Warm Hands At Home

What is it?
Warm Hands At Home is a customised telemedicine service which allows COPD sufferers to monitor
themselves and keep a diary of their daily life. It allows them to share that information with doctors, caretakers, friends and family.

Warm Hands is a service built upon an existing telemedicine system. It introduces a new role between patient and health services, which provides care and support on a daily basis. Warm Hands also allows sufferers to build their own care network by sharing their information and helping each other.

Who is it for?
The service is for people diagnosed with COPD who have a telemedicine device. Other primary stakeholders involved are the health system, especially nurses and doctors, but also physiotherapists. Secondary stakeholders include other services such as grocery and laundry services.

Why is it valuable?

A safety net in the home: We found that the sufferers have a safety net outside the home, such as GPs, hospital, family members or friends. However, this implies the need to ask for help at the right time. We observed a tendency not to ask for help before it is too late – or only asking if it is in an emergency. We aimed to create a sense of safety. The Warm Hands service will always be watching and asking if help is needed.

Self learning: Our findings indicated that it can be difficult for COPD patients to accept the state they are diagnosed with. This lead to denial – which does not help to stabilise the condition. The diary, which links to the telemedicine device, helps the sufferer to be more aware of his/her daily activities
and therefore more conscious of his/her actions. Also, by observing others, the sufferer might feel inspired to change behavior or perhaps lend a helping hand or advice to others.

Prevention: A person suffering from COPD can catch another illness, like pneumonia, easily and if not treated rapidly the person can risk being admitted to the hospital.

Our findings indicated that sufferers tend to wait too long before receiving treatment, because they think it is just a cold which they, before they got COPD, would have left untreated.

How does it work?
We designed a 3D diary with blocks which indicates different activities. The diary is connected to the telemedicine device which makes it possible for a Warm Hands nurse to follow the person’s activities. It is also possible for a friend or family member to follow the sufferer to see if a helping hand is needed.

The Warm Hands system notes how long it has been since the sufferer had performed routine tasks, like shopping or doing their laundry, and will suggest services that will take care of this for them. The system will also suggest joining gym sessions, if they are not able to get there, perhaps because of bad weather conditions or because of recovering from an illness.

What were your key learnings?

We found that the best future scenario will focus on care and secondary prevention instead of today’s damage control. Our aim was to create a care system which could evolve and care for COPD sufferers by involving outside parties, such as grocery stores, and by including friends and family.

PROCESS

Week One – The Context
We attended lectures by COPD and telemedicine specialists as well as interviewed sufferers in their homes. We learned about the hospital system, the intent of the telemedicine device, everyday life of a COPD sufferer and the medical details of the disease. We focused on the following points:

1. People often get diagnosed with COPD after they have been suffering from it for a long time. They think that they are getting old or out-of-shape so they don’t tell their GP. We also learned that the time of diagnosis or quality of the given advice, depends on the GP which results in the disease not being handled the best possible way.

2. COPD often results in isolation. COPD patients are not able to use as much energy moving around as non-patients. Some sufferers use around 70% of their energy only on breathing. Since they use a lot of energy on breathing, they seemed to calculate if activities are worth ‘paying’ for – if not, they stay in their homes.

3. COPD patients are also venerable to weather conditions. If it is cold or windy it can be difficult to catch one’s breath.

These are some of the reasons that mobility is an issue for people with COPD. We also observed that prediction is an issue. A sufferer cannot tell if it is going to be a good or a bad day which leads to a feeling of uncertainty. This combined with the fact that many have trouble adopting the ‘COPD mental model.’ They tend to continue leading the same life as they did before being diagnosed – which makes it difficult to make changes to stabilise the disease.

The areas that absorbed our attention these weeks were: The daily life of the COPD sufferers; mobility; self-management/teaching; and empowerment.

Week Two – User Insight
I can never tell if it is going to be a good or a bad day.” – We found that the disease creates a feeling of uncertainty since the disease is so unpredictable.

“I have lots of energy in my mind but not in my body.” – This insight showed us that sufferers want to be active but needs to priorities how to spend the energy they have.

“It can take weeks to get over being sick. You need to use all your energy on getting better! You don’t think about getting food.” – This quote showed us that when COPD sufferers get sick – they get very sick. They do not have energy to do practical chores – even chores as crucial as getting food or even asking someone to do the shopping for them.

“I hate doing exercise but I want to have the best life possible. It helps when I am meeting people – that makes it easier to actually go to the gym! Exercise is one of the best ways of stabilising the illness – it is difficult getting to the location and doing the work – but meeting up with others is a crucial motivation factor. We keep an eye on each other – that feels nice – especially when being single.”

We found that family and friends are very involved in helping the sufferer. They get
more and more involved as the disease progresses. The sufferer does not ask for help unless it is absolutely necessary because they know that his/her need for help will increase. We also observed that it is very important to feel useful. Sufferers help each other out if they need assistance with a visit to the GP.

Week Three – First Concepts
The Map: This service concept built on the logistic network around the COPD sufferer. People share tips on routes to take and tips on places around their home – sharing logistic knowledge. The concept focused on included people helping people. We knew that family and friends helped the sufferer in their everyday life – therefore this concept aims to make it a system in which family members help two people at a time instead of one. The reason behind this was that helping the sufferer seemed to take up a lot of the family member’s time.

The Kitchen Service: This concept centered on making meals together. The social interaction aimed to make it possible for sufferers to make great meals without using all their energy on things not worth spending energy on, like shopping, doing the dishes and cleaning up afterwards.

The Diary: A physical diary which would make it possible for sufferers to be aware of their actions and more conscious of their behaviour.

The Hot-Line: A future scenario for using the telemedicine device as a part of everyday life instead of only having the device when recovering after being hospitalised. The service is centered on advice and coaching given by the nurse in order to achieve the best possible life quality. We also saw the service as the ‘extra layer’ between the sufferer and the hospital system. The nurse functions as a support person who knows the sufferer and also knows when it is time to get in touch with the GP instead of waiting too long.

Week Four – Experience Prototyping
We created an experience prototype, which included a COPD sufferer and a COPD nurse. We wanted to create a session that would feel as real as possible so we could achieve the most realistic feedback. Ruth was asked to show which activities she did the day before using a physical diary. The diary is a box with blocks that represent activities.

In our test, the information, the content of the diary, was sent to Steffen, a nurse. We wanted to know if this was of value for Ruth or for Steffen and if it provoked new insights. We learned that using the diary helped the nurse ask the right questions and that it made Ruth consider her daily activities. This experience as well as an in-depth interview – helped us adjust our service concept – getting closer to reality and specific needs.

Week Five – Solution/Concept
Warm Hands at home is a service that keeps an eye on you. We assume that in the future every COPD sufferer will have a telemedicine device in their home – Warm Hands is activated by using a physical diary which links to this device.

The content of the diary is sent to the Warm Hands nurse every day – and also to friends or family if preferred. The content of the diary helps the nurse or doctor save time. They can focus on actual health issues and offer more relevant advice.

The content of the diary is sent to the system which can suggest activities based on the diary. If a person has not been shopping or doing the laundry, the system will suggest a delivery service. If the person is not interacting with the diary, a nurse will call him or her to check if everything is okay. If the person has been sick or for another reason is not possible to attend their gym class – the system suggests a remote gym session, which makes it possible to have the social interaction at home instead.

The system can create a contact to a nurse, which creates an opportunity for care at the right time. The nurse will suggest a visit to the doctor if needed – which can lead to lowering the duration of illnesses by getting help on time, then avoiding a stay at the hospital. The sufferer can also keep track of their fellow sufferers, perhaps creating a sense of competition or lending a helping hand when needed.

The service aims to create a care system which makes it possible for COPD sufferers to get what he/she needs when they don’t have the energy to ask for it. The Warm Hands service also gives sufferers the peace of mind of knowing that someone is always looking after them.

STUDENTS