Tara French

The future of post-reproductive health – The role of the Internet, the Web, information provision and access

The World Wide Web celebrated its 25th birthday in 2014. In those 25 years, the Web has evolved from static websites (Web 1.0) to a highly complex dynamic system (Web 3.0) with health information processing one of the primary uses. Until now, the western biomedical paradigm has been effective in delivering healthcare, but this model is not positioned to tackle the complex challenges facing healthcare today. These challenges have arisen by increasing healthcare demands across the world, exacerbated by an ageing population, increased lifespan and chronic conditions. To meet these needs, a ‘biopsychosocial’ shift from reactive to proactive health is necessary with a patient-centric emphasis (personalised, preventative, participatory and predictive) that includes ‘gender-specific medicine’. The management of the menopause, part of post-reproductive health, requires a life-course approach as it provides a framework for achieving a women’s preferred health outcome. Surveys from www.menopausematters.co.uk have consistently shown that women do not feel informed enough to make decisions regarding Hormone Replacement Therapy and alternative therapies. Health professionals must meet this challenge. The recently published National Institute for Health and Care Excellence guidance on the diagnosis and management of the menopause highlights the need for tailored information provision. The Internet underpinned by the academic disciplines of Health Web Science and Medicine 2.0 has potential to facilitate this shift to biopsychosocial medicine and tailored information within a life-course framework. The concept of Health Web Observatories and their potential benefit to a life-course approach using tools such as www.managemymenopause.co.uk is discussed.

Co-designing a Digital Directory of Services☆

Abstract The Digital Health and Care Institute is a new innovation centre in Scotland which aims to transform health and social care delivery using a dynamic model of innovation ( www.dhi-scotland.com ). Experience Laboratories are at the core of this model and are led and developed by the Institute of Design Innovation at The Glasgow School of Art. Experience Labs provide a new way of working collaboratively within health and social care contexts in Scotland through a process of exploration, co-design and co-creation, and rapid prototyping of ideas. Bring together academic, business and civic partners, Experience Labs provide the opportunity for extreme collaboration in a safe and realistic environment. Through a series of design-led activities, which position the user at the centre of the design process, the Labs enable the trialing of ideas and co-design of sustainable health and social care solutions, together with end-users. This paper presents the findings of a design-led project to co-design a new directory of services application for the Scottish Ambulance Service. The Experience Lab aimed to explore and develop a basic prototype of a Directory App to support ambulance clinicians to consider alternatives to Accident and Emergency where appropriate, and support initial small scale testing. The Experience Labs provided the opportunity to co-design, develop and test a solution with users. The design-led approach enabled the delivery of a set of user-driven requirements for the development of the Directory App. The safe space for trialling and testing provided by the Labs together with the design-led approach allowed users to share their ideas and experience, contributing to the design of the ideal Directory App.

Developing design principles for a Virtual Hospice: improving access to care

Objectives Providing access to hospice services will become increasingly difficult due to the pressures of an ageing population and limited resources. To help address this challenge, a small number of services called Virtual Hospice have been established. This paper presents early-stage design work on a Virtual Hospice to improve access to services provided by a hospice (Highland Hospice) serving a largely remote and rural population in Scotland, UK. Methods The study was structured as a series of Experience Labs with Highland Hospice staff, healthcare professionals and patients. Experience Labs employ a participatory design approach where participants are placed at the centre of the design process, helping to ensure that the resultant service meets their needs. Data from the Experience Labs were analysed using qualitative thematic analysis and design analysis. Results A number of themes and barriers to accessing Highland Hospice services were identified. In response, an initial set of seven design principles was developed. Design principles are high-level guidelines that are used to improve prioritisation and decision making during the design process by ensuring alignment with research insights. The design principles were piloted with a group of stakeholders and gained positive feedback. Conclusions The design principles are intended to guide the ongoing development of the Highland Hospice Virtual Hospice. However, the challenges faced by Highland Hospice in delivering services in a largely remote and rural setting are not unique. The design principles, encompassing digital and non-digital guidelines, or the design approach could be applied by other hospices in the UK or overseas.

Trust and provenance in communication to ehealth consumers

The future of medicine is shifting to a patient-centric model. One aspect of this model involves an increasing utility to triangulate health-related data. These data sources will be of variable quality and new ways of kitemarking and weighting the data is required. The exemplar of I-Choose may provide a framework for health-related searches with the end user providing the weighting of the criteria used in the search algorithms. NHS Grampian’s No Delays concept uses video on demand to provide clinician-made personalised patient postcards to the patient. This chapter explores trust and provenance issues arising from health care delivered via the Internet and how the end user engages with the technology rather than the wishful hope of “building it and they will use it”.

Formulating ehealth utilizing an ecological understanding

Current evaluation and impact of health care on health outcomes via the Internet is limited in its scope in terms of feedback and interaction between the Web, health-care providers, and patients.

Design-led Approach to Co-production of Values for Collective Decision-Making

Abstract Experience Labs are design-led spaces for co-creating preferable futures by bringing academic, business and civic stakeholders to work together with citizens using a participatory design approach. Differing value systems of stakeholders, however, can pose challenges when working collaboratively. Experience Labs support exchange and co-production of values among diverse stakeholders by making them articulate and visible through design, to resolve conflict and to support meaningful decision-making towards progressing ideas whilst integrating a multiplicity of perspectives. In this paper, we discuss the creation of an ‘ethical imagination space’ to explore preferable futures with diverse stakeholders; the core values of the Experience Labs which support the creation of this space; and the key qualities that support the exchange and co-production of shared values to enable collective decision-making. We propose that the ‘next thinking’ for design involves consideration of the ways in which we engage with values in cross-sectoral collaborations to enable collective decision-making.