Systemic Design for Chronic Disease Management in China: A Solution for the Self-Management of Knee Osteoarthritis in Shanghai

Chronic diseases present enormous challenges to every health system. In recent years, there is a growing consensus in the global health community that digital health technologies, such as wearable technology and artificial intelligence, can bring new opportunities to ensure better health and well-being for more people. It shows the potential of changing traditional doctor-patient relationships, communication methods, and patients’ passive medical experience. Tech is changing the way of managing diseases and it is worth discussing how to use it to help patients and medical staff manage chronic diseases. The population of chronic diseases in China is already large, and as China is aging rapidly, chronic disease prevention and treatment will become an increasingly important part of public health and medical services. However, China's primary care (community healthcare) lacks enough suitable medical resources and has many other problems, making Chronic Disease Management (CDM) hard and inefficient. When facing such a complex problem combining individuals, society, technology, and so on, adopting the systemic design approach is a suitable and efficient way to analyze and solve the problem. Systemic design intends to take an overview of the complex healthcare problem in a macro vision; on the other hand, it also takes into consideration both objects and their relations in a certain system in a relative micro vision. The thesis aims to discuss how the systemic design approach can support the improvement of chronic disease management, especially when digital health product systems begin to take part in disease management. A systemic design framework for chronic disease management is proposed, verified, and improved by case analysis, and adopted in the case study of the self-management of Knee Osteoarthritis (KOA) in Shanghai, in order to guide the design research and practice. The systemic solution and the concept of a product system including hardware and software are produced, intending to help the patient with early-stage KOA avoid rapid disease deterioration and surgery, as well as make CDM at the primary care level effective.