care delivery.

One exhibit proposes a therapy tool for children and therapists, aiming to positively impact education for children with neurodivergent needs. My first question is: what do the current care pathways for these children look like across different settings? Waiting lists for specialized healthcare for these kids can easily extend from months to a year. In my view, the design or solution should be a new care pathway which includes education for these children. A sensor-augmented ball might fit in this new pathway - but equally - it might not. The insights yielded by this research into the design of educational pathways are, in my view, the essence of the exhibit.

Another exhibit features a redesign of a handheld ECG device. An electrocardiogram checks the heart’s functioning. If we could truly take ECGs at home as proposed by this handheld device, it could indeed change how we deliver care. However, the solution would again be a redesigned care pathway where cardiologists and patients trust the device to take over measurements currently done in hospitals. Without this trust and a proper redesign of the current care pathway and workflows, we might end up taking more ECGs, leading to an increase in care questions.

This relates to the fact that we still tend to design 'point solutions'. We're still hindered by our Cartesian heritage, even in design. While we take a more holistic view and consider multiple perspectives, point solutions still outnumber system solutions in the exhibition. More point solutions reduce the chance of actually impacting the system. The current challenges in healthcare push us to go far beyond designing things or even services. We must find ways to push our imagination further. The current co-design methods and explorations are just beginning to touch the first branches of the network or system. How we will truly deal with the system’s complexity is still unknown to our design research community.

As transformative design practices have described, a design stance from within, a first-person perspective, is needed to tackle these system challenges. However, the systemic design solutions in this year’s exhibition do not grasp the true reality and complexity of our current challenges. The true context in which the system is tangible and impacts experiences and outcomes in healthcare is often missed. I worked for a health technology company for nearly a decade on healthcare challenges, including full-blown design-driven clinical studies in the hospital setting. I now work in a hospital and realize that I didn't grasp half of the things impacting the success of my designs. More than the new care pathway itself, the supporting processes are also an essential part of the design. We can only achieve this if we design and research from within, taking the first-person perspective deeper into the system.

Part of system design is to surface and magnify those parts that are dominant, out of balance, underrepresented, discriminated against, or even ignored. This combination of exhibits does a fine job of making this beautifully and painfully clear. Touching on subjects such as design for the elderly, design for intimacy, feminism, neurodivergence, prevention and mental health, the exhibition openly addresses the challenges of our healthcare system. However, it's the system and the relational aspects of the exhibition pieces and dialogues that provide my greatest inspiration.

The reaction to many of the points I discuss will be: these designs are research tools. Design researchers are eliciting ideas, scenarios, and possible futures. I understand and value each contribution, but I am also biased. I've spent more time in practice and in the healthcare context than in the academic world. From this experience and my current position, I know we need more from design to address our current healthcare challenges; things we haven't yet fully grasped as a community.  However, based on the work presented I'm confident we can deliver. We need to be able to design and deliver network care pathways. We need tools to design and deliver non-linear, multi-care organizations and population-driven pathways that help keep care accessible. Which of these research, artefacts and dialogues will help us achieve that?

Remember, this is a design critique. A design critique challenges good work to become even better.

Eva Deckers leads digital healthcare programs at the Catharina Hospital Eindhoven, developing hybrid care solutions with a multidisciplinary team. As head of the AI Center of Excellence, she works alongside her team to build a local AI platform to enhance care. Eva also spearheads the hospital’s strategy process to ensure future excellence and accessibility in regional healthcare.

Previously, Eva was Design Director at Philips Experience Design, where she pioneered Data Enabled Design, integrating design, data and AI. She crafted and executed customer-driven strategies for various businesses and was part of the SaaS and Data & AI transformation leadership teams, emphasizing a customer and user-centric approach. 

Her extensive design background continues to influence her work in healthcare. With other designers, she started a movement to further mature design in healthcare.  

Eva holds a PhD from Eindhoven University of Technology, where she explored AI from a design perspective. She remains actively involved in research and PhD mentorship, underscoring her commitment to innovation in healthcare.