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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!)
11/04/23Business Modelling in eHealth 13
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) .
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