gdewsbury universal design: health and technology milton keynes 2014

Guy Dewsbury PhD

www.gdewsbury.com

ESRC Seminar Series: Inclusive environments: shaping transitions from theory to practice Seminar 3: Translational practices and the operationality of universal design, 21st February 2014

www.gdewbury.com: Enabling independence for older and disabled people through person-centred design technologies

Introduction

Who Am I?


Contents

1. Health and Technology: The Rationale

2. Health and Technology: the Interconnection

3. Supporting Personalisation?

4. Personal Health

5. Health at Home

6. Person - Centred Design

7. Technological Responses to Health

8. Future Trends and Possibilities

9. Conclusion


Health and Technology: The Rationale

•Ageing Population

•Increasing disabilities

•Living longer

•Greater recognition of illnesses

• Limited economic resources

• How can an increasingly older/disabled population be supported?


The UK Govt response...

Introducing telecare and telehealth.

Technologies that can enable people to maintain and support personal health.

Technologies that support people in their own home environment.


Health and Technology: the Interconnection Maintaining health in the general population should increase the ‘older well’.

Ideally, people should only become very ill before they die if their health is supported.

Health promotion

Nudging health technologies (e.g.apps)

Social media

Greater access to preventative care (e.g. screening)


Health and Technology: the Interconnection An implicit assumption is that the population will embrace these nudges and become fitter.

Technologies are designed to support getting fit and take exercise e.g. the “fitbit” “The Fitbit family motivates you to stay active, live better, and reach your goals... We'll help you achieve what you set out to do, by sharing a full picture of your progress over time.” (fitbit.com)

Also see http://www.quanttus.com/

The Fitbit Flex mobile tracker


Supporting Personalisation?

The idea of personalisation is central to the UK’s response to the ageing society.

People should have control over their own health (Maintenance and Choice).

Technologies have been developed to support health promotion... For the able fit.


Personal Health

Your health is ...Your responsibility.

Your illness is... Your responsibility.

Your Health condition is... Your responsibility.

It is Your responsibility to obtain/purchase what ever technology would be beneficial to maintaining Your health.


Health at Home

Telecare and telehealth enable a person to manage their health remotely from their home.

Telecare alerts others when something happens.

Telehealth alerts health professional and the person when their health condition changes.

These technologies enable people to remain at home rather than go to hospital.

Telehealth allows for remote health management.


Health at Home

The rise of the virtual nurse and virtual ward are implicit in the rise of these technologies’ use.

Currently their are no criteria for the use or uptake of these technologies.

This means anyone can obtain them and this is where the issues start...


Health at Home

In precious research (e.g. Sommerville I & Dewsbury G (2007) ‘Dependable Domestic Systems Design: A Socio- Technical Approach’. Interacting with

Computers. 19 (4): 438-456) many of the issues with using technology to support vulnerable people were outlined.

These include the poor design of homes specifically designed to support disabled people in the community.


Health at Home

Technologies to support health tend to not consider the non-standard user.

Assumptions such as having access to a computer; Being able to open and modify documents; have access to a range of movements; be sighted and fully hearing are all implicit in many of the current designs.

Take one example: the Alert Call button in telecare assumes the person can press at a certain pressure.


Health at Home

Telehealth monitors assume the person speaks and reads English.

They also assume the person will read the instructions and act on them.

They also assume the person knows how to correctly attach medical devices and to accurately take a reading for upload to the remote computers.


Health at Home

Just as the Fitbit assumes a certain level of ability to move, many current technologies being used in health and social care .

Smart homes, smart devices, smart technology, pervasive systems, ubiquitous systems, ambient systems are often developed without the user in mind.


Health at Home

As a result I co-developed:

MDDS: The Method for Dependable Domestic Systems

and

DTA: The Dependability Telecare Assessment tool.

Both were developed as a result of ethnography, using cultural probes with older and disabled people. MDDS was developed at Lancaster University as part of my PhD and DTA was piloted whilst I was at Barnet Council .


Person - Centred Design

Person - Centred Design (PCD) is a methodology I developed in designing systems for older and disabled people.

PCD embodies and incorporates the person in the design.

What it tries to avoid is over simplification of data and responses.

PCD deals with ‘People’, Not ‘Humans’ or ‘Users’.

People have emotions and do not think in linear lines.


DTA



People are obtuse and every person has different needs.

People are not things

Take two people with dementia, they might share the same medical condition but their lived experience of the condition is different and their needs are different.

This difference in need is attempted to be captured in DTA and MDDS.



When we design for people we design for the whole of them, including their activity patterns, and the technology should fit into their lives not them fit to the technology.

This means we have to take into account the variety of stakeholders (such as friends, family, relatives, support groups) into the design.

Similarly, we should take their activities and levels of isolation into account.



Most importantly although we can develop a generic design, we have a design that is fluid enough to incorporate the needs and wishes of people and their future needs and wishes.

Through a deep understanding of a person’s needs and their stakeholder needs any design should have better stick-value, and be less likely to eb rejected.

Most importantly it is something that will be used.


Technological Responses to Health

Although technology is possibly the best response to the health crisis, poorly designed technology will only exacerbate conditions and could actually prove lethal, if not used appropriately.

Technologies designed for people, whether they live at home or are more mobile must reflect the divergence of the individuals who will use them.

Standardisation is fine if there is also customisation possible.


Future Trends and Possibilities

The future is now, as technology develops so fast.

We see apps appear that encourage healthy lifestyles but rely on able bodied people to use them.

We have fitness devices that rely on a number of presuppositions in their use.

We have robots entering hospitals and homes but their are designed for the able bodied.

We have a world that omits people who are not standard.


Conclusion

Design needs to lose the age/ability bias and UD has taken steps to achieve this.

Technologies should be a part of a person’s life and complement their lifestyle rather than be an adjunct.

Technologies that support people should be person-centred and responsive to the changes in people as their abilities change.

Let us design for real people with real people.


Questions?

Thanks for listening

Contact Guy

[email protected]

or go to www.gdewsbury.com

mailto:[email protected]

http://www.gdewsbury.com/