One-to-one interviews with health professionals

With increasing austerity measures and an ageing population, the healthcare sector is continually seeking ways to reduce cost and improve service and care delivery for older adults. With internet connected devices becoming increasingly accessible and affordable, sensor technologies in individual’s homes to assist and improve healthy living is revealing its face as the next step in the future of healthcare. Sensors for Health and Wellbeing project is performed alongside a pilot study steered by Blackburn with Darwen County Council examining potential for simple low-cost internet connected sensors (detecting temperature, humidity, and movement) to improve the wellbeing of persons aged 50+ living in single occupancy homes.

To understand how health and care organisations might use the information from such technologies to improve health care and service delivery; Sensors for Health and Wellbeing conducted interview with 7 clinical health professionals who primarily work with the 50+ population. Interview questions covered several topics such ‘life on the job’, ‘communities and individuals health’, ‘tracking health’, and ‘sensing the home’.

These interviews revealed insights to the lives of people aged 50+ and their interactions with health services, highlighting some of the challenges and paths to improving health and wellbeing through understanding of the environments sensors devices are placed in.

A recognised challenge for all of the health professionals interviewed was the point at which they engaged with their patients, often described as a “snap-shot” following an incident and lacking the contextualising information of the person and their daily life. This posed challenges in the understanding of individuals and their context outside of and surrounding the event which may have led to the medical treatment taking place – a significant challenge for the rapid assessment and falls rehabilitation/prevention teams.  Consequently, these patient’ and home assessments were required to cover a broad range of information that sought to quickly maximise usefulness of the contact and provide an overview for future use, other services, and the rest of their ‘team’; resulting in the visiting health professional adopting many roles.

• “We have-, we use an overview assessment, which is quite generic, ‘cause in our team we have nurses, physios, occupational therapists so, it has to have a bit of everything in it really. So, that’s the main assessment we go out and do and it covers literally everything really. Even if people have smoke alarms, we have to be firemen when we’re going out, you know, because I think there’s very much that attitude of ‘every contact counts’. So, if you know, anybody going out, any health professional, we’re not just narrow minded and looking at the one thing, we’re checking out other things out as well. Then there will be specific O.T. assessments or physio assessments or nursing assessments which could then complement the overview. But generally, it tends to be that overview.”

Gathering, communicating and co-ordinating these “snap-shot’s” of health and care to build a richer understanding of patients, however, was often significant in diagnosis, treatment, and prevention.

• “I saw another very frail man, who may have a significant medical condition. Who’s clearly been deteriorating, becoming frailer over the last six months, and understanding his, if you like, trajectory of illness, so, what’s been course of his illness; is a really important factor in determining what’s the best care for him. Because if that’s been a rapid deterioration and a severe deterioration, then treatment may not help him; if that’s been a slow deterioration and then perhaps a rapid change because of something else happening, then treatment might help him. But gathering that information, at a cross sectional point in time, is pretty tricky.”

While frailty and physical health are significant aspects of an individual’s wellness the health professionals we met with highlighted that ‘frailty is not just a physical state’. How a patient “feels” can induce “downward spirals” in health or improve resilience and recovery.

• “[…] in terms of their wellbeing, that affects what they do. You know, their physical activity, their social interactions and then therefore their psychological health. I think also in terms of how resilient they are and how resilient they feel on a day to day basis. So, how anxious they might be, about being back in their own home after a period of hospitalisation or something. You know, that will influence- [recovery].”

The knowledges gained from these engagements informed design considerations for future sensors for health and wellbeing (to be detailed in a following report).