Co-design, implementation and evaluation

There are many smart solutions to creating healthier home environments, from enabling localized and remote control of the built environment, promoting virtual exposure to green and blue spaces and supporting activities of daily living to remotely monitoring and notify health and care staff of abnormal events. 

In contexts (generally outside the UK) that allow the real-time transfer of physiological data from wearables to electronic patient records, there is evidence of benefit to elderly care in general, for example, as well as supporting the early diagnosis of deterioration in, for instance, cardiovascular, neurological and pulmonary diseases and the identification (for example through AI) of triggers for rapid intervention. Smart devices and environmental sensors can also facilitate the remote monitoring of the home environment as well as important physiological signs and activities of occupants, supporting functions from the simple (such as alarms for critical event alerts) to the more complex diagnosis of risk (for instance for falls or dementia). There are now plausible studies demonstrating the potential value of VR in supporting a range of physical, mental, or psychosocial health outcomes, including pain management, cognition and depression. Care robotics are also an emerging technology in the UK and can support independence in daily activities as well as compliance (such as in treatment regimes). There are also numerous applications of AI/ML. Voice assistants can be used to set simple reminders to do things like take medicines. As the uptake of wearables, personal devices and sensors increases, the potential of AI based technologies to monitor individual patient risk and design intelligent triggers will also escalate.

These are all very exciting developments – in the laboratory. What are citizens’ views on technologies, with respect to the impacts on their privacy, concerns about surveillance, requirements for safe and clinically validated care as well as confidence in the technology (and in connectivity)? Do people want increasing numbers of gadgets or integrated (and NHS validated) systems for remote monitoring, for example? 

These are questions that can only be worked out in partnership with end-users (citizens and health care staff), technology developers and health and care systems. What a digital living lab enables is stakeholder collaboration from the outset and citizen feedback throughout the process of co-design, prototyping, piloting and evaluation. Against this background the decision, by Plymouth Community Homes (PCH), to work together with CHT to become a digital living lab is a very exciting development. Catering to the housing needs of a very diverse population of over 35,000 individuals residing in Plymouth and its rural environs, the Plymouth Living Lab is poised to be the largest in the world. 

While we are at an early stage of this partnership, we have secured investment from Cisco to support a living lab user engagement researcher. This researcher will work with citizens, clinicians (primary, community and acute), local authority staff (such as those in social care), the VCSE sector and industry to support the co-design, piloting and evaluation of home-based technologies and to create an innovative environment in which stakeholders can experiment and test disruptive technologies in a safe environment. This is an amazing opportunity for the health and care sectors, academics and industry, insofar as it offers a space for the latter to demonstrate the value proposition of digital health technologies. We hope that CHT partners across all these sectors recognise the value of this and help us to build DHTs that work for both citizens and staff.