WARM HANDS NETWORK

What is it?
The Warm Hands Network (WHN) is a service that provides discreet support to COPD patients in order to improve their mobility and therefore their life quality. The service works as a safety net that can help the patient both on an everyday basis and in an emergency situation.

The service consists of 3 levels:

Online: A website that contains shared knowledge on accessibility to different venues, a ‘heat’ map that visualises the level of safety (health care facilities) in a certain area and a travel planner that provides public transport information that considers a COPD patient’s needs.

Moblile: A direct contact to the healthcare system in the form of a contact nurse that can be reached
anytime through a Telemedicine mobile phone device.

Local: A customised offer in all the venues that are part of the Warm Hands Network.

Who is it for?

The user group is COPD patients in general. The website can give advice on anything from where to rest when you shop for groceries to which hotels in Århus has no elevators. It is therefore useful to patients in both mild and more severe stages of the disease. In more severe cases, COPD
patients need a higher level of healthcare and the Warm Hands telemedicine application on the
mobile phone will enable them to get in touch with a contact nurse whenever needed.

Why is it valuable?
The service will improve the users’ life quality by enhancing their mobility and freedom. The value lies in the autonomy and the mobility that the user derives from using the whole service system (online, mobile and local). The service works on both the micro and macro scales giving advice on local and global issues.

Offering an overview and testimonial about destinations helps the user assess the energy needed to participate and thus reduces anxiety. The value is created by the users who share knowledge through the website and by the healthcare system that provides the ‘hard side’ of the service in the form of medical backup in case of emergency.

How does it work?
WHN creates a network of ‘ friendly places’ certifying their accessibility for COPD patients with a report. In the invitation letter, a patient receives a physical PIN that will enable her/him to get support and information within the Warm Hand Network of ‘friendly places’. WHN also includes an online service to which the patient receives a username and password, granting access to both view and add data to the website.

to protect their privacy, the level of anonymity is left up to the users. The online service enables the sharing of knowledge and tips with other COPD patients and with the Health Care System. WHN also offers video cell phone counseling and monitoring of critical health values in case of anxiety and/or emergency. The service provides the user with the software and tools needed to receive this level of care.

What were your key learnings?
Our main insight is that COPD is a ‘hidden’ disease both in the medical and social context. How might we as designers create a discreet and gentle design solution to enhance a patients comfort zone?

PROCESS

Week One – The Context

We were very inspired by the visits we made to the homes of Vibeke, Birgitte and Birgit. They are all 60+ years and have lived for more then a decade with their disease. They gave us a clear idea of a disease that limits them physically and mentally, one that you do not care to show or to speak of in public. These meetings also gave us the opportunity to explore the possibilities in connection to telemedicine and to see the home environment that these solutions might be implemented.

Observing the interviewees underlined that no two patients are alike and that no two days are alike. We also learned that COPD is a chronic disease that is continuously debilitating but that it can be put off with smoking secession, regular exercise and a healthy diet.

When diagnosed with COPD it is possible to be enrolled in a program at Hvidovre Hospital offering exercise, and a dietician, along with knowledge sharing and networking with other COPD patients.

The week also offered a lecture on labour saving technologies explaining the systemic background for the creation of telemedicine and showed valuable perspectives on the COPD treatment of the future.

A key insight of the week was also that the GP plays a major part in the treatment of the disease and not always in a positive sense. We also noted that different municipalities have different ways of
supporting the patient. Changing GP seemed to be a huge challenge to our interviewees as they did not have the energy to tell their story all over again.

Week Two – User Insight

Throughout the second week we continued visiting patients and also managed to visit at the rehab clinic in Hvidovre. The insights were that people feel relieved meeting other patients who are at the same stage of the disease as them.

Observing them while doing exercises made the physical reality of the disease very clear to us. Since this was the last round of therapy a network was being established and some of the patients seemed quite keen to keep the connection to their peers. The nurse afterwards emphasised that life quality is enhanced when they exercise and their feeling of autonomy increases. According to her the biggest factor of motivation they can have is when they feel the effect of their training enhancing their mobility and thus their level of freedom.

We also went to visit a nurse at Frederiksberg Hospital, Steffen, with whom we went through the telemedicine equipment and the procedure that newly diagnosed COPD patients are offered. What made the biggest personal impact for us was meeting a patient with severe COPD in Frederiksberg Hospital. She was receiving oxygen and her daughter was sitting by the foot of the bed. Despite the mother’s illness and clearly deteriorating state, the daughter insisted on continuing to smoke and her daughter was a heavy smoker as well.

We discussed several topics including assisted suicide. On a more operational level we learned that
mornings are the worst and that it can take hours to get out of bed every day. We also observed that being restricted to one’s bed diminishes a patient’s life spirit.

Week Three – First Concepts

The first three days of the brainstorming produced many inspiring questions. We sorted them in categories and voted for three domains: Motivation, Understanding and Medical Equipment.

The topics evolved around how we could make users become more autonomous and how they could overcome the challenges that limit their mobility. We carried these considerations with us
and created a rough storyboard around a service for users taking the trip to Århus
to visit Aros art museum. A front end experience took shape in the form of a web service that could be accessed in the home allowing the COPD patient to make contact with patient peers under the theme: “I am leaving my comfort zone – can I borrow yours?”

A major discussion was whether or not we should have the service connected to a known/respected organisation such as Red Cross or if it should be a stand alone relying on the assumption that COPD patients and next of kin know what is best for other COPD patients.

Our discussions culminated in another and bigger question: How might we facilitate an easier life for the COPD patient in the area of mobility and autonomy? What is our responsibility in designing for a group of people that has unmet needs but don’t wish to be public about these needs?

Week Four – Experience Prototyping

The week kicked off with a prototype test. We went to two of our respondents and did an interview showing them the video prototype. The interview revealed interest in the concept but the video
did not communicate our idea efficiently and our interviewees didn’t connect to parts of the concept. We therefore contacted another of our respondents who is less mobile and
conducted a 45 min phone interview.

The response was better and we set up a co-creation session where we evolved the concept together. An old insight came back, in that COPD is a ‘closet’ disease and some patients prefer to keep it from next of kin. At the same time a COPD patient has the need to keep people around in case of emergency. These people need to know about the disease and it’s consequences.

On the Sunday, we took Ruth out to try out our service in Roskilde Viking Ship Museum. The trip revealed two more possible pieces of feedback into the museums profile on the WHN website: The pavement outside is not very good for people using walkers; and the swivel door granting access to the museum is very heavy.

Week Five – Solution/Concept

At the beginning of week 5 we presented two movies; one showing our experience prototyping and one showing our service as Ruth experienced it. Following our review we split the recordings into two separate stories showing both an everyday scenario and a scenario where the telemedicine part of the service comes into play. Splitting the two allowed us to show the value for the user more clearly.

We created a service that allows the users to have the level of discretion that they demand while
enhancing their mobility. The service supports COPD patients in getting out of the home and still being able to receive the level of support that they would have staying indoors.

The system is designed to be discreet when it is able and explicit when required. The PIN is a subtle but necessary touch point that allows vendors to recognise a guest with special needs.