Client-centered and value driven Health Technology .

Lisette van Gemert-PijnenCenter eHealth Research & Disease Management 16 februari 2012 NSRII VU Amsterdam

Center for eHealth Research & Disease Management

to intensify cooperation with international research centres and healthcare institutes

to advice about (re)designing and implementing technology in healthcare

to contribute to the solution of global health problems, like ageing and chronic care, via a multidisciplinary approach (social sciences & technology)

HIGH TECH HUMAN TOUCH

http://ehealthresearchcenter.org eHealth onderzoek in beeld

eHealth, our approach….

“eHealth is not only a technical development, but also a state-of-mind, a way of thinking, an attitude, and a commitment for networked, global thinking, to improve healthcare locally, regionally, and worldwide by using information and communication technology.” (Eysenbach, 2001) 

eHealth a catalyst to innovate Healthcare Client-centered (persuasive designs) Value-driven (Business modelling)

Self-Management & Safety support (what works for whom)

Decision Support HCWs (to increase safety, to reduce errors)

International network R & D eHealth

Uptake: Who are the hard-core users?

those that might feel they have much to gain….

eager to realize goals, quality-driven

positive attitude in advance to use the application

more healthy than they think they are

persuasive designs that fit with client profiles

client profiles ≠ disease-profiles

big 5 personalities ≈ different persuasive designs

Uptake: Persuasive Designs & Clientprofiles

Reminders

Multimedia

Dialogue Support

Social Support

Impact: Client-centered & Blended care

Integration offline & online: optimum? For whom? Match clientprofiles & treatment-design Effects on self-care, adherence, costsavings Business modelling (innovation/ ketenzorg)

Implementation; Value-driven technologies

Implementation no afterthought

Stakeholder involvement during development

Value-creation & Value-cost-matrix

Drivers for deployment

Business models (before deployment!)

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VALUE SPECIFICATION

Purpose. Which stakeholders are important? What do stakeholders want?

Who can offer it?

Stakeholder salience mapping: which

stakeholders are crucial in the project

Value mapping: identifying added values

by keystakeholders and ranking values

(using e.g. critical decision systems)

What business model drives e(M) Health?

Workshops stakeholders

eMental Health & Gepast gebruik

Hoe kan blended care ‘gepast gebruik’ bevorderen in de GGZ?

Voor welk cliëntprofiel is eMental health gepast?

Welk design van blended care is voor welke clientenprofiel “gepast” ?

Welk business model past bij eMental health, in het bijzonder bij blended care?

Casus depressie, eerstelijn/tweedelijn instellingen GGZ

Focus Development & Implementation

eHealth-roadmap

eHealthwiki, Toolkit

Needs assessments

Critical decision system (value-matrix)

Persuasive designs

Business models

Workshops & advice

Supporting Health by Technology IV 22 mei Amersfoort, best practices implementation

Contact: dr. J (Lisette) van Gemert-Pijnen

J.vanGemert-Pijnen@utwente.nl

www.ehealthresearchcenter.nl

health by technology

Education materials …New Book & Suppl ehealthwiki.org

Health professionals

to know the key-factors for eHealth

quality

Studentsto learn how to

develop and implement eHealth-

technologies Management

to know the key-factors for implementation of eHealth

Policy, governance

to know how to measure the impact

of eHealth

Developers

to know how to deal with a human

centered development

approach

lessons learned

Technology blows up shortcomings in current healthcare systems!

Capacities of technology overlooked in eHealth research

Implementation no issue in eHealth research

Better adherence via persuasive designs

Better implementation via stakeholders’ involvement /investment

Staff, patients can manage IT; participation=motivation

Persuasive technology and personalities (Halko&Kientz, 2010)

More or less persuadable (Big Five Personalities) Conscientiousness successful for tech-persuasion (realising goals) Extraversions hard to persuade via tech Openness more likely to favour competitive or authoritative tech Agreeableness not very successful to persuade via tech Neuroticism no cooperation, enjoyment of negative reinforcement

Personalizing: Which design fits with specific user groups

Data base with 190-studies

•Chronic condition

•Lifestyle

•Mental health

•Data extraction based on CeHRes roadmap

• Predictors of usage (patient-drivers)

• Predictors of implementation (stakeholder-drivers)

•Results comparable (and interpretable to other studies)

Primaire taakReductieTunnelingop maat makenpersoonlijk makenzelf monitoren, Simulatieoefening

Dialoog ondersteuningPrijzenBeloningenGeheugensteunSuggestiesGelijkvormigheidVoorkeurensociale rol

Systeem geloofwaardigheid vertrouwenswaardigExpertiseoppervlakkige geloofwaardigheid “real world feel”Autoriteitderde partij instemming verifceerbaarheid

Sociale ondersteuning sociaal lerensociale vergelijkingnormatieve invloedsociale facilitatieSamenwerkingCompetitie herkenning

Persuasive System Design Model (PSD)

Triggers and incentives

 “You can take measurements from your glucometer and the app will

automatically know you’ve taken the measurement and it will log that,”

said Cafazzo UHN. “It will prompt you when it detects trends in your

blood sugar that are problematic.”

“It gets the adolescent to start thinking about what’s happening and

encourages positive behaviours by asking them to take

measurements…if they have a lot of consecutive readings as they

should, they will get a reward.”

The rewards, iTunes redemption codes, allow teens to buy other apps

or music that appeal to them.

11-04-23Presentatietitel: aanpassen via Beeld, Koptekst en voettekst 24

Wall-meetings eMental Health

Training online communicatie met cliëntenTraining/overleg inpassing in reguliere werkzaamhedenTraining omgaan met techniek

wachttijden verkorten, effectiever maken (voor behandeling plaats vindt al online intake, oefeningen)tijdsbesparing, betaalbaarheid van zorgextra service; klanttevredenheid

Discontinued users (web-based systems ) Technology frustrates

Usability problems; people get lost in the system

They have a high demand for push factors Triggers; feedback; incentivesNo obligations, free use, free choice, free of charge: low

adherence

Technology does not motivate no fit into daily live

they think their condition is under control (ceiling effect)

Cooperation

• Cooperation with University of Waterloo, NIHI• Cooperation with the University of Toronto (Dr G Eysenbach,

visiting professor)• Cooperation with the University of Munster (Eursafety Health-

net)• Board e-Telemed (IARIA/ ETELEMED ), scientific committee

/fellow; editorial board (since 2008)• Board Eursafety-Health-net ( 2009) , Board MRSA-net (2005-

2009)• European Center for Disease Prevention & Control (ePublic

Health).• Cooperation with knowledge centers eHealth; MedicInfo,

Mediarts/NVU, FocusCura, Philips Medical Systems, UMC Radboud, UMCU, TNO quality of life.

• Formal cooperation with RIVM, ePublic Health • Contacts with WHO, international Center eHealth Australia,

Center for global eHealth Innovation (Toronto), Norwegian telemedicine center, Tromsø , California Healthcare Foundation

• Cooperation with RAND-Europe eHealth business modelling. • Coordination of Annual conference “Supporting Health by

Technology “(mei 2008, 2009. November 2010 Medicine 2.0 (Uni Toronto) with Supporting Health by Technology III (GW/UT).

• Organisation of Congress business modelling eHealth; eTelemed (St Maarten 2010, Guadeloupe 2011) .