STRETCH: Socio-Technical Resilience for Enhancing Targeted Community Healthcare

Lead Research Organisation: The Open University
Department Name: Faculty of Sci, Tech, Eng & Maths (STEM)

Abstract

Treating older adults for medical conditions is complicated because they may need treatment for multiple conditions and they may also have chronic conditions such as reduced strength, mobility, hearing, eyesight or cognitive impairments such as dementia. This means hospital in-patient treatments may take longer and they may be unable to leave hospital to recover at home if they do not have a spouse/partner or family/friends/neighbours able to look after them. Older adults recovering at home frequently rely on 'circles of support' which range from relatives and neighbours, to the voluntary sector, social workers, paid carers, and medical professionals.

The STRETCH project aims to help coordinate these circles of support with both wearable and smart home technologies to enhance the social and technical resilience of these circles of support. This should have the double benefit of increasing NHS capacity to cope with increasing numbers of older patients while improving care by making sure that medical professionals have timely and accurate information at all times about their patients. By having intelligently combined both the human and sensor-based sources of data, physicians will be able to recognize when a patient is deteriorating and intervene early to pre-empt problems or longer hospital stays.

Planned Impact

We are proposing a multi-disciplinary programme of research that will demand and deliver contributions across ICT, Healthcare Technologies, and Social and Clinical Psychology. The results of the project will address research challenges of engineering ICT solutions that contribute to software engineering, ubiquitous computing, and usable interactive technologies, in settings that are informed by and evaluated in social and clinical contexts that will also be investigated in this project.

The primary impact target of the STRETCH project is on the delivery of effective community healthcare that is enhanced by socio-technical resilience. As such we expect the outcomes of the proposed research to have direct impact on the work of health and social care practitioners and enhance the quality of care experienced by patients. We also expect the findings on how to deliver more resilient, targeted community healthcare, to have impact on health policy makers and wider society. Finally, we expect that the STRETCH technology platform will enable others to build resilient socio-technical systems that combine ubiquitous computing technologies, adaptive user interfaces and trade-off driven information flows.

In short, the project will deliver fundamental research framed in an applied healthcare context.

Publications

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Pearce O (2023) The challenges of technology adoption in the NHS: lessons learnt from deploying PROMs collection devices in The Bulletin of the Royal College of Surgeons of England

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Stuart A (2019) The psychology of privacy in the digital age in Social and Personality Psychology Compass

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Price B (2017) Logging you, Logging me A Replicable Study of Privacy and Sharing Behaviour in Groups of Visual Lifeloggers in Proceedings of the ACM on Interactive, Mobile, Wearable and Ubiquitous Technologies

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Gooch D (2021) A Design Exploration of Health-Related Community Displays in Proceedings of the ACM on Human-Computer Interaction - CSCW

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Gooch D (2021) A Design Exploration of Health-Related Community Displays in Proceedings of the ACM on Human-Computer Interaction

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Bennasar M (2019) Knowledge-Based Architecture for Recognising Activities of Older People in Procedia Computer Science

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Georgiou T (2020) Rhythmic Haptic Cueing Using Wearable Devices as Physiotherapy for Huntington Disease: Case Study. in JMIR rehabilitation and assistive technologies

 
Description We have developed a combination of software and passive monitors installed in the homes of older adults that allows unobtrusive privacy-sensitive monitoring of older adults. We have also developed an app to allow carers and those who support the older adult to monitor them and to receive notifications of important events as well as machine learning software to detect subtle changes that may indicate a need for intervention before a condition becomes serious.
Exploitation Route While we are still in the development and evaluation stage, our platform could be reproduced with inexpensive technology to allow third sector organisations like Age UK to provide better support for larger numbers of older adults.
Sectors Communities and Social Services/Policy

Digital/Communication/Information Technologies (including Software)

Healthcare

 
Description Methods for using tangibles for logging mood are being translated into an app in a follow on project related to relieving lonliness in populations affected by the covid-19 pandemic. Apps developed from this research have contributed to improving practice at Milton Keynes University Hospital.
First Year Of Impact 2020
Sector Communities and Social Services/Policy,Healthcare
Impact Types Policy & public services

 
Description Prof Price invited to participate in Nuffield Bioethics in focus worksho:p The human-technology frontier: biohacking, cyborgs and wearables
Geographic Reach National 
Policy Influence Type Participation in a guidance/advisory committee
 
Description Exploring Community Responses To Health-related Community Displays
Amount £19,401 (GBP)
Funding ID BB/T018194/1 
Organisation Biotechnology and Biological Sciences Research Council (BBSRC) 
Sector Public
Country United Kingdom
Start 02/2020 
End 09/2020
 
Description SAUSE
Amount £1,330,879 (GBP)
Funding ID EP/R013144/1 
Organisation Engineering and Physical Sciences Research Council (EPSRC) 
Sector Public
Country United Kingdom
Start 03/2018 
End 03/2023
 
Description SAUSE: Secure, Adaptive, Usable Software Engineering
Amount £1,330,879 (GBP)
Funding ID EP/R013144/1 
Organisation Engineering and Physical Sciences Research Council (EPSRC) 
Sector Public
Country United Kingdom
Start 03/2018 
End 03/2024
 
Description SERVICE: Social and Emotional Resilience for the Vulnerable Impacted by the COVID-19 Emergency
Amount £400,243 (GBP)
Funding ID EP/V027263/1 
Organisation Engineering and Physical Sciences Research Council (EPSRC) 
Sector Public
Country United Kingdom
Start 07/2020 
End 01/2022
 
Title Heuristics for Privacy Analysis of Quantified Self mHealth Apps 
Description A set of privacy heuristics were developed to allow comparison between mHealth Quantified Self apps. 
Type Of Material Improvements to research infrastructure 
Year Produced 2018 
Provided To Others? Yes  
Impact Tools were only recently released so no notable impacts at present. 
URL https://figshare.com/articles/Quantified_Self_Privacy_Heuristics_v1/5514082
 
Title PainPad Hardware, iOS/Android Apps and backend infrastructure 
Description The PainPad hardware device (recently patented) along with a two new apps (one for nurses and one for patients) and the backend infrastructure to support them allows in-patients at Milton Keynes Unviersity Hospital to self-log pain in order to save nurse time as well as to produce data to inform future treatment. 
Type Of Material Improvements to research infrastructure 
Year Produced 2023 
Provided To Others? No  
Impact Nurses can now have live self-reported pain data so they can intervene with analgesia before pain becomes severe. The data sets produced have lead to 3 medical papers currently in preparation or under review. 
URL https://play.google.com/store/apps/details?id=pain.pad&hl=en_US
 
Title Tangible devices for mood logging 
Description Tangible devices in the shape of a wooden clock and board to enable particpants to self log mood. 
Type Of Material Improvements to research infrastructure 
Year Produced 2020 
Provided To Others? Yes  
Impact Further grants to study how to improve loneliness among older adults affected by the covid-19 pandemic. 
URL https://doi.org/10.1145/3374920.3374922
 
Description Age UK Exeter 
Organisation Age UK
Department Age UK Exeter
Country United Kingdom 
Sector Charity/Non Profit 
PI Contribution We are collaborating to understand how to improve in-home care for older adults.
Collaborator Contribution Age UK Exeter have located pilot participants and got initial feedback from them.
Impact No output yet.
Start Year 2017
 
Description AgeUK 
Organisation Age UK
Department Age UK Milton Keynes
Country United Kingdom 
Sector Charity/Non Profit 
PI Contribution We hope that STRETCH technology will help both Age UK MK clients and help Age UK MK improve their practice.
Collaborator Contribution Age UK Milton Keynes is helping the STRETCH Team identify key stakeholders to trial STRETCH technology
Impact No outputs yet.
Start Year 2017
 
Description Milton Keynes University Hospital 
Organisation Milton Keynes Hospital NHS Foundation Trust
Country United Kingdom 
Sector Public 
PI Contribution Development of lifelogging devices for pain logging.
Collaborator Contribution Medical expertise, helping supply study participants
Impact Outputs are still pending as studies are still running
Start Year 2014
 
Title Painpad 
Description A handheld device for self-logging pain. 
IP Reference 1909746.8 
Protection Patent / Patent application
Year Protection Granted 2021
Licensed No
Impact none yet.
 
Title Owl Energy Monitor Python Library 
Description This python library allows whole home energy consumption data to be extracted live from Owl Intuition E energy monitors. 
Type Of Technology Software 
Year Produced 2018 
Open Source License? Yes  
Impact This is a part of the enabling technology for the low cost passive monitoring of households to infer activity from occupants. 
 
Title PainPad 
Description Apps for Patients and Nurses on the iOS App Store and Android Play Store for in-patients to self-report pain. 
Type Of Technology Webtool/Application 
Year Produced 2023 
Impact More timely and accurate patient pain data is recorded saving nurse time. Nurses can intervene with analgesia before pain reaches critical levels. Clinicians have access to better data for research. 
 
Company Name Healthtech Un Ltd 
Description  
Year Established 2017 
Impact Currently deployed technology in 2 wards of Milton Keynes University Hospital with one additional hospital trialling it.
 
Description Age UK Exeter Staff Presentation 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Third sector organisations
Results and Impact About 20 Age UK Exeter staff members attended a presentation on the STRETCH project and how it could help their practice.
Year(s) Of Engagement Activity 2018
 
Description Patient Group Workshop London 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Patients, carers and/or patient groups
Results and Impact Workshop 3: Triggering acquired knowledge for self-care
How do we design UIs that trigger the user's acquired knowledge at the appropriate time?

We all depend on our acquired knowledge to make better informed decisions. For people with diabetes who must make important decisions each day, such knowledge gained through experience and trial and error, is crucial for sustainable self-care. In this 1 day we will explore how technology can help to build and activate these important mental models.

Goals:
Exploring methods of interaction to help people with diabetes make use of their personal acquired knowledge.

This 1 day session we will brainstorm, prototype and test ideas for:

Smartphones
Smartwatches
Voice (Echo, Siri)
Chatbots
Light
Adaptive interfaces
Contextual awareness
Year(s) Of Engagement Activity 2017
URL http://www.ideas4diabetes.com/lesson/london/
 
Description Pyliss Court Invited Lecture 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact An invited talk at https://www.phylliscourt.co.uk/ following on from my previous talk at the Royal College of Physicians about patients self-logging data to improve or monitor health.
Year(s) Of Engagement Activity 2020
URL https://youtu.be/rrETqfsbSxI
 
Description Royal College of Physicians Public Lecture 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact Public lecture at Royal College of Physicians including practictioners and the general public, covered use of consumer self-logging devices for medical and health purposes. Disusussion afterwards led to follow on talk at a London Club and research contacts
Year(s) Of Engagement Activity 2020
URL https://www.rcplondon.ac.uk/events/public-lecture-please-dont-show-me-your-data-yet
 
Description Talk at Silverstone Technology Cluster Event on Wearable Technology and Wellbeing 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Industry/Business
Results and Impact This was a hybrid event with an invited talk jointly with Prof. Oliver Pearce from Milton Keynes University Hospital presenting the range of research and knowledge transfer activities in digital health innovations.
Year(s) Of Engagement Activity 2022
URL https://www.youtube.com/watch?v=SEhEISFImr0
 
Description University of Lancaster Town/Gown Ageing and Communities Event 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Third sector organisations
Results and Impact Ageing and Communities

Many of us expect to stay in our current home as we age, while others envisage moving to somewhere that may suit us better, perhaps to be near family, to live in a beautiful rural area we've always loved, or to a home more suited to our lifestyle or needs. We may move because we want to downsize (or "rightsize"), need to give up driving, or potentially need some support. We may also care for people living with impairments such as dementia, mobility or sensory difficulties and recognise that our local communities, neighbourhoods and towns could develop in ways that would make them more "age friendly" and in which the different generations could mix better.

This one day event will showcase work from Lancaster University's Centre for Ageing researchers and partners, touching on themes such as digital innovation in new and into existing housing, alternative housing choices, neighbourhoods that are supportive for people with dementia, out of home mobility, active ageing and staying connected, and intergenerational projects.

Timed to coincide with the development of the Health Innovation Campus (HIC) in Bailrigg, and Healthy New Towns like Whyndyke Garden Village, the event will feature talks from researchers and linked non-academic organisations who are using new community models and technologies to support healthy ageing. There will also be a showcase with further information and some examples for you to explore. Come and discover what the future holds, and explore ways to get involved yourself.
Year(s) Of Engagement Activity 2019
 
Description Workshop 1: Improving interaction with data for diabetes patients 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Patients, carers and/or patient groups
Results and Impact Workshop 1: Improving interaction with data
How can we design more engaging User Interfaces that help people more easily understand their personal diabetes data?

This workshop will bring together a diverse and interdisciplinary group to explore new and easier to understand ways of communicating personal data, in order to help people with diabetes to make better treatment decisions.

Moving beyond graphs, charts and tables to discover new and more intuitive ways of interacting with diabetes data such as blood glucose values, exercise, insulin dosages, food and other relevant information.
Year(s) Of Engagement Activity 2017
URL http://www.ideas4diabetes.com/lesson/berlin/
 
Description Workshop 2: Emotional Sensitivity for Diabetes Apps 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Patients, carers and/or patient groups
Results and Impact Workshop 2: Emotional Sensitivity
How can we design emotionally sensitive interfaces that draw attention to important but unwelcome information while continuing to engage the user?

For people with diabetes managing blood glucose levels can be a frustrating experience. Interfaces need to alert users to important situations, while being sensitive to the users emotional state. It is especially important to keep users engaged and not add to their daily stress level. In this 1 day workshop we will consider how we might move beyond current strategies, and create more sensitive interactions.
Year(s) Of Engagement Activity 2017
URL http://www.ideas4diabetes.com/lesson/heidelberg/