AXA Health Tech and You, Thought Leadership #4: Personal Health Technology – What’s stopping You?

BY KATHY MASON, 2020HEALTH

“Morning! And how are you today?” asked Katie the ever-cheerful Occupational Therapist as she bustled into Mum and Dad’s small living room, weighed down by her large computer bag. Like many people with chronic conditions both the old folk now need help with daily activities, and a recent car accident had upped the ante. Katie extracted a large bulky laptop out of her bag and sat down to talk things through with her grateful clients. After a few minutes of irritated prodding of the keyboard, Katie abandoned the laptop and pulled out a note book and pen. “It won’t connect again,” she said pulling an apologetic face. “I’ll sort it when I get to the office. Now, Joe, tell me how you are getting on with the new walking frame?”.

Despite huge investment in technology across the health and care sector, in many cases we are not getting the benefits that were anticipated. There are a variety of reasons for this, including insufficient training, poorly specified and inadequate technology solutions. However, time and again the core reason for poor adoption and take-up comes down to usability, or rather lack of. In the scenario above, the dedicated and experienced care professional ‘worked around’ the issue that the technology had thrown up; not letting it get in the way of the service she was delivering, but knowing full well that she would have an extra 30 minutes of keyboard time added onto the end of her already busy day.

Whilst some of the variability surrounding health technology adoption can be explained by demographics, geography, personal preference, and other factors; the matter of usability is key in adoption and take up.

We have seen an exponential growth of digital channels providing access to health advice and services – most of us could not now imagine searching the bookshelf for the battered copy of ‘Family Health’ to check their symptoms, instead Googling or searching NHS Choices on our smartphone.

The development of trusted online services has not been without its challenges, and one of those has been usability. HealthSpace, an early version of an NHS online record for patients to access their information and communicate with their clinicians, never got beyond a few hundred users despite significant government investment, and it was canned in 2012. Dr Charles Gutteridge, the clinical lead at the time admitted that, although he had used HealthSpace to communicate with patients, he did not think it was a technology that would ever take off. “It is too difficult to make an account; it is too difficult to log on; it is just too difficult,” he said.

Luckily, innovators, entrepreneurs and government alike have taken the lessons and only four years later we are making significant headway towards a healthy marketplace of NHS, voluntary and private sector services. Accessible from smartphones, tablets and pretty soon smart watches, usability will be a key factor in gaining, and keeping users. If you haven’t already, check out some of the following: Patient Online, NHS Choices , NHS111 , Big White Wall, Sheffield Flourish , and AXA PPP HT&Y finalists and winners, PsyOmics , Patients Like Me , Patients’ Know Best , and Babybuddy .

A second key element in adoption and take up is engaging the users in the design and development of technology aimed at them. Despite Steve Jobs and others quoting the old Henry Ford adage, “If I had asked people what they wanted, they would have said faster horses.” (which he apparently never said anyway! ), working with and consulting the people who will use the technology inevitably leads to greater usability and adoption. As with most areas of science and industry that form a major component of UK development and prosperity, there is a massive body of evidence and research about this topic. This includes significant insight into the so-called ‘socio-technical aspects of digital systems design’; how people feel and react to technology in their lives .

In my long career in health ‘informatics’ I learnt early the importance of bringing the techies and the users (patients, carers, health professionals) together to design and implement new systems. In my first senior job I visited a community clinic in West London to try and find out for myself why they were having so much trouble getting their new electronic patient record system running. I was led to a small, and very full, supplies cupboard – and there was the shiny new terminal! The staff had no idea what it was for, and had no room on the reception desk for it – no-one had thought to include them in the choice of the system, or the planning for its implementation. Needless to say, we swiftly revised the approach and plans for the new system to ensure that the users, patients as well as healthcare professionals, were at the centre.

As the digitisation of our world continues apace, affecting both health and care professionals and organisations, as well as patients, carers and citizens generally, the themes of usability and user engagement will be central to widespread and successful adoption. The HT&Y programme recognises that usability underpinned by good design is crucial to take up of personal health technology; the partnership with the Design Museum is not by chance and the central role of design in personal health technology is one of the central criteria that the Awards are measuring entries against.

About the author

Kathy Mason is an associate of 2020health, a social enterprise think tank working to improve health through research and one of our partners for the Health Tech & You programme. With over 25 years’ senior management and board level experience across both public and private sectors, Kathy is passionate about increasing the use of digital technologies to activate people to take greater control of their own health and wellbeing.

Our 2017 Health Tech & You Awards are now open.

Posted in Uncategorized | Leave a comment

Health Tech and You Awards: Personal Health Technology: Looking Back and Moving Forward Part 3

The AXA PPP HT&Y Awards are built on the premise that success and progress rely on continuous innovation and this is reflected in the development of the award ethos and the categories.  The importance of developing personal health tech in a human context and the central role that good design has on usability and take up is acknowledged by the AXA PPP HT&Y partnership with the Design Museum.  Last year’s winners of the Innovator Award, Helen Hamblyn Centre for Design, provide an exemplar of people-centred design, using technology to improve lives[1].

In Year 1 the Awards, Forum and Showcase took a snapshot of recent health tech developments and examined what these changes could mean for designers, healthcare professionals and users of new technologies.  In Year 2 the 2016 Awards celebrated the best in personal health technology innovation across seven categories from individuals, designers, developers, entrepreneurs and healthcare professionals from the UK and around the world.  Recognising that this is a rapidly developing environment the aims and objectives for Year 3 the focus is again on sharing, promoting and supporting the best in consumer digital health innovation and development[2].

The Awards also recognise that to succeed in pushing the boundaries of health tech innovation forward, you need tenacity and staying power as well as vision.  Every award winner will have overcome many challenges to achieve success.  Indeed they have pushed the boundaries and been prepared to fail, trying things out and learning from each attempt, working with users to ensure a usable design.  Our award categories not only reward and applaud success, but aim to support those who have that combination of vision and determination to keep at it when the going gets tough.

At our Year 3 launch this year at NHS Expo in Manchester, we were delighted that three of our past winners were able to join us.  Winning entry in the Health & Care category was Food Maestro[3], developed in response to the innovator’s own family’s challenges with extreme allergies to certain foods.  Independent Living Award winners, Walk with Path showcased their ‘Pathfinder[4]  walking aid for people with conditions such as Parkinson’s disease. We also heard from the designers of Ostom-I[5], winner of the Breakout Award, a sensor that links via Bluetooth to a user’s phone, alerting them in good time when they need to attend to their colostomy bag.   Although these achievements are at the forefront of personal health technology, it took years of hard work and development to arrive at the award winning solutions that we celebrated earlier this year.

So, following the launch of year three of the Awards, let’s look forward over the next 10 years and beyond and consider the anticipated areas of progress in personal health tech.  The indications are that the increasing personalisation of health and wellbeing enabled by the growth in data analytics will be a central theme.   This will impact at both at an individual level, with people being able to manipulate and review their own data as part of an holistic personal record[6], and at a population health data level, with the rise of ever more sophisticated ‘big data’ analytics, derived from the inexorable shift of our daily lives into the digital arena.  Data about our genetic makeup and state of health and wellbeing will be core components in the tailoring of our increasingly personalised digital identity, enabling personalised healthcare designed ever more precisely and effectively for our individual needs and preferences.  Our younger generation clearly expect and seem comfortable with this direction of travel, as evidenced by the HT&Y 2015 State of the Nation Report[7].

Alongside these developments is the convergence of the hardware devices; it seems our personal technology devices are becoming interchangeable, their capabilities and functions merging into increasingly well designed and intuitive personal portals, bringing together all the facilities of smartphones, Fitbits, and other life enhancing wearable devices.  So the next generation of personal devices will not be single function, whether we wear or carry them, or even have them implanted or woven into the fabric of our clothes, they will be our secure, individually tailored personal portals enabling our digital selves to participate in an ever more sophisticated digital universe.

As these technologies become more widespread and easily accessible to all, this will support and enable people to take greater ownership and control of their own health and wellbeing.  The AXA PPP HT&Y Awards will continue to support this future vision and build on the success to date in identifying, showcasing and supporting an exciting and inspirational group of developers, designers and businesses that are – or soon will be – helping people become true  ‘Participatients’ in clinical settings, in the workplace and at home.

[1] https://www.axappphealthcare.co.uk/healthtechandyou/past-award-winners/2016/the-innovator-award/

[2] https://www.axappphealthcare.co.uk/healthtechandyou/2017-awards/

[3] https://www.axappphealthcare.co.uk/healthtechandyou/past-award-winners/2016/the-health-and-care-award/

[4] https://www.axappphealthcare.co.uk/healthtechandyou/past-award-winners/2016/the-independent-living-award/

[5] https://www.axappphealthcare.co.uk/healthtechandyou/past-award-winners/2016/the-breakout-award/

[6] file:///C:/Users/Windows/Downloads/2020PHRreport_ONLINE.pdf

[7] https://www.axappphealthcare.co.uk/healthtechandyou/stories/survey/

Posted in Uncategorized | Leave a comment

Health Tech and You Awards: Personal Health Technology: Looking Back and Moving Forward Part 2

As we look back over the past 10 years or so, we can also see that there are some things have not progressed as anticipated, and consider why that is.  Back in the 1990’s the government and the NHS were actively supporting the development of digitally enabled ‘telehealth’ and ‘telecare’ as a key factor in delivering more efficient and consistent services to patients[1] and to shift health record keeping from paper to digital.  The reality has been slow and patchy adoption by our health service providers, both public and private, and the evidence of value and benefits has been mixed at best[2].

More recently health tech policies have focused on the drive for greater participation and transparency through digital channels, driving the move to online service delivery, such as the Patient Online[3] programme to promote the shift of GP services online; and numerous initiatives making health service performance information more readily available to inform peoples’ choices and support greater accountability.   The current policy focus has shifted back towards digital and information technology as the enabler of more efficient services that are increasingly personalised.  The NHS CEO Simon Stevens and the Health Secretary Jeremy Hunt have both spoken consistently on this topic, including recently at the NHS Expo in Manchester, where AXA PPP HT&Y launched their third year Award categories[4].

An important factor in slow take-up has consistently been acknowledged as insufficient time and focus on the end users of the technology, both health care professionals and their patients.  This has affected both the design of technology healthcare solutions and the approach to implementing technology; even well designed technology can be badly implemented and poorly used.  Failure to really put the person or patient at centre of design remains a significant issue.  Although almost all health IT solutions and personal health Apps contain personal records, they are not easily joined up.  Hospital and GP records remain bounded within the organisations that create them and whilst personal data in Apps might upload to your laptop or smartphone, as yet it is not easy to integrate all the data to create a holistic picture useful to individuals themselves or their health care professionals and community healthcare planners and commissioners.  A third key factor is the variability of progress in gaining people’s confidence in government and tech suppliers’ ability to maintain the confidentiality and security of personal information and ensuring an acceptable balance between  surveillance and support.

Looking ahead, what is important is that we learn from our mistakes as well as build on success.  In line with personal wellbeing goals, prompted by my own Fitbit, my summer holiday this year included getting up early to walk in the cool of the day, before the obligatory loafing by the pool.  The effort was rewarded with classically beautiful views across Tuscan hills and valleys sprinkled with picturesque medieval towns.  It also highlighted that for every climb achieved, and dish of pasta justified, another higher peak was revealed.  As Newton understood, to advance human knowledge we need to look beyond the current horizon, and acknowledge the development of those who went before, as he remarked about his own achievements he was “standing on the shoulders of giants”[5].

[1] http://webarchive.nationalarchives.gov.uk/20130107105354/http:/www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4014469.pdf

[2] http://www.parliament.uk/business/committees/committees-a-z/commons-select/public-accounts-committee/news/nhs-it-report-/

[3] https://www.england.nhs.uk/ourwork/pe/patient-online/

[4] https://www.england.nhs.uk/expo/

[5]https://en.wikipedia.org/wiki/Standing_on_the_shoulders_of_giants

Posted in Uncategorized | Leave a comment

Health Tech and You Awards: Personal Health Technology: Looking Back and Moving Forward

Since the early nineties the increase in digital capability has grown exponentially in our society, we now expect to interact with all manner of services digitally, indeed the government instructs public services to be ‘digital by default[1]. We are without doubt out the other side of the Information Revolution and well into the Information Age, including in health and care.

Those of us who remember the early episodes of Star Trek, celebrating its 50th anniversary this year, recall how the crew communicated via wearable technology in the form of the badges on their tunics and how ‘Bones’ the medic, used a handheld device to assess the health status of patients in the field or in the Enterprise sick bay. That imagining of the future 50 years ago is now increasingly commonplace reality – digital communication between patient and healthcare professional: smartphones giving access to a wealth of health apps and even clinical interventions and services; wearables such as Applewatch, the Microsoft Band, and the Fitbit encouraging healthier lifestyles; digital portable ECG machines, heart rate and other vital sign monitors enabling better management of chronic conditions.

We explored in our previous article how the continuing growth in digital technology is affecting the arena of personal health and wellbeing; impacting people’s behaviours across all age groups[2].  We have also considered how the older generation is increasingly digitally capable, how they are using technology to help improve their health, wellbeing and continued independence, and how their appetite to use it is increasing year on year[3].

Now, looking back over the last 10 years it is interesting to consider the question: where has the most progress been made in applying digital technology to personal health?  There are certainly many more easily accessible channels to access information, advice and services, in both the public and private health sectors available today than ten years ago.  Online and telephone services such as NHS 111 provide a comprehensive and increasingly reliable 24/7 route to NHS services, directing people to the most appropriate services, information and support.  The growth in private online services is now well established and growing apace.  Development and delivery of interventions and treatment through digital channels has been particularly helpful to people living with mental health conditions where examples include the Big White Wall,[4] and AXA PPP HT&Y winner, PsyOmics[5], which support clinical trials for psychiatric treatment.  The rise of the smartphone giving instant access to such services and innumerable other health and wellness Apps is arguably the biggest contributor to opening up these instant access channels to the population at large.

As digital channels have expanded people have increasingly taken the opportunity to join together in online communities, sharing knowledge and information and providing peer support.  There are online communities for every aspect of health and wellbeing, as well as for common and rare conditions, such as the international community, Patients Like Me[6], which links people and families facing similar health challenges all over the world.  Other examples abound: from key life stages, such as new mums getting support and advice from Mumsnet[7] or Apps such as AXA PPP HT&Y finalist Babybuddy[8]; Apps that link people and their personal data together to share experience and even compete in physical challenges, such as the cycling App Strava[9]; and geographically focused ‘digital localities’ providing online support systems for vulnerable groups, such as Sheffield Flourish[10], which coordinates and communicates support for people managing mental health conditions in that city’s community.

This progress has underpinned an ever more knowledgeable population, people are becoming more informed about their health conditions, chronic and acute, and about how to stay healthy in the first place.  There are clear signs of a shift in the relationship between individuals and their health care professionals.  Patients now increasingly attend consultations having accessed their own records, using online services such as 2016 AXA PPP HT&Y Champion Award winner, Patients’ Know Best[11], researched online beforehand and prepared questions and considered treatment options available, to an extent unseen even 10 years ago.  When considering where and by whom to be treated, people now have instant access to information about the care providers available via both government sponsored information services such as NHS Choices[12] and myriad independent sources.  The consumer generation who demand ever more choice and flexibility from their services are increasingly seeking it from their health services, as illustrated by the politicians pressing for a ‘truly 7 day service[13]; despite the culturally embedded reverence for the NHS that sometimes inhibits change, even for the better.

[1] https://www.gov.uk/service-manual

[2] https://www.healthtechandyou.com/news-room/2016/02/thought-piece-1-the-impact-of-health-technology-on-peoples-behaviours/

[3] https://www.axappphealthcare.co.uk/healthtechandyou/stories/older-generation-are-power-users-of-health-tech/

[4] https://www.bigwhitewall.com/landing-pages/landingV3.aspx?ReturnUrl=%2f#.V_OYHigrKUk

[5] https://www.axappphealthcare.co.uk/healthtechandyou/past-award-winners/2016/the-problem-solution-award/

[6] https://www.patientslikeme.com/

[7] http://www.mumsnet.com/

[8] https://www.axappphealthcare.co.uk/healthtechandyou/past-award-winners/2015/special-category-award/

[9] https://www.strava.com/

[10] http://sheffieldflourish.co.uk/

[11]https://www.axappphealthcare.co.uk/healthtechandyou/past-award-winners/2016/the-champion-award/

[12] http://www.nhs.uk/pages/home.aspx

[13] https://www.gov.uk/government/speeches/pm-on-plans-for-a-seven-day-nhs

Posted in Uncategorized | Leave a comment

Childline – the past, the present and the future

This week Childline celebrated its 30th birthday with a blaze of publicity fronted by their founder and most prominent supporter and champion, Dame Esther Rantzen. Magazine and national and regional newspaper features about the tireless work of Dame Rantzen over the past 30 years, both in London and across the UK, were accompanied by a string of news stories about how Childline had seen a sharp rise in children and young people contacting them suffering from anxiety problems. This was followed by the announcement of Cheryl as the new Childline campaigner, with the Pop and TV star specifically looking to reach out to teenage girls who in the past may have thought they were too old for Childline or that their problems were not serious enough to warrant reaching out for help. All of this publicity served two important purposes for the NSPCC service. The first was to further raise its profile around the country, both with adults and young people, which in turn will hopefully encourage more children and teenagers in need to access the free and confidential service. The second was to highlight just how much Childline has changed in the past 30 years in terms of the issues it is dealing with and how it is engaging with all those who are seeking help.

When Childline launched from a London office in 1986 most children and young people contacted the service via a landline, with many doing so from a telephone box. The main concerns being raised during its first year included sexual and physical abuse, pregnancy and drug abuse. Fast forward to 2016 and you find Childline with 12 call-centres located across the UK delivering more than 300,000 counselling sessions a year. Almost three quarters of these are conducted online via email and 1-2-1 chat. One of the main challenges Childline now faces is how to cope with this growing demand, especially with the added time it takes to help children and young people when engaging with them over the internet. The types of problems counsellors are dealing with on a daily basis has also shifted, with mental health issues such as low self-esteem, self-harm, depressive disorders and, most worrying, suicidal feelings all featuring in the top ten concerns in 2015/16.

In response to these challenges Childline has redoubled its efforts to be there for every child and young person with extra volunteers being put on the peak shift of 8pm -1am. This has been complemented by the launch of a new website (www.childline.org.uk) which contains chat features, therapeutic tools and new ways of communicating with counsellors, and is soon to be followed by the first Childline app.

The service is also constantly looking to improve the accessibility of Childline, and reach out to vulnerable groups who may not use the service such as gang members, ethnic minorities and boys in general. It’s well-known that boys tend to bottle-up their feelings instead of talking about them, with statistics showing that four times more girls were counselled last year. Other new projects include piloting facilities for children who have hearing impairments. All this work is directed by Childline towards achieving the single overall objective of being there to listen and help 24/7 for every child or young person in need, no matter what their background or circumstances.

Children and young people can contact Childline in confidence 24 hours a day, 365 days a year on 0800 1111 or by visiting www.childline.org.uk . Childline is a service provided by the NSPCC. 

Childline_Logo_Black

Posted in Uncategorized | Leave a comment

Stress and Your Lifestyle

BY Carole Spiers, Founder of National Stress Awareness Day.

Life should be exciting and pleasurable.  How many times have you said that to yourself?  Perhaps as you have waited in a traffic jam or opened all those bills and invoices for last month’s purchases!

However, for life to be enjoyable we all need to be able to manage the challenges that we face.  Unfortunately, there will be times when we feel we cannot cope and it is then that we may experience stress. But experiencing signs of stress does not mean you are a weak individual who cannot cope – it just means you are human like everyone else!  We all react differently to the situations we have to face because we are all unique individuals.  Some of us may be passive personalities whilst others may be very competitive and our reaction to pressure, and especially excess pressure, will vary enormously. And dependent on our reaction, will be the state of our wellbeing and health.

Life in the 21st century is very different to that of only a few years ago and perhaps it would be useful to look at how we can improve our stress levels during the coming year.

‘Stress is the adverse reaction people have to excess pressure or other types of demands placed upon them.  It arises when they perceive that they are unable to cope with those demands’ HSE (www.hse.gov.uk).

It is often mistakenly thought that stress is good for people, when in fact long-term stress invariably harmful.  A certain amount of pressure can indeed motivate and can therefore be useful, but stress is never so.  People perform well when pressure is effectively managed.

That which causes us to be stressed is the way that we think about the situation rather than the situation itself. Problems occur when the pressure we are under seems to be overwhelming or out of control.  We may perceive ourselves as not possessing the necessary skills to manage the pressure, and so we feel unable to cope.

Many people experience stress at some point in their lives.  Stress is like a light switch; your mind turns it on automatically but you need to learn how to turn it off.

Some of the most common signs of stress are:

¨       Mood swings ¨       Anxiety and/or depression
¨       Skin problems ¨       Tiredness
¨       Muscle tension ¨       Poor concentration/ memory
¨       Waking unrefreshed ¨       Changes in eating patterns
¨       Low self esteem ¨       Digestive problems

It is very important to take positive action when faced with stress as, if experienced over a prolonged period of time, it can seriously damage mental and physical health.

The following proven coping strategies can really start to help reduce the effects of any stress in your life.

  • Be self-aware of your own warning signs – maybe this could be a sudden feeling of anxiety, extreme tiredness or feeling very tearful.
  • Review what is really causing your stress. Think about what action you could take to change things. Examine whether your expectations of yourself, and others, are realistic?
  • At times of stress, we often fall into the trap of either not eating sufficiently or over-eating, or even smoking.
  • Try always to eat a balanced diet. Eat plenty of fresh fruit and vegetables and keep sugar and salt intake to a minimum. This will help to support your immune system in its fight against colds and flu. Try and keep coffee and all caffeine consumption to a minimum and avoid using nicotine or any other self-prescribed drugs.
  • Drink plenty of water, it helps general health as it rehydrates your body.
  • Eat complex carbohydrates such as wholemeal bread and pasta, rather than biscuits or chocolate! Remember, what you eat influences mood.
  • Do not feel guilty about including a period of relaxation every day. We all need to ‘switch off’ from time-to-time. Do something you enjoy that complements your life-style. This could, for example, be reading, listening to music, yoga or meditation, enjoying a warm bath with aromatherapy oils added. Remember – to be comfortable both inside and out, is a vital part of living successfully!
  • Make sure also that regular exercise is part of your everyday life and which is suitable for you. Make sure you choose an exercise that you like or you wont stick to it! If you have any doubts as to the correct intensity or duration then always check with your doctor before starting a new regime.
  • Do you often find yourself saying “Yes!” when in fact you mean “No!”? Are you always late for appointments? Do you get frustrated knowing you could have done a better job if only you had organised your time better? Then learn how to be more assertive and manage your time properly. Many of us waste a lot of the day, then make excuses for things we have not done!
  • Consider attending a stress management training course. You do not have to be stressed to attend one of these. It is far better to know what to do prior to experiencing stress than waiting  

TIPS TO AVOID UNDUE PRESSURE

Avoid stress by finding your natural SPEED:

Sleep – get a minimum of 7 hours every night

Priorities – Focus on that which is most important

Empathy – Find friends who will empathise with you

Exercise – set an exercise goal to meet every week

Diet – limit sugar, heavy meals, alcohol, smoking and caffeine

Talk to Us About Stress! The International Stress Management Association [UK] would love to hear your views about stress.  Please take part in a major new survey to mark National Stress Awareness Day on Wednesday 2nd November 2016  http://bit.ly/2dqvfTs

You can see details of National Stress Awareness Day here:  http://bit.ly/1RyIZKL

nsad-2016-event

 

Posted in Uncategorized | Leave a comment

Arthritis Research UK campaign asks you to ‘Share your Everyday’

BY ARTHRITIS UK

This week, Arthritis Research UK has launched their ‘Share your Everyday’ campaign. Running for six weeks across October and November, the charity are encouraging people to get involved by sharing their experiences of living with arthritis. They have created a dedicated sharing space for people with arthritis to not only tell their story, but also learn from others’ experiences.

Last year’s campaign saw hundreds of people share their everyday challenges, demonstrating how arthritis attacks what it means to live; from struggling to board a bus to the effect the weather has on their joints. Arthritis Research UK have since used this insight to guide their research, funding three new research projects focused on breaking through the daily pain that arthritis causes.

This year, the charity is looking for even more people to get involved. The simple act of sharing your everyday experiences can shape the big ideas and little changes that will help to push back the limits of arthritis.

Share your everyday experiences of living with arthritis to help Arthritis Research UK find your everyday freedom. Share your story here.

arthritus-uk-share-your-everyday

Posted in Uncategorized | Leave a comment