An Evaluation of the Provision of Oncology Rehabilitation Services via Telemedicine Using a Participatory Design Approach

2021 ◽  
Author(s):  
Grainne Carmel Brady ◽  
Kate Ashforth ◽  
Siobhan Cowan-Dickie ◽  
Sarah Dewhurst ◽  
Natalie Harris ◽  
...  
Keyword(s):  
Participatory Design ◽  
Healthcare Services ◽  
Patient Choice ◽  
Design Approach ◽  
Rehabilitation Services ◽  
Complex Needs ◽  
Cancer Centre ◽  
Staff Members ◽  
Patient Interviews ◽  
Effective Delivery

Abstract Background The COVID-19 pandemic has fundamentally impacted the delivery of healthcare services globally. In line with UK government guidelines on social distancing, the use of telemedicine was implemented to facilitate the ongoing provision of cancer rehabilitation. Purpose We sought to evaluate and co-design telemedicine services to meet the complex needs of our patients and carers at a tertiary cancer centre. Methods Experience based co-design (EBCD) methodology was adapted to include virtual methods. Staff members (n = 12) and patients (n = 11) who had delivered or received or delivered therapies services at our UK cancer centre since March 2020 were recruited to take part in one-to-one virtual interviews. Patient interviews were video recorded, analysed and edited to a 30-minute summary video. Patient and staff virtual events were undertaken thereafter. A joint virtual patient and staff event occurred, where staff could see the video and with patients as partners, agree areas for change and develop groups for service co-design. Results Positive aspects regarding telemedicine provision were highlighted including reduced financial and time burden on patients, and increased flexibility for both staff and patients. The key concerns included digital exclusion, safety, communication and patient choice. Four co-design groups have been established to enact changes in these priority areas. Conclusion Using a participatory design approach, we have worked in partnership with patients and staff to ensure the safe, acceptable and effective delivery of rehabilitation services with integrated telemedicine.

scholarly journals An evaluation of the provision of oncology rehabilitation services via telemedicine using a participatory design approach

2021 ◽  
Author(s):  
Grainne Brady ◽  
Kate Ashforth ◽  
Siobhan Cowan-Dickie ◽  
Sarah Dewhurst ◽  
Natalie Harris ◽  
...  
Keyword(s):  
Participatory Design ◽  
Healthcare Services ◽  
Patient Choice ◽  
Design Approach ◽  
Rehabilitation Services ◽  
Complex Needs ◽  
Cancer Centre ◽  
Staff Members ◽  
Patient Interviews ◽  
Effective Delivery

Abstract Background The COVID-19 pandemic has fundamentally impacted the delivery of healthcare services globally. In line with UK government guidelines on social distancing, the use of telemedicine was implemented to facilitate the ongoing provision of cancer rehabilitation. Purpose We sought to evaluate and co-design telemedicine services to meet the complex needs of our patients and carers at a tertiary cancer centre. Methods Experience-based co-design methodology was adapted to include virtual methods. Staff members (n = 12) and patients (n = 11) who had delivered or received therapies services at our UK cancer centre since March 2020 were recruited to take part in one-to-one virtual interviews. Patient interviews were video recorded, analysed and edited to a 30-min “trigger film”. Patient and staff virtual events were undertaken thereafter. A joint virtual patient and staff event occurred. Staff and patients watched the trigger film and as partners, agreed areas for change and developed groups for service co-design. Results Positive aspects regarding telemedicine provision were highlighted including reduced financial and time burden on patients, and increased flexibility for both staff and patients. The key concerns included digital exclusion, safety, communication and patient choice. Four co-design groups have been established to enact changes in these priority areas. Conclusion Using a participatory design approach, we have worked in partnership with patients and staff to ensure the safe, acceptable and effective delivery of rehabilitation services with integrated telemedicine.

scholarly journals Identifying Service Gaps Between Patients and Providers in a Native American Outpatient Clinic

2021 ◽  
Author(s):  
Robert Dorsey ◽  
David Claudio ◽  
Maria A. Velazquez ◽  
Polly Petersen
Keyword(s):  
Native American ◽  
Health Services ◽  
Outpatient Clinic ◽  
Healthcare Services ◽  
Patient Expectations ◽  
Indian Reservation ◽  
Staff Members ◽  
Patient Interviews ◽  
Service Expectations ◽  
Level Satisfaction

Abstract Background: Native American communities in Montana reservations have reported low-level satisfaction in health services. This research explored if the services provided at a Blackfeet Indian Reservation outpatient clinic were designed to meet patient expectations. Methods: Staff and patient interviews and surveys allowed service expectations to be assessed according to the clinic’s ability to meet those expectations. A total of 48 patients and ten staff members (83% of the staff at this clinic) participated in the study voluntarily. Results: We found a disconnect between what patients anticipate for care and what staff think they are anticipating. We also found a discontent between what staff believes patients need versus what the patients feel is needed. Conclusions: These gaps combine to increase the breach between patient expectations and perceptions of their healthcare services. With better insight that captures what patients are looking for from a service, the potential to meet those needs increases and patients feel that their voice is respected and that they are valued.

scholarly journals The future of rehabilitation in the United Kingdom National Health Service: Using the COVID-19 crisis to promote change, increasing efficiency and effectiveness

2020 ◽  
pp. 026921552097114
Author(s):  
Derick T Wade
Keyword(s):  
Healthcare Providers ◽  
Organisational Change ◽  
Well Being ◽  
Healthcare Services ◽  
Rehabilitation Services ◽  
Complex Needs ◽  
Cord Injury ◽  
Palliative Care Services ◽  
The Uk ◽  
Rehabilitation Needs

The problem: Rehabilitation services in the UK are inadequate, with insufficient capacity or flexibility to meet the needs of patients after Covid-19. History: Rehabilitation developed in a piecemeal way, focused on specific problems: spinal cord injury, burns, polio, stroke, back pain, equipment and adaptations etc. Rehabilitation is also provided using other names (e.g. intermediate care). Patients with complex needs do not fit easily within this system. System failure: After Covid-19, patients have problems that cross existing condition-specific and/or treatment-specific services. Covid-19 has exposed the lack of any coherent organisational principle underlying development or commissioning of rehabilitation services. Consequently, in order to have their needs met, patients either have to engage with two or more separate services or they receive good management for some problems and sub-optimal management for other problems. The goals: The multitude of small specific services need to coalesce into an integrated service able to meet all the needs of any patient referred. Second, rehabilitation needs to be fully integrated into all healthcare services. A solution: The purpose of healthcare is to ‘ improve our health and well-being . . . to stay as well as we can to the end of our lives’. (NHS constitution) All healthcare services need to consider patients holistically, giving equal attention to disease, disability, and distress. Rehabilitation, acute care, mental health and palliative care services need to work in parallel to achieve this purpose. Healthcare providers, supported by commissioners and rehabilitation experts, could achieve structural and organisational change, meeting the needs of patients.

Supporting Storytelling With Evidence in Holistic Review Processes: A Participatory Design Approach

2020 ◽  
Vol 4 (CSCW1) ◽  
pp. 1-24
Author(s):  
Ronald A. Metoyer ◽  
Tya S. Chuanromanee ◽  
Gina M. Girgis ◽  
Qiyu Zhi ◽  
Eleanor C. Kinyon
Keyword(s):  
Participatory Design ◽  
Design Approach ◽  
Holistic Review

scholarly journals Building Capabilities Through Democratic Dialogues

Design Issues ◽  
2018 ◽  
Vol 34 (4) ◽  
pp. 80-95 ◽  
Author(s):  
Liesbeth Huybrechts ◽  
Katrien Dreessen ◽  
Ben Hagenaars
Keyword(s):  
Design Process ◽  
Participatory Design ◽  
Design Approach ◽  
Railway Track ◽  
Alternative Futures ◽  
Design Processes ◽  
Self Organized ◽  
Complex Design ◽  
Developing Strategies

Designers are increasingly involved in designing alternative futures for their cities, together with or self-organized by citizens. This article discusses the fact that (groups of) citizens often lack the support or negotiation power to engage in or sustain parts of these complex design processes. Therefore the “capabilities” of these citizens to collectively visualize, reflect, and act in these processes need to be strengthened. We discuss our design process of “democratic dialogues” in Traces of Coal—a project that researches and designs together with the citizens an alternative spatial future for a partially obsolete railway track in the Belgian city of Genk. This process is framed in a Participatory Design approach and, more specifically, in what is called “infrastructuring,” or the process of developing strategies for the long-term involvement of participants in the design of spaces, objects, or systems. Based on this process, we developed a typology of how the three clusters of capabilities (i.e., visualize, reflect, and act) are supported through democratic dialogues in PD processes, linking them to the roles of the designer, activities, and used tools.

Improvisation as Technique and Practice for Design

2020 ◽  
pp. 170-187
Author(s):  
Kristian Kloeckl
Keyword(s):  
Performing Arts ◽  
Participatory Design ◽  
Role Play ◽  
Design Methods ◽  
Design Approach ◽  
Concrete Situation

This chapter explores the richness of practice-based frameworks and improvisation techniques in the performing arts. It illustrates how these can become a resource for an improvisation-based design approach by developing a concrete hybrid city application. Participatory design methods use improvisation to develop applications in collaboration with users. They attempt to unlock tacit kinds of knowing and gain firsthand appreciation of existing or future conditions by engaging participants and designers together in a concrete situation. In role-play techniques, for example, cards are handed to each participant that introduce the scene and contain information about rules associated with that specific scene, goals to be achieved, and the roles that participants enact.

scholarly journals Creating Gameful Design in mHealth: A Participatory Co-Design Approach (Preprint)

2018 ◽  
Author(s):  
Stian Jessen ◽  
Jelena Mirkovic ◽  
Cornelia M Ruland
Keyword(s):  
Chronic Conditions ◽  
Participatory Design ◽  
Design Approach ◽  
Self Management ◽  
Chronic Patients ◽  
Starting Point ◽  
Wide Range ◽  
Design Activities ◽  
The Look ◽  
Mhealth Apps

BACKGROUND Gameful designs (gamification), using design pieces and concepts typically found in the world of games, is a promising approach to increase users’ engagement with, and adherence to, electronic health and mobile health (mHealth) tools. Even though both identifying and addressing users’ requirements and needs are important steps of designing information technology tools, little is known about the users’ requirements and preferences for gameful designs in the context of self-management of chronic conditions. OBJECTIVE This study aimed to present findings as well as the applied methods and design activities from a series of participatory design workshops with patients with chronic conditions, organized to generate and explore user needs, preferences, and ideas to the implementation of gameful designs in an mHealth self-management app. METHODS We conducted three sets of two consecutive co-design workshops with a total of 22 participants with chronic conditions. In the workshops, we applied participatory design methods to engage users in different activities such as design games, scenario making, prototyping, and sticky notes exercises. The workshops were filmed, and the participants’ interactions, written products, ideas, and suggestions were analyzed thematically. RESULTS During the workshops, the participants identified a wide range of requirements, concerns, and ideas for using the gameful elements in the design of an mHealth self-management app. Overall inputs on the design of the app concerned aspects such as providing a positive user experience by promoting collaboration and not visibly losing to someone or by designing all feedback in the app to be uplifting and positive. The participants provided both general inputs (regarding the degree of competitiveness, use of rewards, or possibilities for customization) and specific inputs (such as being able to customize the look of their avatars or by having rewards that can be exchanged for real-world goods in a gift shop). However, inputs also highlighted the importance of making tools that provide features that are meaningful and motivating on their own and do not only have to rely on gameful design features to make people use them. CONCLUSIONS The main contribution in this study was users’ contextualized and richly described needs and requirements for gamefully designed mHealth tools for supporting chronic patients in self-management as well as the methods and techniques used to facilitate and support both the participant’s creativity and communication of ideas and inputs. The range, variety, and depth of the inputs from our participants also showed the appropriateness of our design approach and activities. These findings may be combined with literature and relevant theories to further inform in the selection and application of gameful designs in mHealth apps, or they can be used as a starting point for conducting more participatory workshops focused on co-designing gameful health apps.

Immersive Virtual Reality Exergames for People Living with Dementia: Working Through a User-Centered Co-Creation Process as a Multi-Stakeholder Team During the COVID-19 Pandemic (Preprint)

2021 ◽  
Author(s):  
John Muñoz ◽  
Samira Mehrabi ◽  
Yirou Li ◽  
Aysha Basharat ◽  
Jennifer Boger ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Collaborative Design ◽  
Participatory Design ◽  
Healthy Lifestyle ◽  
Lessons Learned ◽  
Term Care ◽  
Design Elements ◽  
Complex Needs ◽  
Activity Promotion ◽  
Multi Stakeholder

BACKGROUND Advancements in supporting personalized healthcare and wellbeing using virtual reality (VR) has created opportunities to use immersive games to support a healthy lifestyle for persons living with dementia (PLWD) and mild cognitive impairment (MCI). Collaboratively designing exercise-video games (exergames) as a multi-stakeholder team is fundamental to creating games that are attractive, effective, and accessible. OBJECTIVE This research explores the use of participatory design methods that involve PLWD in long-term care facilitates, exercise professionals, content developers, game designers, and researchers in the creation of VR exergames targeting physical activity promotion for PLWD/MCI. METHODS Conceptualization, collaborative design, and playtesting activities were carried out to design VR exergames to engage PLWD in exercises to promote upper-limb flexibility, strength and aerobic endurance RESULTS Our results demonstrate how different stakeholders contribute to the design of VR exergames that consider/complement complex needs, preferences, and motivators of an underrepresented group of end-users as well as game design elements that reflect feedback for therapists and researchers. CONCLUSIONS This study provides evidence that collaborative multi-stakeholder design results in more tailored and context-aware VR games for PLWD. The insights and lessons learned in from this research can be used by others to co-design games, including remote engagement techniques that were used during the COVID-19 pandemic.

Envisioning a National e-Medicine Network Architecture in a Developing Country

2011 ◽  
pp. 35-53
Author(s):  
Fikreyohannes Lemma ◽  
Mieso K. Denko ◽  
Joseph K. Tan ◽  
Samuel Kinde Kassegne
Keyword(s):  
Developing Countries ◽  
Developing Country ◽  
Health Professionals ◽  
Network Architecture ◽  
Healthcare Services ◽  
Sub Saharan Africa ◽  
Policy Makers ◽  
Effective Delivery ◽  
Sub Saharan ◽  
Medical And Healthcare

Poor infrastructures in developing countries such as Ethiopia and much of Sub-Saharan Africa have caused these nations to suffer from lack of efficient and effective delivery of basic and extended medical and healthcare services. Often, such limitation is further accompanied by low patient-doctor ratios, resulting in unwarranted rationing of services. Apparently, e-medicine awareness among both governmental policy makers and private health professionals is motivating the gradual adoption of technological innovations in these countries. It is argued, however, that there still is a gap between current e-medicine efforts in developing countries and the existing connectivity infrastructure leading to faulty, inefficient and expensive designs. The particular case of Ethiopia, one such developing country where e-medicine continues to carry significant promises, is investigated and reported in this article.

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