An exploratory study of healthcare technology development using a Lean thinking perspective

  • Stephen McComb

Student thesis: Doctoral Thesis


The use of Lean in healthcare as an improvement approach is commonplace with the results being widely reported in operational and academic literature. Despite the prevalence of Lean as an improvement approach, healthcare remains in a position of crisis which raises questions about the appropriateness of the historic approaches for Lean. In parallel the growing influence of technology to improve healthcare is evident with operational and policy decisions reflecting an ongoing appetite to improve healthcare through technology. This thesis analyses Lean literature to understand the use of Lean and technology in healthcare for patients. It focuses on the growing ageing population with long term conditions prior to creating a high-level value stream map for cardiovascular patients from Northern Ireland. This exploratory research utilised available open data sources and expert focus groups over a 5-year period to develop a Lean healthcare technology model as a contribution to Lean knowledge. The thesis identifies that Lean healthcare is focused on providers and not patients leading to unmet value for patients and system level non-value add activities across the patient journey. A Lean healthcare technology model can be utilised to identify and address both patient value and non-value add activities. A number of propositions are presented which provide a platform for further studies of other long-term conditions beyond cardiovascular disease which are likely to benefit from a similar research methodologies. Future studies could also extend the research beyond public health care systems to private healthcare systems as the literature highlights similar Lean healthcare failures in other geographies. The findings will assist operational, strategic and healthcare academics implementing healthcare reform. Healthcare managers should consider the role for technology and Lean to address wastes across the current silos to improve healthcare outcomes and address wasted resources in resource constrained organisations.
Date of AwardJul 2018
Original languageEnglish
SupervisorJim McLaughlin (Supervisor) & Rodney McAdam (Supervisor)


  • Lean
  • Healthcare
  • Long term conditions
  • Chronic conditions
  • Reform
  • Cardiology
  • Waste
  • Value stream mapping

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