determining success in digital health engagement – the ... · determining success in digital...
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Determining success in digital health engagement – the dallas case study Siobhán O’Connor School of Nursing, Midwifery & Social Work, University of Manchester Prof Frances Mair & Prof Catherine O’Donnell, University of Glasgow Dr Marilyn McGee-Lennon & Dr Matt-Mouley Bouamrane, University of Strathclyde The King’s Fund Digital Health & Care Congress Wednesday 17th June 2015 (Session W2C)
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Societal Changes
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Poten0al Solu0ons
Health Challenges
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Aim 1: Develop and implement digital health and wellbeing products and services at scale to improve people’s lives
Aim 2: Promote a large-‐scale consumer market (>160,000 people) that drives service and social innovaBon1
Timeframe: 2012 – 2015
Investment: £37 million
Living It Up (LiU)
More Independent
(Mi)
Year Zero (YZ)
i-‐Focus (iF)
Four dallas consor0a: NHS Trusts -‐ Local authoriBes – Private Industry -‐ Voluntary
Sector -‐ Academia
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Digital health technologies: telehealth & telecare – mobile health apps -‐ electronic PHRs -‐ online health portals -‐ assisted living devices and sensors
Geographies: rural and urban areas of Scotland and the north of England
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• Small scale pilot studies and randomized controlled trials (RCTs)
• eHealth implementaBon is complex & challenging in the real-‐world2
• Research focuses on clinical informaBon systems • Research focuses on usability/adopBon or retenBon/normalizaBon
Reach Enroll Use Retain
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Research aims: • Explore digital health engagement strategies in primary care • Determine factors for successful eHealth recruitment
Methodology -‐ Exploratory case study -‐ Ethical approval (University of Glasgow)
Secondary Analysis -‐ Baseline & midpoint interviews -‐ Project documentaBon (n=25/163)
Thema0c Analysis -‐ Framework approach3
Interviewee Type
Baseline Midpoint
Health service 6 9
Industry 6 5
Voluntary Sector 3 4
Academia 2 1
Government 0 1
Total 17 20
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Five themes facilitate digital health engagement 1. Community engagement 2. High quality technical design 3. Digital awareness & accessibility 4. Clinical engagement 5. OrganisaBonal eHealth capacity
• Market research • Personalised recruitment • Financial incenBves • User champions • ExisBng community networks
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1. Community Engagement
“There are things like health trainers. You know, we don’t directly commission the health trainer service but what we do is we augment it with the ability to understand & know
about the technology that’s occurring”
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2. High quality technical design
• Co-‐design methodology • Integrated digital login • Easy to use interface • Automated system
“by basing it all around co-‐design and working with the communi?es to develop it … so if we keep that process
going, then I think it could be something that communi?es really use and want”
• Digital champions programme • Digital hubs • Large retail outlets • Smarthouse
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3. Digital awareness & accessibility
“What most of the community hubs in the city are in exis?ng places where people … if we can get a computer in there from the union learn and with a digital champion to help people use them then that’s what they are really targe?ng for and
that’s overcoming the barrier for access”
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4. Clinical Engagement
• Clinical champions • Demonstrator projects • Digital skills training • Financial incenBves
“So there’s definitely an interest from the medical profession, par?cularly GPs and saying how might Living It Up help with the kind of social prescribing…. we have communica?on on that
basis I think ul?mately they will be very good champions for this going forward”
• Digital health policy/strategy • SupporBng IT infrastructure • Digitally enabled clinical staff • eHealth ethos or culture
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5. Organisa0onal eHealth capacity
“they’re much further developed in terms of their own digital strategy as an organisa?on so their staff do mobile working, they have tablets and, you know, they’re digitally enabled.”
Health Service
Pa0ents & Public
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• Lessons learned about successful digital health engagement
Introduce digital health strategy
Design tailored recruitment strategies
CollaboraBve grassroots
engagement
Consider co-‐design
IncenBvise eHealth engagement
Invest in technical infrastructure
Digital Awareness
& Accessibility
Provide eHealth educaBon & setup digital literacy training
Create digital health hubs & clinical/user champions
Study LimitaBons • Only one perspecBve captured • eHealth programme not finished • Non-‐parBcipaBon not explored Next Steps • Interviews & focus groups
• Users (paBents, carers, health professionals) • TheoreBcal framework for complex intervenBons4,5
• NormalizaBon Process Theory (NPT)6
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1. McGee-‐Lennon M, Bouamrane M, Barry S, Grieve E, LaBna D, Watson N et al. EvaluaBng the Delivering Assisted Living Lifestyles at Scale (dallas). HCI 2012. Proceedings of the 26th Annual BCS Conference on Human Computer InteracBon; 2012 Sept 12-‐14; Birmingham, UK. hnp://ewic.bcs.org/content/ConWebDoc/48790
2. Mair FS, May C, O'Donnell C, Finch T, Sullivan F, & Murray E. (2012) Factors that promote or inhibit the implementaBon of e-‐health systems: an explanatory systemaBc review. Bulle?n of the World Health Organiza?on, 90(5), 357-‐364. hnp://www.who.int/bulleBn/volumes/90/5/11-‐099424/en/
3. Ritchie R, Spencer L. QualitaBve Data Analysis for Applied Policy Research, In: M. Hubermann & M. Miles, The Qualita?ve Researcher’s Companion, Sage PublicaBons, Thousand Oaks, California, 2002.
4. Craig P, Dieppe P, Macintyre S, Mitchie S, Nazareth I & Peqcrew M. (2008) Developing and EvaluaBng complex intervenBons: the new Medical Research Council guidance. BriBsh Medical Journal, 337. hnp://www.bmj.com/content/337/bmj.a1655
5. O’Connor S, Mair FS, McGee-‐Lennon M, Bouamrane M, O’Donnell C. Engaging in large-‐scale digital health technologies and services. What factors hinder recruitment? Proceedings of the 26th Medical I n f o rmaBc s Eu rope Con fe r ence (M IE ) 2015 , May 27 -‐ 29 th , Mad r i d , S pa i n . hnp://ebooks.iospress.nl/publicaBon/39349
6. May CR, Mair F, Finch T, MacFarlane A, Dowrick C, Treweek S. et al (2009) Development of a theory of implementaBon and integraBon: NormalizaBon Process Theory. ImplementaBon Science 4(29), 29.
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Siobhán O’Connor is a Lecturer in Adult Nursing at the School of Nursing, Midwifery and Social Work, University of Manchester. She has a mulBdisciplinary background with an honours B.Sc Nursing and B.Sc. Business InformaBon Systems from University College Cork, Ireland. She is currently compleBng her doctorate at the University of Glasgow, exploring the digital health engagement process to paBent focused technologies in primary care. She is a member of the BCS BriBsh Computer Society, the Health InformaBcs Society of Ireland (HISI) and the European FederaBon for Nursing InformaBcs (EFMI NI).
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Siobhán O’Connor, B.Sc., CIMA CBA, B.Sc., RGN
hnps://soconnor.ie @shivoconnor