This study demonstrated that incorporating the photovoice technique into the design framework of an innovation workshop helped to generate innovative ideas for improving patient care by helping workshop participants better understand the problems faced by patients. From the participants’ feedback, more than 90% of HCPs strongly agreed or agreed that they could generate ideas to improving asthma care, and the workshop helped drive innovation. In another design thinking workshop, more than 70% of participants agreed that they could apply design thinking to a problem in the clinical setting to generate potential ideas15.

To the best of the author’s knowledge, this is the first innovation workshop that used photovoice in the empathise step of design thinking. As ‘A picture speaks a thousand words’, photographs give context to a narrative by providing information on the environment (e.g. objects, landscape, events), relationships and norms. HCPs could visualise patients’ lives16,17, leading to discussion of topics that mattered to the participants18. From the participants’ feedback, more than 90% strongly agreed or agreed that photovoice helped them understand the challenges and enablers of good asthma care. This supported the use of photovoice in the empathise step of design thinking.

Stakeholder engagement allows interventions to cater to the preferences of both patients and care providers, which are then more likely to improve patient care and outcomes19. The stakeholders’ feedback that they favoured the multidisciplinary team approach to group allocation. Being in different professions, they often did not know the work processes of the other departments. As the operation and logistical challenges could pose a barrier to the interventions, it enabled them to understand the challenges faced by the different departments in executing the intervention. Such team grouping opened discussions on tackling these challenges from a clinical and logistics perspective.

The HCPs appreciated having patients present and share their perspectives during the workshop and suggested inviting more patients to such events in the future. Increasing involvement of laypeople in healthcare research can provide information on users’ expectations and experiences20. This study is novel as involvement of patients was less common in developing technological innovations21. It is also vital that stakeholder engagement remains a continuous activity to seek feedback on the interventions developed and to keep them informed on the discussion outcomes. A limitation with inviting patients to the discussion could be related to confidentiality issues if the patient did not want to be identified and the inability to anonymise if sensitive topics were raised.

The strength of this workshop was the participation of multidisciplinary teams and patient advocates to co-create innovative ideas that have meaningful outcomes for patients. As this was a 1-day workshop, the prototype and test stage of the design thinking framework was not achieved. We plan to adopt the Medical Research Council framework for evaluating complex interventions22,23. This framework emphasises the importance of a phased approach, including the development, feasibility, and evaluation stages. By incorporating the prototype and test stages into our future work, we aim to gather more comprehensive data on the effectiveness and practicality of the proposed solutions. This iterative process will allow us to refine and optimise the interventions based on real-world feedback and ensure their relevance and applicability in practice.

While the design thinking framework is widely used, the integration of the Photovoice method brings a novel and valuable dimension to intervention development. Its participatory nature, generation of rich qualitative data, user-centred approach, and collaborative decision-making contribute to the depth, relevance, and authenticity of the interventions. We believe that the inclusion of Photovoice enhances the workshop’s uniqueness and strengthens the overall quality of the intervention development process.

We acknowledge the limitations of having only two patients involved in the workshop, which limited the breadth of patients’ experiences shared. Despite this, the photographs allowed for a deep exploration of the topic, with rich and detailed insights obtained from patients’ perspectives and experiences expressed through photographs. In addition, the workshop team spent a significant time with each patient to foster trust and rapport. This facilitated the collection of detailed and nuanced findings, uncovering the complexities and intricacies of the patients’ perspectives.

One of the challenges of a face-to-face workshop is the patient not being able to turn up last minute. Thus, it is essential to have contingency plans. An alternative would be to record the patient’s presentation before the workshop as a backup.

A design thinking framework can be used for innovation workshops. Photovoice is a useful method for understanding the problems faced by patients. A multidisciplinary team format with patient involvement was highly favoured. This framework could be considered in the design of future innovation workshops for other health conditions and settings.

Further information on research design is available in the Nature Portfolio Reporting Summary linked to this article.