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.
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.
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
Stuart A
(2019)
The psychology of privacy in the digital age
in Social and Personality Psychology Compass
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
Gooch D
(2020)
How are you feeling?
Spiller K
(2018)
Self-Tracking
Bennaceur A
(2023)
Socio-Technical Resilience for Community Healthcare
Katz D
(2018)
Data, Data Everywhere, and Still Too Hard to Link
Mehta V
(2019)
Tangible Interactions for Privacy Management
| 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/ |