The role of inclusive design in improving people's access to treatment for back pain

Inclusive Design is usually applied to consumer products and services; here we investigate if it can be applied to healthcare delivery services. Methods: A case study approach was used by applying Inclusive Design methods to a telephone 'Physio-Direct' service for patients with back pain. Online surveys and interviews with healthcare professionals were used to gather insight into the delivery of back pain care and to construct a task analysis of the patient care journey. The task analysis was used to estimate the service demand made on patients' capabilities. Finally, an exclusion calculator was used to estimate the proportion of a population excluded from the service. Results: The surveys (n = 30) and interviews (n = 4) showed that communication difficulties, patients' reduced capability, service misconceptions and difficulties in obtaining information were the main barriers, which prevented patients from accessing the service. Some tasks placed a high demand on the patients' capabilities. These included telephone assessment, waiting for a telephone response, memorising the verbal advice, understanding the posted exercise leaflets and doing the exercises. It was estimated that at least 15% of the British population are excluded from the 'Physio-Direct' service. Conclusion: Inclusive Design methods were applied to the 'Physio-Direct' service and demand on its users identified ways in which the service could be improved. This suggests that Inclusive Design may be a useful tool in improving healthcare service delivery.