03/07/21
By its very nature, the application of new technology in health and care contexts involves a variety of different stakeholders. Stakeholders may include health and care professionals, technology providers, sector academics and researchers, healthcare administrators and managers, care home providers, informal carers, and, not least, public and patients themselves.
The perspectives and goals of these distinct stakeholder groups will differ quite dramatically, and even within each group there will be found a diversity of experiences, abilities, knowledge, goals and requirements. In addition, and for good reason, the sector tends to be cautious and conservative when it comes to adopting new ways of working, including the adoption of new technologies.
This reticence and the stakeholder diversity can present particular difficulties when developing and deploying applications based on technologies such as the Internet of Things, which in itself can be complicated and whose ramifications can be difficult to grasp, even for those working in the field.
The purpose of this project was to raise awareness among stakeholders of the possibilities presented by Internet of Things technologies, while also exploring some of the questions, doubts and misgivings that the stakeholders themselves possess. The project was managed by researchers from the Centre for Assistive Technology and Connected Healthcare (CATCH), University of Sheffield, and partners were to be healthcare technology researchers at Newcastle University and the University of Oxford.
The initial goals of this project were for partners individually to develop a series of events for different stakeholder groups that would be run locally and which could then be ‘exported’, mutatis mutandis, to the other partners to hold with their equivalent local groups. The events were to be focussed around different aspects of IoT for healthcare, and could involve, for example, case studies, technology demonstrations and other elements of an educational nature, as well as exercises to explore the stakeholders’ ideas about its use.
As such, the barriers addressed were primarily to be educational in nature (lack of familiarity with technology and the domain and its various tasks), as well as those of the lack of opportunities for different groups to meet, interact and co-create (connectivity barriers), and of the lack of trust and reluctance to engage (dispositional barriers).
Beneficiaries would be the stakeholder groups themselves, including the digital healthcare researchers running the project whose appreciation of the domain would be increased accordingly.
The project team delivered a number of events and outreach media, but fewer and of a different nature than originally envisaged, since the restrictions imposed by Covid-19 were to have a profound effect on the work. The initial intention was to run the events as face-to-face activities, but that obviously became untenable during the pandemic. And although online delivery was possible – and, indeed, several events were run this way – the involvement of specific stakeholder groups (NHS personnel, for instance, and care home workers) was made difficult due to additional pressures they faced, which meant that the reach of the project was less comprehensive that it might have been.
Furthermore, the pandemic also had an impact on the involvement of the partner sites, with first Oxford (which was to have involved clinical-related staff in the delivery of events) reallocating its funds in their entirety to a different health-and-wellbeing-related project (H17), and later Newcastle, finding itself unable to deliver all the planned events, returning a significant portion of its funds to the general Pitch-In funds. The lead team at the University of Sheffield would also return a non-negligible sum of money, being unable to spend the money originally allocated for supporting in-person activities.
The project delivered the following face-to-face events:
The mystery of IoT
Pitch-In IoT for health and wellbeing awareness-raising workshop, University of Sheffield, December 2018.
Collocated with the annual CATCH Technology for Independence event which attracts occupational therapists as well as healthcare professionals more generally, technology providers and academics. The workshop attracted circa 40 attendees. Content included presentations and videos, and group activities based around the domestic locations included in a popular murder-mystery board game.
From completed post-event questionnaire responses (25 responses): 52% of attendees were healthcare professionals and 40% technologists; 72% felt that their awareness of IoT had been improved by the event (81% when excluding those whose awareness was already very good); and 64% had a more favourable view of IoT after the event.
How much does my toaster know about me?
The data dilemma and IoT workshop, Crown Plaza Hotel, Newcastle, September 2019.
Organised by VOICE, a network of citizens who contribute ideas and opinions to research and innovation in support of healthy ageing. VOICE is based at Newcastle University and is affiliated with the UK’s National Innovation Centre for Ageing (NICA). The event was co-sponsored by Pitch-In and EIT Health.
The content included presentations from academics and industry, and group activities. It attracted circa 50 attendees, mainly members of the public drawn from VOICE’s community, but also technology providers.
The following events took place online:
Trust, digital healthcare and Covid-19
Online community philosophy workshop, June 2020.
Convened to explore the then-emerging concerns and issues raised by the use of IoT and digital technology more widely to respond to Covid-19, nine members of the public took part in the session which was delivered by two accredited community philosophy facilitators (due to the discursive nature of the approach, group sizes have to be relatively small). A follow-up questionnaire collected the participants’ views about the use of different digital technologies in the context of the pandemic.
Will IoT care for me?
Online workshop organised and hosted by VOICE, Newcastle University, June 2020.
Attended by around 30 members of the public. Presentations discussed the different ways in which IoT could deliver care, as well as some of the issues its use raises, before the participants were given the opportunity to express their opinions during persona-based group activities and later through a short follow-up questionnaire.
The questionnaire responses (17 responses) revealed that 76% of respondents now considered their awareness of IoT for care to be “good” or “very good”, with the same percentage considering it constitutes a good idea.
Trust and digital healthcare
Online community philosophy workshop, July 2020.
Expanding on some of the themes that emerged during the earlier community philosophy workshop, this session explored people’s attitudes towards digital healthcare technologies and their health data. Seven members of the public, all of whom had participated in the first workshop, took part in this session, which was again delivered by two professional community philosophy facilitators, and a follow-up questionnaire was used to gather their opinions about, in particular, the role of trust in making decisions about healthcare data and technologies, as well as their evaluation of the workshops themselves.
All participants found the workshops to have clarified their thinking to a “large” or “great” extent, and all found them to be “very” or “extremely” interesting.
The project commissioned and/or contributed to the production of the following public engagement videos:
Digital mental health tools co-production: video publicising the findings of health and wellbeing project H3, ‘Breaking social barriers to the use of IoT for mental healthcare’.
Digital-enabled social prescribing: video publicising the findings of health and wellbeing projects ‘Understanding how IoT-enabled social prescriptions can deliver value in healthcare systems’ and ‘Social prescribing at Blenheim Estate’.
Digital health development webinars: editing, copy-writing and publishing the recordings of the series of digital health webinars delivered as part of health and wellbeing project ‘IoT and mental health: training sessions and hacking the system’.
Introduction to IoT for healthcare: video discussing IoT and its potential for healthcare.
Talking IoT blues (provisional title): members of the VOICE community discuss their experiences of, hopes for and fears about the use of IoT, and some of the myths that surround IoT are dispelled.
The principal impact of this project concerns public and sector stakeholder engagement and awareness-raising. Although the number and nature of activities differed from that envisaged, the responses from attendees at events was generally positive. The outputs of the events and, in particular, the videos, constitute a legacy for continuing impact/engagement.
Although there are no specific plans to capitalise directly on the results of this project, the individual academics/research centres involved in the production of the videos would be expected to exploit that content according to their own strategies.
The project enabled different health-related groups from the three universities involved – Sheffield, Newcastle and Oxford – to establish links, even where this did not lead to joint activities in the manner envisaged. The project was able to pivot, to some extent, in response to the pandemic, moving to different delivery modes or, where this was unfeasible, recognising that the funds would be better used elsewhere.
Leaving aside the difficulties presented by Covid-19, the main lesson learned is that the preparation and delivery of public- and sector-engagement events is time consuming and requires particular skill sets to be done properly.
Insufficient staff effort (money) was allocated to this role, and specific personnel able to deliver the project at each site were not identified in advance. This was not helped by staff changes at one partner site (Newcastle) and staff unavailability at another (Oxford). To a certain extent this was mitigated by the recourse to external event facilitators, but even in this case collaboration, especially where this involves technical or expert subject matter, or engagement with particular stakeholder communities, still requires time and effort, and so this is not always the most efficient way of operating.
Possibly more internal support for running events would have helped. The long duration of the project perhaps created the false impression that careful planning and role-allocation was not a priority, when in fact the project from the outset would have benefited from a detailed plan for at least the first 12 months, with the plan then subject to frequent revisions and extensions.
The unique manner in which Pitch-In has been able to support projects has provided the team with the opportunity to engage in activities and generate resources for which it is otherwise difficult to obtain funding in this particular sector, but which are nonetheless critical components in the two-way process of knowledge exchange.
Professor Luc De Witte, health and wellbeing theme lead – the University of Sheffield