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Background
The Danish Health Authority (Sundhedsstyrelsen) assesses that up to 80% of total Danish healthcare costs connect to patients with chronic diseases and forecasts an increase in population ageing. Chronic diseases are not only a mounting challenge for the Danish health service, a third of the Danish population also lives with one or more chronic diseases, which significantly impair their quality of life. The potential for developing sustainable solutions that elevate the long-term quality of life of the target group as well as lower demand for scarce health resources will have a significant societal value.
In Denmark, about 1 million inhabitants are living with hypertension (high blood pressure), which is the leading cause of blood clots and bleeding in the brain, and may lead to heart failure and kidney problems if no precautions are taken. Despite understanding the implications, inability, willingness, and motivation to follow life-enhancing guidance is experienced among chronic patients, i.a. due to side effects of medicine and unstructured cross-sectoral treatment. However, this is particularly distinctive with hypertensive patients, as the disease is usually symptom-free and the motivation to commit profound lifestyle changes may be lacking.
In order to drive the necessary patient responsibility for ensuring optimal treatment results, support for permanent behavioural change requires more than just the conception of a better life. Active participation in self-treatment necessitates continuous motivation and strengthening of the relationship between patient and health care professionals. This is exactly where this project strives to make an impact. Our claim is that increased patient participation and collaboration not only strengthens patient-provider relationships with shared decision-making and ownership of treatment, but also strengthens self-help skills and willingness, while increasing the patient’s understanding of their influence on their own state of health, and thus self-efficacy. From this, patient compliance increases and can drive patient responsibility for making daily efforts in improving their health, which in the end is envisaged to minimise the risk of diseases.
To support involvement and cooperation, it is necessary to balance the relationship between patients and healthcare professionals, as well as continuous motivation needs to be supported to maintain patients’ healthier lifestyle. In present times, an increased use of digital technology as a tool to facilitate communication, to visualise data, and to increase patients’ knowledge, impact, motivation, and understanding of their own state of health has arisen. However, some studies indicate that digitalisation does not necessarily come with an intrinsic efficiency or support of continued motivation - human behaviour and system thinking are essential for implementation and impact. We incorporate knowledge from e.g. design for behavior change and psychology into the development of a solution that will serve as a communication tool between a number of stakeholders, including healthcare practitioners and hypertensive patients.
Project objectives
With a starting point in hypertension and in collaboration with ATAH (Application for the Treatment of Arterial Hypertension), Trifork, Bispebjerg and Frederiksberg Hospitals, and Cachet, this PhD project entitled "Healthcare Design for Collaborative Care" aims to investigate how technology and services in collaborative healthcare can be designed in such a way that digital and human-centered treatment models can ensure better and more effective treatment of the chronic patient group. Principles such as personalisation and shared decision-making may promote behavioural changes that through increased patient collaboration and preventive treatment go beyond compliance, to responsibility, and to a higher level of life quality by self-help for self-care and thereby helps to ensure treatment that is more efficient, possibly fewer hospitalisations and thus better allocation of funds. Thus, a focus on hypertension should be looked upon in a whole, where a given solution should be able to be applied in a broad spectrum for treatment of patients with multiple and different chronic diseases, and as a positive overall effort in relation to increased quality of life and scarce health resources. In this way, the project can help improve
existing treatment models with the development of a knowledge base and tangible solutions, and thus has the potential to help a large number of people among chronic patients in Denmark.
Publication:
Valentin-Hjorth, J. F., Patou, F., Syhler, N., Vall-Lamora, M. H. D., & Maier, A. (2018). Design for Health: Towards Collaborative Care. In DS92: Proceedings of the DESIGN 2018 15th International Design Conference (pp. 2775-2786). Design Society.
https://doi.org/10.21278/idc.2018.0506