L.W.L. Simonse
Please Note
9 records found
1
Libra Care
An interactive tool that stimulates active patient participation to create customized care plans that contribute to trauma patients quality of life
The designed tool is called Libra Care, which refers to ‘care that is in balance’. This means that the optimal customized care plan is created with medical input from the health care provider, but also with personal input from the patient. Patients are the only ones that can determine the value of various health outcomes for their quality of life. And therefore, Libra Care provides support for patients to actively participate in the process of aligning care provision with their personal values, goals and preferences.
Libra Care uses a guided exercise in combination with generative techniques and mind-switching to elicit personal values and the things that are important in the life of this patient. These techniques are used to extract deeper and more valuable personal information. The generated ‘What matters to me’-dossier is the starting point for consultation with different health care providers, and supports expectation management, shared decision-making and personal goal-setting. All goals a patient works towards with different health care providers are documented in relation to the overarching goal and patient reported outcome
measurements (PROMs) they support. This ensures that health care providers can align their care, facilitating effective interdisciplinary collaboration. Regular patient reported outcome measurements (PROMs) ensure continuous patient involvement and evaluation.
The information in the dossier can also be used by psycho-social workers to support conversations about acceptance. The dossier helps to broaden a patient's perspective, by making them realize that most of what is important to them remains unaffected by the trauma injury. Personal goal-setting focuses on what is still possible for the patient (or could be possible in the future). Libra Care provides patients with the opportunity to explore the coping strategies of other patients. This will help them to realize that quality of life can be achieved in many ways and that their losses can often be mitigated or compensated. Within Libra Care, patients can share their experiences, concerns, and emotions. Feeling supported and connected with other patients supports mental, physical and emotional health, and it improves the capacity to cope with losses.
Although the desirability and value of the tool was proven during patient and expert focus groups, the project and design have some limitations. Therefore, recommendations have been provided for further research and testing. The implications of this project offer actionable insights for transforming health care practices and policies, ensuring that care remains person-centered and value-driven, despite the challenges posed by increasing healthcare demands. ...
The designed tool is called Libra Care, which refers to ‘care that is in balance’. This means that the optimal customized care plan is created with medical input from the health care provider, but also with personal input from the patient. Patients are the only ones that can determine the value of various health outcomes for their quality of life. And therefore, Libra Care provides support for patients to actively participate in the process of aligning care provision with their personal values, goals and preferences.
Libra Care uses a guided exercise in combination with generative techniques and mind-switching to elicit personal values and the things that are important in the life of this patient. These techniques are used to extract deeper and more valuable personal information. The generated ‘What matters to me’-dossier is the starting point for consultation with different health care providers, and supports expectation management, shared decision-making and personal goal-setting. All goals a patient works towards with different health care providers are documented in relation to the overarching goal and patient reported outcome
measurements (PROMs) they support. This ensures that health care providers can align their care, facilitating effective interdisciplinary collaboration. Regular patient reported outcome measurements (PROMs) ensure continuous patient involvement and evaluation.
The information in the dossier can also be used by psycho-social workers to support conversations about acceptance. The dossier helps to broaden a patient's perspective, by making them realize that most of what is important to them remains unaffected by the trauma injury. Personal goal-setting focuses on what is still possible for the patient (or could be possible in the future). Libra Care provides patients with the opportunity to explore the coping strategies of other patients. This will help them to realize that quality of life can be achieved in many ways and that their losses can often be mitigated or compensated. Within Libra Care, patients can share their experiences, concerns, and emotions. Feeling supported and connected with other patients supports mental, physical and emotional health, and it improves the capacity to cope with losses.
Although the desirability and value of the tool was proven during patient and expert focus groups, the project and design have some limitations. Therefore, recommendations have been provided for further research and testing. The implications of this project offer actionable insights for transforming health care practices and policies, ensuring that care remains person-centered and value-driven, despite the challenges posed by increasing healthcare demands.
Navigating value tensions in the use of AI for policy preparation
Towards guidelines & a practical tool
AI holds promise for improving policy quality, efficiency, and democratic engagement; it also introduces serious risks, such as depoliticisation, bias, loss of professional judgment, and declines in public trust. These risks, combined with organisational barriers like low AI literacy, limited capacity, and fragmented structures, have led to hesitant adoption within ministries.
The thesis uses a constructive design research method. Answering research question by means of design. With a design project that uses an design approach based Frame Innovation, Vision in Product Design (ViP), and Value Sensitive Design (VSD). Resulting in a prototype tool that is evaluated with civil servants. The design balances encouragement and responsibility, aiming to stimulate AI curiosity, proposed as a key mechanism for learning and soft AI capacity-building, while reinforcing awareness of ethical and procedural boundaries. The tool incites reflection rather than prescription, helping users think critically, recognise dilemmas, and connect to existing support resources, which anchors quality assurance in the Dutch policy process.
This thesis contributes to bridging the gap between theoretical frameworks of responsible AI and practical application in policy preparation.
...
AI holds promise for improving policy quality, efficiency, and democratic engagement; it also introduces serious risks, such as depoliticisation, bias, loss of professional judgment, and declines in public trust. These risks, combined with organisational barriers like low AI literacy, limited capacity, and fragmented structures, have led to hesitant adoption within ministries.
The thesis uses a constructive design research method. Answering research question by means of design. With a design project that uses an design approach based Frame Innovation, Vision in Product Design (ViP), and Value Sensitive Design (VSD). Resulting in a prototype tool that is evaluated with civil servants. The design balances encouragement and responsibility, aiming to stimulate AI curiosity, proposed as a key mechanism for learning and soft AI capacity-building, while reinforcing awareness of ethical and procedural boundaries. The tool incites reflection rather than prescription, helping users think critically, recognise dilemmas, and connect to existing support resources, which anchors quality assurance in the Dutch policy process.
This thesis contributes to bridging the gap between theoretical frameworks of responsible AI and practical application in policy preparation.
The data collection of the project includes desk research on the TeleNeo pilot, a comprehensive literature review on digital health solutions, implementation settings, and service experiences. This research highlighted the common challenges faced when implementing digital health solutions, such as conflicting stakeholder values and the need for alignment with end-users and the broader healthcare system. An opportunity for design practice was identified through the use of visualizations as service prototypes by envisioning how solutions should ideally function and integrating them into existing healthcare systems.
In-depth stakeholder interviews and a Thematic Analysis on the obtained interview data revealed situation-specific barriers for implementing TeleNeo, including difficulties in planning and scheduling consultations, and unclear roles and responsibilities for healthcare professionals during the preparation, execution, and follow-up of consultations. Building upon the literature on existing visualization techniques and insights from expert interviews on visualization and co-design, the project's design phase emphasized the development of CoVisioning: a customized visualization guided co-design technique. This approach aimed to engage healthcare professionals in a collaborative session to address the situation-specific barriers through visual activities.
An iterative design process was adopted to incorporate feedback from designers and healthcare professionals, refining the visualization guided co-design technique. Utilizing the developed technique in a session with healthcare professionals from both hospitals, the project resulted in revised workflows for the NICU (EMC) and HC (Amphia) departments. These revised workflows integrated planned TeleNeo consultations, complemented with clearly defined roles for all involved.
CoVisioning proved instrumental in fostering a sense of ownership and collaboration among participants, leading to a more seamless integration of TeleNeo into routine healthcare activities and an initial step towards allocating TeleNeo responsibilities among involved healthcare professionals. Furthermore, the guidelines developed in this study for creating a similar visualization guided co-design technique can be applied to support the implementation of other digital health solutions dealing with scheduling and role allocation issues, promoting broader improvements in healthcare systems. ...
The data collection of the project includes desk research on the TeleNeo pilot, a comprehensive literature review on digital health solutions, implementation settings, and service experiences. This research highlighted the common challenges faced when implementing digital health solutions, such as conflicting stakeholder values and the need for alignment with end-users and the broader healthcare system. An opportunity for design practice was identified through the use of visualizations as service prototypes by envisioning how solutions should ideally function and integrating them into existing healthcare systems.
In-depth stakeholder interviews and a Thematic Analysis on the obtained interview data revealed situation-specific barriers for implementing TeleNeo, including difficulties in planning and scheduling consultations, and unclear roles and responsibilities for healthcare professionals during the preparation, execution, and follow-up of consultations. Building upon the literature on existing visualization techniques and insights from expert interviews on visualization and co-design, the project's design phase emphasized the development of CoVisioning: a customized visualization guided co-design technique. This approach aimed to engage healthcare professionals in a collaborative session to address the situation-specific barriers through visual activities.
An iterative design process was adopted to incorporate feedback from designers and healthcare professionals, refining the visualization guided co-design technique. Utilizing the developed technique in a session with healthcare professionals from both hospitals, the project resulted in revised workflows for the NICU (EMC) and HC (Amphia) departments. These revised workflows integrated planned TeleNeo consultations, complemented with clearly defined roles for all involved.
CoVisioning proved instrumental in fostering a sense of ownership and collaboration among participants, leading to a more seamless integration of TeleNeo into routine healthcare activities and an initial step towards allocating TeleNeo responsibilities among involved healthcare professionals. Furthermore, the guidelines developed in this study for creating a similar visualization guided co-design technique can be applied to support the implementation of other digital health solutions dealing with scheduling and role allocation issues, promoting broader improvements in healthcare systems.
Digital communication of polygenic risk for breast cancer to female recipients
A service design approach
Although PRS itself does not pose a direct health threat, its communication may cause worry and lead recipients to seek support from healthcare professionals, adding strain to the healthcare system. Therefore, EHIF aims to convey PRS results through a digital channel that helps recipients understand their results without causing undue worry or prompting unnecessary consultations.
This graduation project focuses on the digital communication of BC PRS, aiming to provide recipients with peace of mind regarding their genetic risk. A literature review was conducted to analyze genetic risk, existing PRS services, and the informational and social support needs of recipients. To further understand the needs of 40-year-old women in Estonia, the target group for this service, 15 user and expert interviews were conducted.
Based on the insights from the interview studies and the literature reviews, the following aspects from genetic counseling are highlighted to create peace of mind for recipients receiving a BC PRS result:
• Use of empathic statements,
• reflective interaction with the recipients and clarification of PRS information,
• use of analogies,
• providing a sense of control to the recipient,
• framing genetic risk as a small change, and
• highlighting the value of PRS communication as an early warning.
As part of the conceptualization phase, a service blueprint and two roadmaps were developed. The service blueprint proposes the My Genetic Mirror concept, aiming to create an identity- focused perception of the service, simplify the PRS result using a fire safety metaphor, spread out information delivery to prevent overwhelming communication and provide resources for follow-up questions.
To consider future development of the service concept, both a strategic and a tactical roadmap were formulated. The future vision of these roadmaps for 2030 focuses on creating emotionally reassuring yet cost-efficient genetic health management for a peace of mind. A preliminary evaluation of the service concept was conducted with four design students. The thesis concludes by highlighting contributions to new knowledge, identifying limitations, providing recommendations, and offering a personal reflection. ...
Although PRS itself does not pose a direct health threat, its communication may cause worry and lead recipients to seek support from healthcare professionals, adding strain to the healthcare system. Therefore, EHIF aims to convey PRS results through a digital channel that helps recipients understand their results without causing undue worry or prompting unnecessary consultations.
This graduation project focuses on the digital communication of BC PRS, aiming to provide recipients with peace of mind regarding their genetic risk. A literature review was conducted to analyze genetic risk, existing PRS services, and the informational and social support needs of recipients. To further understand the needs of 40-year-old women in Estonia, the target group for this service, 15 user and expert interviews were conducted.
Based on the insights from the interview studies and the literature reviews, the following aspects from genetic counseling are highlighted to create peace of mind for recipients receiving a BC PRS result:
• Use of empathic statements,
• reflective interaction with the recipients and clarification of PRS information,
• use of analogies,
• providing a sense of control to the recipient,
• framing genetic risk as a small change, and
• highlighting the value of PRS communication as an early warning.
As part of the conceptualization phase, a service blueprint and two roadmaps were developed. The service blueprint proposes the My Genetic Mirror concept, aiming to create an identity- focused perception of the service, simplify the PRS result using a fire safety metaphor, spread out information delivery to prevent overwhelming communication and provide resources for follow-up questions.
To consider future development of the service concept, both a strategic and a tactical roadmap were formulated. The future vision of these roadmaps for 2030 focuses on creating emotionally reassuring yet cost-efficient genetic health management for a peace of mind. A preliminary evaluation of the service concept was conducted with four design students. The thesis concludes by highlighting contributions to new knowledge, identifying limitations, providing recommendations, and offering a personal reflection.
Consent practices and disclosure interactions in the context of digital platforms
A design proposal to improve current practices by leveraging value similarities and resolving value tensions
This thesis investigates how consent practices and disclosure interactions can be redesigned to instate future data practices and digital platform relations which both digital platform organisations and end-users desire. This thesis adopts a sociotechnical perspective on digital platforms, as in de Reuver et al. (2018) and Tilson et al. (2012). The hypothesis is that future visions on 1) digital platform relations, 2) data practices, and 3) consent practices and disclosure interactions, from digital platform organisations and end-users should be explored, defined and compared to identify commonalities that provide a foundation for solution exploration, and to identify fundamental tensions that need to be resolved to create the conditions in which new practices can be effective and meaningful.
Future visions are defined through semi-structured interviews and Context Mapping conducted with eight field experts and eight (sensitised) end-users, led by the Path of Expression line of inquiry and analysed accordingly to the Grounded Theory Method. For every future vision topic, one theoretical framework is made to extract values and sources of friction. While the first are the drivers of the future visions, the latter contain conflicting interests to resolve before they can occur. By comparing the values extracted from the future visions on consent practices and disclosure interactions from the experts and end-users, it is concluded that some values match and others clash, which are defined as value similarities and value tensions respectively.
Methods to leverage value similarities in consent practice redesign are investigated through creative sessions with (former) design students employing How To – Questions, Brainwriting and Creative Confrontation. As all values can be leveraged in different ways, strategies for creating new consent practices are defined by using a Morphological Chart. A similar creative session employing Personal Analogy, Role-Play and Scenarios is used to investigate how to resolve value tensions in a consent redesign. All common tactics used to reach agreements on the value tensions are analysed and applied to the redesign for resolving the value tensions. Eventually the design objective of the thesis is reached by creating new (aspects of) consent practices and disclosure interactions based on the design propositions, for a total of 21 design directions including 88 different ideas from several ideation activities.
The digital platform organisation Flickr served as a real-life case for applying the research insights and design directions. A new consent journey proposal which balances privacy considerations from end-users and interests of the AI community is created for obtaining users’ photos to create image data sets. The proposal is validated with representatives from Flickr, Flickr’s end-users and the AI community, and evaluated as desirable, sufficiently feasible and viable, with part of it effectively contributing to solving the design case. Additionally, the proposal enables the exercise of end-users’ digital right to privacy and consent. It’s effect on individual-level relations also contributes to solving data practice-related societal issues.
This thesis concludes that consent practices and disclosure interactions can successfully be redesigned by leveraging the set of identified value similarities and resolving the set of identified value tensions. It is also found that ensuring a match between desired practices and reducing opportunities for dissension allows redesigning consent practices to be effective and meaningful. The early assumption that the identified sources of friction are solved limits however this thesis’ effective implementations, possibly requiring future research and investigations in these regards.
...
This thesis investigates how consent practices and disclosure interactions can be redesigned to instate future data practices and digital platform relations which both digital platform organisations and end-users desire. This thesis adopts a sociotechnical perspective on digital platforms, as in de Reuver et al. (2018) and Tilson et al. (2012). The hypothesis is that future visions on 1) digital platform relations, 2) data practices, and 3) consent practices and disclosure interactions, from digital platform organisations and end-users should be explored, defined and compared to identify commonalities that provide a foundation for solution exploration, and to identify fundamental tensions that need to be resolved to create the conditions in which new practices can be effective and meaningful.
Future visions are defined through semi-structured interviews and Context Mapping conducted with eight field experts and eight (sensitised) end-users, led by the Path of Expression line of inquiry and analysed accordingly to the Grounded Theory Method. For every future vision topic, one theoretical framework is made to extract values and sources of friction. While the first are the drivers of the future visions, the latter contain conflicting interests to resolve before they can occur. By comparing the values extracted from the future visions on consent practices and disclosure interactions from the experts and end-users, it is concluded that some values match and others clash, which are defined as value similarities and value tensions respectively.
Methods to leverage value similarities in consent practice redesign are investigated through creative sessions with (former) design students employing How To – Questions, Brainwriting and Creative Confrontation. As all values can be leveraged in different ways, strategies for creating new consent practices are defined by using a Morphological Chart. A similar creative session employing Personal Analogy, Role-Play and Scenarios is used to investigate how to resolve value tensions in a consent redesign. All common tactics used to reach agreements on the value tensions are analysed and applied to the redesign for resolving the value tensions. Eventually the design objective of the thesis is reached by creating new (aspects of) consent practices and disclosure interactions based on the design propositions, for a total of 21 design directions including 88 different ideas from several ideation activities.
The digital platform organisation Flickr served as a real-life case for applying the research insights and design directions. A new consent journey proposal which balances privacy considerations from end-users and interests of the AI community is created for obtaining users’ photos to create image data sets. The proposal is validated with representatives from Flickr, Flickr’s end-users and the AI community, and evaluated as desirable, sufficiently feasible and viable, with part of it effectively contributing to solving the design case. Additionally, the proposal enables the exercise of end-users’ digital right to privacy and consent. It’s effect on individual-level relations also contributes to solving data practice-related societal issues.
This thesis concludes that consent practices and disclosure interactions can successfully be redesigned by leveraging the set of identified value similarities and resolving the set of identified value tensions. It is also found that ensuring a match between desired practices and reducing opportunities for dissension allows redesigning consent practices to be effective and meaningful. The early assumption that the identified sources of friction are solved limits however this thesis’ effective implementations, possibly requiring future research and investigations in these regards.
Arhealth
Enabling wellness as a road to health with service design
Key to these consultations is the use of medical devices to gather information relating to the patient's state. New medical device categories now allow people with little or no training to collect accurate information (European Commission, 2017), including by using wearables first intended for tracking activity-related metrics that are currently being fitted with state-of-the-art sensors that allow them to become a realistic alternative to strict medical devices (Raja et al., 2019). Despite this, several key issues impede their use in standard medical practice and are more commonly used as informational tools only (Raja et al., 2019).
The use of wearables as informational tools has the potential to increase the awareness of people of the effect of the things they do on their wellbeing, an essential part of the concept of preventative medicine. A concept that aims to enhance wellbeing is wellness, with health being a state of being and a goal to achieve (Stoewen, 2015).
Wellness is also a concept that is well entrenched on the product lines of the brands of Arçelik, and is seen as an important opportunity to grow medical capabilities in the products they already dominate.
This thesis project presents a service design concept that aims to help people create their own wellness journey by passively tracking habits and receiving advice based on this information. The concept is based around the gathering of information through smart home appliances, focused around four modules: nutrition, activity, sleep and vitals.
The project concludes that the proposed service solution brings the possibility to integrate the capabilities that Arçelik needs to enter the larger healthcare market while staying in the product categories that it dominates.
...
Key to these consultations is the use of medical devices to gather information relating to the patient's state. New medical device categories now allow people with little or no training to collect accurate information (European Commission, 2017), including by using wearables first intended for tracking activity-related metrics that are currently being fitted with state-of-the-art sensors that allow them to become a realistic alternative to strict medical devices (Raja et al., 2019). Despite this, several key issues impede their use in standard medical practice and are more commonly used as informational tools only (Raja et al., 2019).
The use of wearables as informational tools has the potential to increase the awareness of people of the effect of the things they do on their wellbeing, an essential part of the concept of preventative medicine. A concept that aims to enhance wellbeing is wellness, with health being a state of being and a goal to achieve (Stoewen, 2015).
Wellness is also a concept that is well entrenched on the product lines of the brands of Arçelik, and is seen as an important opportunity to grow medical capabilities in the products they already dominate.
This thesis project presents a service design concept that aims to help people create their own wellness journey by passively tracking habits and receiving advice based on this information. The concept is based around the gathering of information through smart home appliances, focused around four modules: nutrition, activity, sleep and vitals.
The project concludes that the proposed service solution brings the possibility to integrate the capabilities that Arçelik needs to enter the larger healthcare market while staying in the product categories that it dominates.
Design for fairness in AI
Cooking a fair AI Dish
This report describes the user-centred design process that explores opportunities on how patients, taking medication, can be helped in their day to day lives. The research revealed bottlenecks in the medication care process that cause unsafe medication care. Unsafe medication care can cause (preventable) hospitalisation. Research focuses on patients that are most likely to encounter problems due to medication. These are patients with polypharmacy and multi-morbidity, taking medication that influences the cardiovascular system.
Patient group
Five in-depth, semi-structured interviews are done with patients to set up a Patient Journey. This journey illustrated pain points in the patient’s live to do with their medication and care. These were taken on as a design challenge to resolve, namely:
To empower patients in searching for a regimen in which living with medication is not restrictive and to take away strong negative emotion around adjustments to the medication regimen.
The interviews also showed a gap between norms for safe pharmaceutical care, to relieve bottlenecks, and patient’s experience. This project aims to resolve these problems areas from the patient side through patient empowerment. With the four aspects of patient empowerment the following design vision was made: 1) Patients will better understand their responsibilities in keeping and transferring their medication overview. 2) Patients will gain knowledge to engage in a consult conversation about their medication treatment. 3)Patients experience that their home and the consult environment is facilitated for safer medication treatment. 4)Patient experience their healthcare skills regarding their medication treatment are anticipated.
The Zeker App
Trends in the pharmaceutical and healthcare market shows opportunities in using e-Health as a significant part of the solution. The Zeker app embodies e-Health for improved accessibility, effectiveness, efficiency, safety and quality, of medication care for patients. The Zeker app is designed using brainstorming, wireframing and digital user interface mock-ups. For patients with polypharmacy, the Zeker app gives reliable personalised answers in finding a medication regimen. When medication is restrictive it will reduce negative emotion by taking patients seriously and helping in the search as to why and what are alternatives for patients. Knowledge and giving overview empowers patients in increasing medication safety together with their caregivers:
“Together Sure about your medication.”
Stakeholders
The Zeker app operates in the complex pharmaceutical health care network. For concept validation and further research into the future stakeholders in medication safety and e-Health interventions stakeholder interviews are conducted. Representatives of KNMP, NVZ, VIG, BOGIN and the Patient Federation with expertise in this field, were questioned about their opinion of the mock-ups. As well as their organisation’s and other stakeholder’s roles in these kinds of developments.
It was made clear collaboration with many different stakeholders required to get this concept of the ground. Both on an organisational level, like involving branch organisations. As well for utilising existing databases and content as building blocks for the app. This project distinguishes three types of data to consider for collaborative development: static data, resilient data and timely data.
The research puts forth the need for nationally arranged (big) data analysis of medication side-effects. This can be used in pharmaceutical development as well as in improvement and personalisation of medication treatment. It is believed the existing side-effect registration centre Lareb can fulfil this role. By digitising Lareb can expand its data collection and increasingly offer analytics as a service.
The government should increase its efforts towards e-Health acceptance and adoption for both patients and caregivers. Current numbers on use of e-Health show patients are still slow to adopt. Besides, patients are unwilling to pay for e-Health. Therefore, it is expected e-Health will increasingly be reimbursed by health insurance companies.
Viabilty
For the Zeker app, this implies that it should be developed with or by a GP information system provider. Initial data exchange can be set up swiftly. The GP has an overview of all medication which the specialist has not. The GP has the ability to change the prescription, which the pharmacist has not. Reimbursement for e-Health by the GP is already arranged under patient self-monitoring.
With the collaborative development of PGOs and the changes in the financial model towards Value-Based Healthcare it is likely e-Health will soon be reimbursed as a separate type of care transcending individual caregivers.
The last iteration of the Zeker design is based on user-research. Thirteen in scope participants indicated that they understood the app and its four main functions. If it would help or whether they would use it frequently depended on whether they experienced problems with their medication before and if they had not already fixed the problems in another way. These patients also, indicated that they would not pay for such an application unless it needs little effort. When they are clearly shown the benefit as opposed to their current ways of working. The iteration improved the clarity of- and simplified the Zeker app design. Besides this, it was decided to make a clearer distinction between self-measurement and side-effects by adding a menu function.
...
This report describes the user-centred design process that explores opportunities on how patients, taking medication, can be helped in their day to day lives. The research revealed bottlenecks in the medication care process that cause unsafe medication care. Unsafe medication care can cause (preventable) hospitalisation. Research focuses on patients that are most likely to encounter problems due to medication. These are patients with polypharmacy and multi-morbidity, taking medication that influences the cardiovascular system.
Patient group
Five in-depth, semi-structured interviews are done with patients to set up a Patient Journey. This journey illustrated pain points in the patient’s live to do with their medication and care. These were taken on as a design challenge to resolve, namely:
To empower patients in searching for a regimen in which living with medication is not restrictive and to take away strong negative emotion around adjustments to the medication regimen.
The interviews also showed a gap between norms for safe pharmaceutical care, to relieve bottlenecks, and patient’s experience. This project aims to resolve these problems areas from the patient side through patient empowerment. With the four aspects of patient empowerment the following design vision was made: 1) Patients will better understand their responsibilities in keeping and transferring their medication overview. 2) Patients will gain knowledge to engage in a consult conversation about their medication treatment. 3)Patients experience that their home and the consult environment is facilitated for safer medication treatment. 4)Patient experience their healthcare skills regarding their medication treatment are anticipated.
The Zeker App
Trends in the pharmaceutical and healthcare market shows opportunities in using e-Health as a significant part of the solution. The Zeker app embodies e-Health for improved accessibility, effectiveness, efficiency, safety and quality, of medication care for patients. The Zeker app is designed using brainstorming, wireframing and digital user interface mock-ups. For patients with polypharmacy, the Zeker app gives reliable personalised answers in finding a medication regimen. When medication is restrictive it will reduce negative emotion by taking patients seriously and helping in the search as to why and what are alternatives for patients. Knowledge and giving overview empowers patients in increasing medication safety together with their caregivers:
“Together Sure about your medication.”
Stakeholders
The Zeker app operates in the complex pharmaceutical health care network. For concept validation and further research into the future stakeholders in medication safety and e-Health interventions stakeholder interviews are conducted. Representatives of KNMP, NVZ, VIG, BOGIN and the Patient Federation with expertise in this field, were questioned about their opinion of the mock-ups. As well as their organisation’s and other stakeholder’s roles in these kinds of developments.
It was made clear collaboration with many different stakeholders required to get this concept of the ground. Both on an organisational level, like involving branch organisations. As well for utilising existing databases and content as building blocks for the app. This project distinguishes three types of data to consider for collaborative development: static data, resilient data and timely data.
The research puts forth the need for nationally arranged (big) data analysis of medication side-effects. This can be used in pharmaceutical development as well as in improvement and personalisation of medication treatment. It is believed the existing side-effect registration centre Lareb can fulfil this role. By digitising Lareb can expand its data collection and increasingly offer analytics as a service.
The government should increase its efforts towards e-Health acceptance and adoption for both patients and caregivers. Current numbers on use of e-Health show patients are still slow to adopt. Besides, patients are unwilling to pay for e-Health. Therefore, it is expected e-Health will increasingly be reimbursed by health insurance companies.
Viabilty
For the Zeker app, this implies that it should be developed with or by a GP information system provider. Initial data exchange can be set up swiftly. The GP has an overview of all medication which the specialist has not. The GP has the ability to change the prescription, which the pharmacist has not. Reimbursement for e-Health by the GP is already arranged under patient self-monitoring.
With the collaborative development of PGOs and the changes in the financial model towards Value-Based Healthcare it is likely e-Health will soon be reimbursed as a separate type of care transcending individual caregivers.
The last iteration of the Zeker design is based on user-research. Thirteen in scope participants indicated that they understood the app and its four main functions. If it would help or whether they would use it frequently depended on whether they experienced problems with their medication before and if they had not already fixed the problems in another way. These patients also, indicated that they would not pay for such an application unless it needs little effort. When they are clearly shown the benefit as opposed to their current ways of working. The iteration improved the clarity of- and simplified the Zeker app design. Besides this, it was decided to make a clearer distinction between self-measurement and side-effects by adding a menu function.