ProACT: Person-centred digital integrated care for adults aged 65 years and over, living with multimorbidity

Abstract

Background: At present in Europe there are 50 million people living at any one time with multimorbidity. However, our healthcare systems have not been designed to effectively support these people in their daily care needs. ProACT (Integrated Technology Systems for ProACTive Patient Centred Care) is a digital health research programme funded under the European Union Horizon 2020 framework that seeks to address this problem by developing and evaluating a digital integrated care system to support older adults (65 years and over) living with multimorbidity. This presentation will outline the main findings of the ProACT project where the daily experiences of participants living with multimorbidity were captured and responded to through the design of digital health solutions. Method: Vital to ProACT, was eliciting the voices of people living with multimorbidity as well as the various people caring for them (formal/informal caregivers, health care practitioners). A co-design methodology was adopted, making these stakeholders active participants in the design of ProACT. Across Ireland and Belgium the following was conducted over a 42 month project period; a qualitative user requirements study (n=124 stakeholders); co-design workshops and usability testing (n=60 stakeholders); a 12 month longitudinal, action research proof of concept trials (involving n=120 patients and their care networks). The primary trial sites were also supported by a transfer site in Italy consisting of 15 people with multimorbidity (PwM) and their care network, and a European transferability study was conducted to assess cultural, social, infrastructural, and political determinants for adoption and scalability of the system Traditional qualitative research techniques were combined with user-centred design methodologies to support the design, development and implementation of the ProACT digital system. Key results: The main findings from the project will be presented, including the main themes that emerged from: the initial user requirements gathering (impact of multimorbidity; self-management; medication; knowledge, information and education; sources of support; communication; training; and technology); the co-design workshops and usability testing, which ensured that the ProACT technologies were designed to respond to previous themes; and finally results of the PoC trials, including themes pertaining to self-management, the ProACT ecosystem, integrated care, and empowerment Conclusion: Conclusions will demonstrate how digital health solutions can improve home-based integrated care, supporting older people with multimorbidity to live independently in their community. Furthermore, this project illustrates how using existing Human Computer Interaction (HCI) and behavioural science methodologies can improve the design, development and implementation of digital assistive technologies focused on older adult self-management of health and well-being within multi-stakeholder and diverse ecosystems of care and support.