Keep it simple: User research driving eHealth adoption

Source: HealthcareIT News.eu
Written by Jack Beaudoin, Editorial Director

LUXEMBOURG -- Healthcare IT vendors say the greatest barrier to eHealth adoption in Europe these days may not be technology hurdles, regulatory issues or even the lack of proven financial models. With refreshing honesty, many are acknowledging that a certain "engineering arrogance" may be to blame.

The silver lining to that arrogance, however, is new multidisciplinary research aimed at involving end users in the design and development of eHealth tools. "Too often we have developed software and pushed it on to providers," conceded Eric Maurincomme, Afga's vice president for eHealth, speaking at the "2008 Med-e-Tel" Conference in Luxembourg on April 17. "And we got push back. We have to work with users to meet their needs and develop solutions for them."  And while Maurincomme was speaking about provider adoption, the same is true when the end user is the patient.

Alcatel-Lucent's Casena project, which aims to support the elderly at home through technology, is currently responding to demographic trends which should prompt greater utilization of eHealth in Europe. But, said Alcatel's Johan Criel, study after study shows that in-home technology must respond to a set of considerations beyond simple costs or utility. "User research showed us how important the feeling of control is in a domestic space," he said. End users wouldn't adopt so-called ambient eHealth tools unless they were virtually invisible and didn't call attention to dependency.

To tease out what will work and what won't, the lab is deploying multidisciplinary teams of scientists, engineers and ethnologists. Next month, the project is kicking off a house-based pilot project with users suffering from mild dementia.

NEW PILOT PROJECTS

In the past, such pilot projects have often been criticized for delaying production-ready tools and taking up funds that could be used for larger scale deployment efforts, but even vendors say they are seeing now great value from the efforts.

"The issue has been that there were so many pilots, so many experiments, how do we scale up," said Nicole Hill, director of Alacatel-Lucent's health division.  Hill said the telecom giant is ready to move its telehealth platform into commercial production after a successful pilot program demonstrated proof not only of concept, but the ability to meet technological, financial and regulatory barriers -- and proved popular with end users.

After an 18-month trial involving 80 users in Barcelona, Spain and Oostend, Belgium showed the platform's viability, commercial scale projects could be rolled out within three months.

The Attentianet platform is a hosted service that provides end-to-end connectivity between home and a variety of service providers. At the heart of the system is a managed care center that can route various messages to family members, healthcare providers and other experts, or to first responders. Leveraging Alcatel's telecom experience in end-to-end security, privacy, availability and time-critical orientation, the system can serve as a multi-vendor, multi-agency platform.

Just as important to Attentianet's success, however, is the simplicity and attractiveness of the devices that connect to it. Examples include a standard television with a simple set-top box, a single-button help device, or a simplified mobile phone with location services.

KEEP IT SIMPLE

Ann Van Mele of Verhaert, a Belgium product development company, said " vendors must connect to known user needs and offer clear added value to their lives" . Her company developed the Zenio personal safety system to detect falls and provide assistance -- and more importantly, confidence -- to the elderly.  Van Mele wore a discreet, attractive pendant -- resembling a small rectangular stone -- around her neck. The pendant housed a sensor engineered to detect ten different kinds of falls and weed out false alarms.

" But having a great fall detection algorithm doesn't mean you have a successful product ," she cautioned.  Users demanded the ability to deactivate a fall alert, as well as the inclusion of a panic button. The small device can also be configured to detect body temperature and measure activity.   " The elderly should never see a new product as an indication of dependency," Van Mele concluded. " They want control over the data, and they want it to harmonize with the environment, or better, keep it invisible."