Workshop DCPH

Design Contributions to Pervasive Healthcare
(DCPH Workshop)

Trento, Italy
Co-located to PervasiveHealth 2019

Background

Healthcare costs for long term conditions such as chronic diseases are a heavy burden on the public purse. At the same time, chronic diseases are significant constraints on patients, in particular those conditions that are detrimental to the quality of life of individuals. In this workshop we focus on the design of Pervasive Healthcare Systems (PHS) for patients of a life-long chronic condition (both mental and physical). A PHS includes a collection of devices to be integrated into a seamless patient’s experience, with the potential to significantly help the patients’ self-management in their daily lives, improve their condition, and reduce their clinics visits.

Motivation

We argue that a design approach (e.g. Interaction Design, Product Design…) to PHS will deliver a better quality of care and quality of life to the patients. The workshop is about design projects that encourage and support patients into adopting better lifestyles to improve their condition, and into practicing better self-management of condition. This could be done with design interventions to stimulate long-lasting effects on patient motivation, affects and engagement. There is also a focus on the medical benefits of such a design approach, notably improvement of medication compliance and reduction of the patients’ demand on health services (visits to the hospital clinics, and interaction with healthcare professionals for routine issues).

Workshop Schedule

9.00a – 9.10 Welcome and introduction of the workshop aims

9.10 – 9.30 Short statements of organisers’ position on the workshop & Programme for the day

9.30 – 11.30 Presentations from each paper followed by short question times. Part 1
9.30 – 9.50 a. OJO: Fuzzy logic based digital health coaching
Prediabetes (the pre-diagnosis of type 2 diabetes) is at epidemic levels all over the world and still increasing. By 2030, 470 million people will suffer from this disease. Lifestyle interventions can significantly counteract the risk of developing type 2 diabetes. We present a scalable approach for lifestyle coaching by translating the American Diabetes Prevention Program into a dynamic, self-empowering, online-program, to which we have added a digital health coach based on fuzzy logic that will act like a nutrition coach. We conducted a 5-year study and concluded with enough evidence that the digital health coach is effective and that participants achieve an average weight loss of 5.6 kg over the course of 2 years.

9.50 – 10.10 b. Data acquisition and visual analytic tool-set
Paediatric sleep disorders have been of interest to the medical community for some time now. Recording and analysing the daily sleep and wake behaviour of a child is challenging for the parents of the children with sleep disorders as well as the paediatric medi- cal community. It is on this premise that we present a web-based system that allows automatic sleep monitoring via radio waves, and an accompanying visual analytic tool which enables medical practitioners to analyse and gather insights on a child’s data.
Our contributions include setting design primitives for the web- interface and the visual analytic tool-set of SWAPP (Sleep-Wake behaviour Application), which supports the diagnosis and treatment of sleep-related disorders in children of age 6-7. The knowledge and theoretical implications of the work may be used for building home- based tools for clinical data acquisition, display, analysis (for the clinicians) and self-management (for parents/caregivers). Finally, the data visualisation techniques used in our work could apply to similar data analysis tasks, both medical and non-medical.

10.10 – 10.30 c. Sharing access to behavioural and personal health data
Behavioural and personal health data can be passively or actively collected from smartphones, wearable and sensors. Besides using this data as a tool for self-reflection and self-management of health issues, it can be also beneficial to share it with others. The purpose of sharing can range from getting peer support to communicating better with clinicians or contributing to scientific research.
However, sharing access to behavioural data can disclose sensitive details of the individuals’ lives and it may be challenging to make shared-access systems adopted, accepted and continuously used. In order to better inform the development of future systems, a review of the literature and a focus group were conducted. The findings presented here provide pointers to some essential considerations to be taken into account when proposing systems for behavioural data sharing.

10.30 – 11.00 Coffee Break

11.00 – 12.20 Presentations from each paper followed by short question times. Part 2
11.00 – 11.20 d. Wearable health: Opportunities and challenges

The large number of sensors and form factors available enhance the potential of wearables to support, assist and facilitate healthcare. From activity trackers that aid to prevent diseases and monitor patients’ conditions to assistive devices that provide therapeutic support, numerous conditions benefit from continuous data collection and long-term analysis. The benefits involve patients, and help to inform and to improve standard care practices thanks to a better understanding of the patients’ conditions and responses to treatments and interventions. Wearable sensors allow objective measures of data, being less error-prone, more accurate that self-reports and more consistent than data manually annotated. While advances in storage, processing power, and battery life raised the number of applications in wearable health, such advances did not come without drawbacks. The potential of wearable health has been increasing with the growth in research and development in the field.

However, many open challenges to be addressed still exist to ensure that applications are effective and safe to use before mainstream adoption. Key challenges that must be addressed to reduce risks are related to the accuracy of the data collection, performance of algorithms for data analysis, patients’ safety and privacy protection. This paper discusses the design space for wearable health, listing form factors, sensors and applications. It also highlights opportunities and challenges in the domain.

11.20 – 11.40 e. Designing motivating interactive balance and walking training
In the ActivAbles and STARR projects we are developing interactive training tools for stroke survivors. Our initial user studies pointed to balance being a key ability, therefore one of the developed tools is an interactive balance pad. Equipment exists for persons with good balance (eg. Wii), but most consumer games and exercises are less suited for many stroke survivors. The development process has been done in close collaboration with stroke survivors, and we have currently a prototype system that has been tested by 10 stroke survivors for a longer period in the home during a feasibility study. The system includes an interactive balance foam pad, feedback lamps and a step counting game app which all connect to a central server. The feedback is designed to be inclusive – designs are multimodal (visual and auditory), and the setup is flexible and can easily be adapted. In this paper we report and discuss the design of the system, pilot test results and the results from a feasibility study in the home.

11.40 – 12.00 f. Towards emotional well-being by design
In the ActivAbles and STARR projects we are developing interactive training tools for stroke survivors. Our initial user studies pointed to balance being a key ability, therefore one of the developed tools is an interactive balance pad. Equipment exists for persons with good balance (eg. Wii), but most consumer games and exercises are less suited for many stroke survivors. The development process has been done in close collaboration with stroke survivors, and we have currently a prototype system that has been tested by 10 stroke survivors for a longer period in the home during a feasibility study. The system includes an interactive balance foam pad, feedback lamps and a step counting game app which all connect to a central server. The feedback is designed to be inclusive – designs are multimodal (visual and auditory), and the setup is flexible and can easily be adapted. In this paper we report and discuss the design of the system, pilot test results and the results from a feasibility study in the home.

12.00 – 12.20 g. Discussing a ‘design-led’ approach to pervasive healthcare
This paper attempt to trigger a debate about the possible existence of a design approach or a design process that can deliver a pervasive healthcare system that is focused on acceptance by its users, that is about improving their daily lives and the healthcare they receive. while at the same time such approach or process should support the healthcare industry in cost-cutting and efficiency gains.

12.20 – 12.40 Summarising Statements
Key issues & questions pertaining to Pervasive Healthcare to be discussed during and after lunch break

12.40 – 2.00p Lunch Break

2.00 – 2.30 Round of discussion about presentations along key issues/questions raised

2.30 – 2.40 Presentation of Survey Results

2.40 – 3.40 Semi-structured Panel sessions on:
2.40 – 3.10 Session 1 Design for users
3.10 – 3.40 Session 2 Pervasive Technologies, Wearables & Robotics

3.40 – 4.15 Coffee Break

4.15 – 5.00 Summary of workshop, aiming for a common position

5.00 – 5.45 Outline of Special Issue of Design Studies & Concluding Remarks

Panel Sessions

Background

The WHO 2019 recommendations on digital interventions for Health System highlights the following issues: Affordability (Direct and indirect costs to users), Quality (effective coverage of health issues), Demand (matching of demand with access to healthcare), Supply (availability of commodities, equipment, human resources and facilities) and Accountability coverage (proportion of people in the target population using the system). WHO guideline: recommendations on digital interventions for health system strengthening. Geneva: World Health Organization; 2019.

‘Pervasive healthcare is the conceptual system of providing healthcare to anyone, at anytime, and anywhere by removing restraints of time and location while increasing both the coverage and the quality of healthcare’. Varshney, U., 2009. Pervasive healthcare computing: EMR/EHR, wireless and health monitoring. Springer Science & Business Media.

‘The most profound technologies are those that disappear. They weave themselves into the fabric of everyday life until they are indistinguishable from it’. Weiser, M., 1991. The Computer for the 21st Century. Scientific american, 265(3), pp.94-105.

Session 1 Design for Users of Pervasive Healthcare

What are the Pervasive Healthcare projected user related …

Impacts: e.g. Behaviour change, self management, Quality of Care, Quality of Life

Opportunities: e.g. Interaction with peers, continuous support, up-to-date medication

Challenges: e.g. privacy, acceptance, dehumanisation, health vs care

Session 2 Pervasive Technologies, Wearable & Robotics

What are the technologies for Pervasive Healthcare…

Impacts: e.g. Monitoring and body sensor networks

Opportunities: e.g. Pervasive assistive, preventive and persuasive technologies

Challenges: e.g. New approaches to healthcare delivery

Workshop Publication

Workshop papers will be published together with PervasiveHealth Proceedings.

All accepted and presented papers will be published by ACM and made available through ACM Digital Library.

Proceedings are indexed in leading indexing services, including Ei Compendex, ISI Web of Science, Scopus, CrossRef, Google Scholar, DBLP, as well as EAI’s own EU Digital Library (EUDL).

All accepted authors are eligible to submit an extended version in a fast track of EAI Scopus indexed journal:

EAI Endorsed Transactions on Pervasive Health and Technology (Scopus indexed)

Workshop Outcomes

The workshop will conclude by identifying promising design approaches and processes to pervasive healthcare, and key opportunities and challenges pertaining to the design of a PHS. The organisers of the workshop will gather insights and summarise the workshop outcomes in a journal paper on design processes and methodologies contributions to pervasive healthcare. Authors of workshop position papers will be invited to develop their contributions following the workshop, for submission and possible publication in a special issue of Design Studies on design contributions (as processes and methodologies) to Pervasive Healthcare.

Your revised paper (8000 words) must be submitted following the Design Studies submission instructions https://www.elsevier.com/journals/design-studies/0142-694x/guide-for-authors

Key dates for Resubmission of the paper to Design Studies:

26th July 2019 – Submission of revised paper (8000 words)

31st October 2019 – Outcome notification following peer-review

January 2020 – Final submission

May 2020 – Early estimate of planned publication date of special issue as a single volume of Design Studies

Workshop Organisers

Ben SALEM – The University of Liverpool, UK

I am a senior lecturer (associate professor) in the School of Engineering, and I have a lasting interest in the combination of Interaction Design, Product Design and System Engineering applied to healthcare. I am running a project where design disciplines contribute to the delivery of healthcare to clinic outpatients, focusing on lifestyle and habits that can have a detrimental effect on the patient’s condition.

JungKyoon YOON – Cornell University, US

I am an assistant professor in the Department of Design + Environmental Analysis. I investigate how products can be systematically designed to enrich users’ momentary as well as long-term experiences by means of emotions, building on knowledge and methods from user-centred design, positive psychology, and persuasive technology.

Natalia ROMERO – Delft University of Technology, NL

I work as an assistant professor in user-centred design, interested in the design of self-reporting and self-experimentation practices in daily life, as a means to support vulnerable groups (low SES) in the transition from mindlessness to mindfulness actions and evidence-based decision making.