The future of digitally enabled health coaching : a proposed model

The epidemic of chronic diseases has started worrying health bodies. The costs of dealing with such a problem (time, money and personnel) are continuously increasing especially with an ageing population. This paper proposes a conceptual large scale digital health coaching intervention model that could be applied by any public health body to design, implement or rationalise digital health coaching solutions. The model aims to support the increase of patient empowerment and the decrease of costs by redistributing the available resources more efficiently across the whole eco-system with the use of Artificial Intelligence coaches. The model is not targeting the replacement of human presence by computers, but a coaching strategy that will enable, assist, promote interaction and help automate (where needed and possible) resource consuming processes

Designing Usable and Acceptable Reminders for the Home

Electronic reminders can play a key role in enabling people to manage their care and remain independent in their own homes for longer. The MultiMemoHome project aims to develop reminder designs that are accessible and usable for users with a range of abilities and preferences. In an initial exploration of key design parameters, we surveyed 378 adults from all age groups online (N=206) and by post (N= 172). The wide spread of preferences that we found illustrates the importance of adapting reminder solutions to individuals. We present two reusable personas that emerged from the research and discuss how questionnaires can be used for technology transfer

Advances in Telecare over The Past Ten Years

This article reviews advances during the past decade or so in telecare (ie, computer-supported social care at home). The need for telecare is discussed along with how it relates to social and health care. The expected benefits of telecare are also discussed. The evolution of telecare technology is reviewed, covering various system generations. The capabilities of present day telecare are covered, along with its advantages, limitations, and barriers to uptake. Recent evaluations and exemplars of telecare are discussed. The user requirements for telecare are presented, complemented by a discussion of the issues in user and professional acceptance. The article concludes with a summary of past developments in telecare and the prospects for the future

Charting Complex Changes: Application of the eHealth Implementation Toolkit (e-HIT) in the Delivering Assisted Living Lifestyles at Scale (dallas) Programme

The 'dallas' (Delivering Assisted Living Lifestyles at Scale) programme is a UK-wide digital healthcare initiative that has been designed to support independent living, enhance preventative care, and improve lifestyles by harnessing the potential of e-health technologies and digital services. This short paper presents a brief update on one strand of the University of Glasgow evaluation of the dallas programme. We have used the e-Health Implementation Toolkit (e-HIT) to investigate processes involved in the implementation of e-health tools and digital services being developed and deployed across the dallas communities and to assess 'distance travelled' by communities from baseline to midpoint of a three year programme. Qualitative data analysis was guided by the Normalisation Process Theory (NPT) and Framework Analysis. The e-HIT scores indicated that the dallas communities had underestimated the amount of work involved in implementing at scale. Qualitative data analysis showed that communities have successfully navigated barriers in order to make significant progress in strategic areas, including the development of new models of partnership working resulting in brand recognition and agile service design. The dallas communities are now sharing lessons learned and generating new professional knowledge, skills and understanding across several key strategic areas required for operationalising the implementation of e-health technologies and digital services at scale. The new knowledge being generated through the dallas programme will contribute to the ongoing transformation of digitally enabled healthcare based on more personalised flexible models of provision which resonates with the current e-health policy environment

Technological memory aid use by people with acquired brain injury

Evans, Wilson, Needham, and Brentnall (2003) investigated memory aid use by people with acquired brain injury (ABI) and found little use of technological memory aids. The present study aims to investigate use of technological and other memory aids and strategies 10 years on, and investigate what predicts use. People with ABI and self-reported memory impairments (n = 81) completed a survey containing a memory aid checklist, demographic questions and memory questionnaires. Chi-square analysis showed that 10 of 18 memory aids and strategies were used by significantly more people in the current sample than in Evans et al. (2003). The most commonly used strategies were leaving things in noticeable places (86%) and mental retracing of steps (77%). The most commonly used memory aids were asking someone to remind you (78%), diaries (77%), lists (78%), and calendars (79%) and the most common technologies used were mobile phone reminders (38%) and alarms/timers (38%). Younger people who used more technology prior to their injury and who use more non-technological memory aids currently were more likely to use technology. Younger people who used more memory aids and strategies prior to their injury and who rated their memory as poorer were more likely to use all types of memory aids and strategies

Implementing a national Scottish digital health & wellbeing service at scale : a qualitative study of stakeholders' views

Digital technologies are being used as part of international efforts to revolutionize healthcare in order to meet increasing demands such as the rising burden of chronic disease and ageing populations. In Scotland there is a government push towards a national service (Living It Up) as a single point of reference where citizens can access information, products and services to support their health and wellbeing. The aim of the study is to examine implementation issues including the challenges or facilitators which can help to sustain this intervention. We gathered data in three ways: a) participant observation to gain an understanding of LiU (N=16); b) in-depth interviews (N=21) with stakeholders involved in the process; and c) analysis of documentary evidence about the progress of the implementation (N=45). Barriers included the need to “work at risk” due to delays in financing, inadequate infrastructure and skill-set deficiencies, whilst facilitators included trusted relationships, champions and a push towards normalisation. The findings suggest that a Scottish ehealth service is achievable but identifies key considerations for future large scale initiatives

The use of a smartwatch as a prompting device for people with acquired brain injury: A single case experimental design study

Prompting-based memory compensation is a potential application for smartwatches. This study investigated the usability and efficacy of a Moto360 smartwatch as a memory aid. Four community dwelling adults with memory difficulties following acquired brain injury (ABI) were included in an A-B-A single case experimental design study. Performance of everyday memory tasks was tested over six weeks with the smartwatch and software provided during weeks three and four. Participants were asked to use their usual memory aids and strategies during the control phases (weeks 1-2, 5-6). Three participants successfully used the smartwatch throughout the intervention weeks and gave positive usability ratings. A fourth participant experienced a seizure and subsequently left the study before the intervention phase. Three participants showed improved memory performance when using the smartwatch. Nonoverlap of all pairs (NAP) analysis showed a non-significant small increase in memory performance between baseline and intervention phases (mean NAP = 0.1, p = .84). There was a larger, significant decline between the intervention and return to baseline (mean NAP = 0.58, p < .01). The use of an off-the-shelf smartwatch device and software was feasible for people with ABI in the community. It was effective compared to practice as usual, although this was only apparent on withdrawal of the device

Factors affecting participation in the eRedBook:A personal child health record

A personal child health record called the eRedBook was recently piloted in the United Kingdom. A qualitative exploratory case study was used to examine how public health nurses engaged or recruited parents and what factors hindered participation. Interviews and focus groups were conducted with those implementing the eRedBook and those taking part in the pilot study. A range of project documentation was also reviewed. Thematic analysis using the framework approach was applied to draw out themes. Numerous socio-technical factors such as the usability of the software, concerns over data protection and costs, poor digital literacy skills and a lack of Internet connectivity emerged. These barriers need to be addressed before the eRedBook is implemented nationwide

Implementation factors affecting the large-scale deployment of digital health and well-being technologies : a qualitative study of the initial phases of the ‘Living-It-Up’programme

Little is known about the factors which facilitate or impede the large-scale deployment of health and well-being consumer technologies. The Living-It-Up project is a large-scale digital intervention led by NHS 24, aiming to transform health and well-being services delivery throughout Scotland. We conducted a qualitative study of the factors affecting the implementation and deployment of the Living-It-Up services. We collected a range of data during the initial phase of deployment, including semi-structured interviews (N = 6); participant observation sessions (N = 5) and meetings with key stakeholders (N = 3). We used the Normalisation Process Theory as an explanatory framework to interpret the social processes at play during the initial phases of deployment.Initial findings illustrate that it is clear - and perhaps not surprising - that the size and diversity of the Living-It-Up consortium made implementation processes more complex within a 'multi-stakeholder' environment. To overcome these barriers, there is a need to clearly define roles, tasks and responsibilities among the consortium partners. Furthermore, varying levels of expectations and requirements, as well as diverse cultures and ways of working, must be effectively managed. Factors which facilitated implementation included extensive stakeholder engagement, such as co-design activities, which can contribute to an increased 'buy-in' from users in the long term. An important lesson from the Living-It-Up initiative is that attempting to co-design innovative digital services, but at the same time, recruiting large numbers of users is likely to generate conflicting implementation priorities which hinder - or at least substantially slow down - the effective rollout of services at scale.The deployment of Living-It-Up services is ongoing, but our results to date suggest that - in order to be successful - the roll-out of digital health and well-being technologies at scale requires a delicate and pragmatic trade-off between co-design activities, the development of innovative services and the efforts allocated to widespread marketing and recruitment initiatives