Health 2050: Bioinformatics for Rapid Self-Repair; A Design Analysis for Future Quantified Self

About 75% of our healthcare costs go to four domains (cardio-, onco-, neuro- and metabolic) of diseases which are largely preventable or even reversible. Instead, they are ‘managed’ and made chronic, not cured. This is very costly and unsustainable for the future. Research is showing new opportunities for enhancing our body’s self-repair in a matter of hours or days. We want to empower personal cure with rapid feedback for self-management. What could be an interventionand bio-feedback portfolio to promote health self-repair within hours or days? Using a cross-case design analysis, we found large differences across the four health domains regarding: intervention aims, (self-)measurement options, focus on symptoms vs causes, plus degree of attention for health selfmanagement. Given recent developments in rapid cure, we advise advanced daily bioinformatics feedback, instead of current quarterly cycles, to improve our self-repair effectiveness

Testing a Multi-Channel Service Design Method

Although the multi-channel shopper has recently become a dominant consumer type, firms are still struggling with consciously designing their multi-channel service mix. In this paper, a design method based on QFD (Quality Function Deployment) is introduced and tested for defining eservices that have to function in a multi-channel context. Within a design research perspective, a structured field experiment was conducted, using control group testing. Two measurement instruments were used: questionnaires for business participants (n=62) and a protocol for external observers (n=56) to measure performance of design tasks throughout the process. We found that business teams tend to bias towards the supplier’s perspective at the expense of customers and channel partners. The new method scored significantly better than the control group method on a number of evaluation criteria: customer orientation, channel coherence and communication between different stakeholder perspectives

Exploring e/mHealth Potential for Health Improvement: A Design Analysis for Future e/mHealth Impact

Our aging population presents a huge challenge especially to our Western (public) health care systems and costs. Recent developments in the area of e/mHealth solutions hold some promise, especially if they are used in lifestyle interventions for several of the main Western diseases. We raise the question how e/mHealth solutions can help improve health by supporting lifestyle interventions? By using a design analysis approach and based on medical literature on health interventions, we raise a number of questions, which span the problem space: Which types of lifestyle interventions are more or less effective in generating health improvements? Which contents and formats of lifestyle interventions hold promise? What could e/mHealth care solutions contribute? System Quality and Information Quality issues are illustrated by using cases. Finally, in the discussion we briefly address the integration with traditional health care provisioning. Regarding the support of health (self-)management, we argue that specific e/mHealth care approaches could offer solutions for current system quality and information quality challenges. These solutions can in turn offer opportunities for care providers to improve the success of their patient recovery programs, and for patients to improve their health significantly. We provide a list of examples for such support provided by e/mHealth care approaches, e.g. integration with the increasing range of health applications in everyday life (on iPhone, Wii, Google, Nike+ and others). A significant number of patients want to actively contribute to improve their health and fight their disease, if they see that it makes a difference. A growing range of e- and m-Health applications is helping them do so

Service Experience Design for Healthy Living Support: Comparing an In-House with an eHealth Solution

Extensive lifestyle interventions towards healthy living can help prevent, stabilize or even reverse some of the most common diseases facing our aging population (cardiovascular diseases, diabetes, obesity, some cancers and even dementia). One promising application can be found in ‘secondary prevention’, which starts from the moment of diagnosis and is aimed at prevention or reversal of disease progression. Several studies have shown that patients who make the largest lifestyle progress gain most (long term) health benefits. An important challenge is to motivate patients to a high degree of compliance with the lifestyle guidelines. In this paper we use principles from Service Experience Design and motivation theories for designing and evaluating (e)Health lifestyle interventions. A two-tier design approach is most sensible: First use generic motivational factors (like cognition/health insights, asking explicit commitments or generating fast results). Next use service experience factors to optimize details. The eHealth solution generates quite different experience benefits compared with the inhouse solution. On the one hand this indicates that they may be used to serve different patient segments. On the other hand, our analysis suggests ways in which in-house and eHealth elements may be combined. We argue, that the level of trust a patient gains in prevention or therapy programs can be increased substantially by this combination. Some innovative examples for ICT-based eHealth approaches are mentioned for illustration

Designing and Testing Service Experiences (Mobile, Web, Public Displays) for Airport Transit

The importance is growing of user experience as part of service design to enhance competitive differentiation for companies. In conceptual and practical terms, it is challenging to design service experiences and measure differences in the utility value of service experiences. Our research question is: What is the best way to design and test user experiences of services? We extracted seven service experience factors from literature. For the case under study, an airport transit service, we used Kansei Engineering to design various user experience scenarios. Via four pre-test iterations, we selected three promising factors for service experience differentiation, as well as five target variables to assess experiential utility. We tested user experience based on an orthogonal conjoint analysis (n=123). The main finding is that using the factors from literature as design inputs within an overall Kansei Engineering approach is practically feasible and results in distinctly different user experiences. With regard to the airport case for example, emotional service clues were found to contribute strongly to ‘feeling valued’ and customer participation was found to enhance comfort

Designing Healthy Consumption Support: Mobile application use added to (e)Coach Solution

Healthy living is an increasingly important topic on the agenda of policy makers. Containment of health care cost through public health and specific prevention programs is seen as a key element of the current social-economic policies in the western world. mHealth technology holds the promise to make healthy living more effective than traditional prevention programs. As part of a broad healthy living support program (including food, physical activity, stress management, social support and smoking cessation), we extended web-based and coach-based ‘healthy consumption’ support with smart phone application (mApp) assistance. This paper focuses on the design analysis phase, following a design research cycle. We start from a user needs analysis, then proceed to solution analysis and service development. The result is a design solution, using an mApp for the support of healthy food consumption, together with practical ‘optimal diet’ guidelines. This solution is embedded in a health coach relationship. For the future, we anticipate more personal and intelligent mobile applications for health behavior tracking and feedback, plus an increasing role in health provider processes

Design Lessons from an RCT to Test Efficacy of a Hybrid eHealth Solution for Work Site Health

Work site healthy lifestyle interventions hold promise for improving health and employability. As part of a larger employer vitality program and a work site RCT (Randomized Controlled Trial, n=59 intervention arm) to assess cardiac risk impacts, we conducted a design analysis on a hybrid eHealth solution. The control condition was a six weeks waiting list and then start of the hybrid eHealth support (n=57). Based on preliminary 6 week- and 3 month-results, the hybrid eHealth support generated statistically significant risk factors improvement (like LDL cholesterol). The waiting list condition yielded no significant improvements. The late start after the waiting list did yield significant improvements, but not as large as a direct start. The direct start also appears to yield higher satisfaction and intention to recommend. Our analysis supports three types of conclusions. First, the hybrid eHealth intervention did significantly improve physical risk factor variables after 6 weeks. Motivation and measurement alone (waiting list) did not. Second, theory on timing of health support for patient appeared generalizable to employees: it did help to offer support at a moment of high motivation, instead of later. Third, a design analysis was conducted regarding service mix efficacy in relation to key requirements for designing ICT-enabled lifestyle interventions. This resulted in several recommendations and improved service adoption

eHealth WhatsApp Group for Social Support: Preliminary Results

Within groups that are starting a healthy lifestyle intervention together, there is potential for social e-support, as an addition to individual coaching. However, the support technology should be low-tech, low- threshold and preferably already omnipresent. A WhatsApp group was chosen as support tool, given the large variety of groups normally coached: from elderly, IT-phobic diabetics to highly educated young professionals. In this explorative pilot study, 11 young professionals volunteered. Despite their time-constrained schedules, 81 user inputs were generated in the first weeks, and the users valued the WhatsApp group as an attractive social support addition to the existing eTools and personal coaching which have a more functional focus on individual progress. Based on preliminary results: a) the WhatsApp group generated higher participation than most other social media, b) deploying social media use motives, c) possibly due to the relatively high ‘presence’ and ‘engagement’ attributes of WhatsApp, and d) contributing to healthy behaviours and health advocacy

Microlearning mApp to Improve Long Term Health Behaviours: Design and Test of Multi-Channel Service Mix

Work place health support interventions are relevant: to support our aging work force and to help reduce the private and social burdens of preventable disease. Moreover, healthy living has become a priority in Dutch society. Previous research showed that health apps should offer enough newness and relevance each time they are used. Otherwise the ‘eHealth law of attrition’ applies: 90% of users are lost prematurely. We developed a hybrid health support solution that uses a mix of electronic and physical support services for improving health behaviours, including a mobile microlearning health quiz. This solution was tested in a multiple-case study at three work sites. The research question was whether a mobile health quiz can provide added value for users within a hybrid service mix and whether it promotes long term health readiness (awareness, motivation, plans and behaviours)? We found that both the mobile health quiz and the overall hybrid solution contributed to health readiness and health behaviour improvements. Users indicated that the microlearning health quiz courses provided new and relevant information. We also observed relatively high utilization rates of the health quiz. Participants indicated that health behaviour insights were given that were directly applicable and that fitted well within the overall service mix. Moreover, even after 10 months they indicated to still have increased health awareness, -motivation and -behaviours (food, physical activity, mental recuperation). A design analysis is conducted regarding service mix efficacy; the mobile microlearning health quiz helped fulfil key requirements for designing ICT-enabled lifestyle interventions, largely in the way it was anticipated

Intensive Lifestyle (e)Support to Reverse Diabetes-2

Advanced diabetes-type-2 patients often have high insulin resistance. Over the years their insulin medication rises, which further increases their insulin resistance and glucose management problems. A HINTc (High Intensity Nutrition, Training & coaching) pilot study was conducted with 11 insulin-dependent patients. Hybrid eHealth support was given, with electronic support plus a multi-disciplinary health support team. Based on preliminary 12 week results, attractiveness and feasibility of the intervention were high: recommendation 9,0 out of 10 and satisfaction 9,1 out of 10. TAM (Technology Acceptance Model) surveys showed high usefulness, feasibility and intentions for future use. Acceptance and health behaviours were also reinforced by the rapid results (average 9% weight loss, 20% lower fasting glucose and 71% lower insulin medication, plus a 46% increase on the Quality of Life Physical Health dimension). Our analysis supports three types of conclusions. First, patients’ health literacy and quality of life improved strongly, both supporting healthier behaviours. Second, a virtuous cycle was started, helping patients reverse diabetes-2 progression. Third, a design analysis was conducted regarding service mix efficacy in relation to key requirements for designing ICT-enabled lifestyle interventions