Client-centered and value driven Health Technology .
Lisette van Gemert-Pijnen
Center eHealth Research & Disease Management
16 februari 2012 NSRII VU Amsterdam
Center for eHealth Research & Disease Management
 to intensify cooperation with international research
centres and healthcare institutes
 to advice about (re)designing and implementing
technology in healthcare
 to contribute to the solution of global health problems,
like ageing and chronic care, via a multidisciplinary
approach (social sciences & technology)
 HIGH TECH HUMAN TOUCH
http://ehealthresearchcenter.org
 eHealth onderzoek in beeld
eHealth, our approach….
 “eHealth is not only a technical development, but also a
state-of-mind, a way of thinking, an attitude, and a
commitment for networked, global thinking, to improve
healthcare locally, regionally, and worldwide by using
information and communication technology.” (Eysenbach,
2001)
 eHealth a catalyst to innovate Healthcare
 Client-centered (persuasive designs)
 Value-driven (Business modelling)
Self-Management & Safety support (what works for whom)
Decision Support HCWs (to increase safety,
to reduce errors)
International network R & D eHealth
Uptake: Who are the hard-core users?
 those that might feel they have much to gain….
 eager to realize goals, quality-driven
 positive attitude in advance to use the application
 more healthy than they think they are
 persuasive designs that fit with client profiles
 client profiles ≠ disease-profiles
 big 5 personalities ≈ different persuasive designs
Uptake: Persuasive Designs & Clientprofiles
Reminders
Multimedia
Dialogue Support
Social Support
Impact: Client-centered & Blended care




Integration offline & online: optimum?
For whom? Match clientprofiles & treatment-design
Effects on self-care, adherence, costsavings
Business modelling (innovation/ ketenzorg)
Implementation; Value-driven technologies
 Implementation no afterthought
 Stakeholder involvement during development
 Value-creation & Value-cost-matrix
 Drivers for deployment
 Business models (before deployment!)
VALUE SPECIFICATION
 Purpose. Which stakeholders are important? What do stakeholders want?
Who can offer it?
 Stakeholder salience mapping: which
stakeholders are crucial in the project
 Value mapping: identifying added values
by keystakeholders and ranking values
(using e.g. critical decision systems)
Business Modelling in eHealth
13/04/2015
13
What business model drives e(M) Health?
Workshops stakeholders
eMental Health & Gepast gebruik
 Hoe kan blended care ‘gepast gebruik’ bevorderen in de GGZ?
 Voor welk cliëntprofiel is eMental health gepast?
 Welk design van blended care is voor welke clientenprofiel “gepast” ?
 Welk business model past bij eMental health, in het bijzonder bij blended
care?
 Casus depressie, eerstelijn/tweedelijn instellingen GGZ
Focus Development & Implementation
 eHealth-roadmap
 eHealthwiki, Toolkit
 Needs assessments
 Critical decision system (value-matrix)
 Persuasive designs
 Business models
 Workshops & advice
Supporting Health by Technology IV
22 mei Amersfoort, best practices implementation
Contact: dr. J (Lisette) van Gemert-Pijnen
J.vanGemert-Pijnen@utwente.nl
www.ehealthresearchcenter.nl
health by technology
Education materials …New Book & Suppl ehealthwiki.org
Students
to learn how to
develop and
implement eHealthtechnologies
Health
professionals
to know the keyfactors for eHealth
quality
Management
to know the key-factors
for implementation
of eHealth

Policy, governance
to know how to
measure the impact
of eHealth

Developers
to know how to deal
with a human
centered
development
approach
lessons learned
 Technology blows up shortcomings in current healthcare systems!
 Capacities of technology overlooked in eHealth research
 Implementation no issue in eHealth research
 Better adherence via persuasive designs
 Better implementation via stakeholders’ involvement /investment
 Staff, patients can manage IT; participation=motivation
Persuasive technology and personalities






(Halko&Kientz, 2010)
More or less persuadable (Big Five Personalities)
Conscientiousness successful for tech-persuasion (realising goals)
Extraversions hard to persuade via tech
Openness more likely to favour competitive or authoritative tech
Agreeableness not very successful to persuade via tech
Neuroticism no cooperation, enjoyment of negative reinforcement
Personalizing: Which design fits with specific user groups
Data base with 190-studies
•Chronic condition
•Lifestyle
•Mental health
•Data extraction based on CeHRes roadmap
• Predictors of usage (patient-drivers)
• Predictors of implementation (stakeholder-drivers)
•Results comparable (and interpretable to other studies)
Persuasive System Design Model (PSD)
Primaire taak
Reductie
Tunneling
op maat maken
persoonlijk maken
zelf monitoren,
Simulatie
oefening
Dialoog
ondersteuning
Prijzen
Beloningen
Geheugensteun
Suggesties
Gelijkvormigheid
Voorkeuren
sociale rol
Systeem
geloofwaardigheid
Sociale
ondersteuning
vertrouwenswaardig
Expertise
oppervlakkige geloofwaardigheid
“real world feel”
Autoriteit
derde partij instemming
verifceerbaarheid
sociaal leren
sociale vergelijking
normatieve invloed
sociale facilitatie
Samenwerking
Competitie
herkenning
Triggers and incentives

“You can take measurements from your glucometer and the app will
automatically know you’ve taken the measurement and it will log that,”
said Cafazzo UHN. “It will prompt you when it detects trends in your
blood sugar that are problematic.”
 “It gets the adolescent to start thinking about what’s happening and
encourages positive behaviours by asking them to take
measurements…if they have a lot of consecutive readings as they
should, they will get a reward.”
 The rewards, iTunes redemption codes, allow teens to buy other apps
or music that appeal to them.
Presentatietitel: aanpassen via Beeld, Koptekst en voettekst
13-4-2015
24
Wall-meetings eMental Health
wachttijden verkorten, effectiever maken (voor
behandeling plaats vindt al online intake, oefeningen)
tijdsbesparing,
betaalbaarheid van zorg
extra service; klanttevredenheid
Training online communicatie met cliënten
Training/overleg inpassing in reguliere werkzaamheden
Training omgaan met techniek
Discontinued users (web-based systems )
 Technology frustrates
 Usability problems; people get lost in the system
 They have a high demand for push factors
 Triggers; feedback; incentives
 No obligations, free use, free choice, free of charge: low
adherence
 Technology does not motivate
 no fit into daily live
 they think their condition is under control (ceiling effect)
Cooperation
•
•
•
•
•
•
•
•
•
•
•
•
Cooperation with University of Waterloo, NIHI
Cooperation with the University of Toronto (Dr G Eysenbach,
visiting professor)
Cooperation with the University of Munster (Eursafety Healthnet)
Board e-Telemed (IARIA/ ETELEMED ), scientific committee
/fellow; editorial board (since 2008)
Board Eursafety-Health-net ( 2009) , Board MRSA-net (20052009)
European Center for Disease Prevention & Control (ePublic
Health).
Cooperation with knowledge centers eHealth; MedicInfo,
Mediarts/NVU, FocusCura, Philips Medical Systems, UMC
Radboud, UMCU, TNO quality of life.
Formal cooperation with RIVM, ePublic Health
Contacts with WHO, international Center eHealth Australia,
Center for global eHealth Innovation (Toronto), Norwegian
telemedicine center, Tromsø , California Healthcare Foundation
Cooperation with RAND-Europe eHealth business modelling.
Coordination of Annual conference “Supporting Health by
Technology “(mei 2008, 2009. November 2010 Medicine 2.0
(Uni Toronto) with Supporting Health by Technology III
(GW/UT).
Organisation of Congress business modelling eHealth;
eTelemed (St Maarten 2010, Guadeloupe 2011) .