A controversial presentation on the application of person-Centred Design (PCD) and Universal Design in health and Technologies to support Health presented to ESRC Seminar Series: Inclusive environments: shaping transitions from theory to practice Seminar 3: Translational practices and the operationality of universal design, 21st February 2014

1. ESRC Seminar Series: Inclusive environments:
shaping transitions from theory to practice
Seminar 3: Translational practices and the
operationality of universal design, 21st February
2014
Guy Dewsbury PhD
www.gdewsbury.com

2. Introduction
Who Am I?
www.gdewbury.com: Enabling independence for older and disabled people through personcentred design technologies

3. Contents
1.
Health and Technology: The
Rationale
2.
Health and Technology: the
Interconnection
3.
Supporting Personalisation?
4.
Personal Health
5.
Health at Home
6.
Person - Centred Design
7.
Technological Responses to
Health
8.
Future Trends and Possibilities
9.
Conclusion
www.gdewbury.com: Enabling independence for older and disabled people through personcentred design technologies

4. Health and Technology: The Rationale
•Ageing Population
•Increasing disabilities
•Living longer
•Greater recognition of illnesses
• Limited economic
resources
• How can an increasingly
older/disabled
population be
supported?
www.gdewbury.com: Enabling independence for older and disabled people through personcentred design technologies

5. The UK Govt response...
Introducing telecare and
telehealth.
Technologies that can
enable people to maintain and
support personal health.
Technologies that support
people in their own home
environment.
www.gdewbury.com: Enabling independence for older and disabled people through personcentred design technologies

6. Health and Technology: the
Interconnection
Maintaining health in the
general population should increase
the ‘older well’.
Ideally, people should only
become very ill before they die if
their health is supported.
 Health promotion
 Nudging health
technologies (e.g.apps)
 Social media
 Greater access to
preventative care (e.g.
screening)
www.gdewbury.com: Enabling independence for older and disabled people through personcentred design technologies

7. Health and Technology: the
Interconnection
An implicit assumption is
that the population will embrace
these nudges and become fitter.
Technologies are designed
to support getting fit and take
exercise e.g. the “fitbit” “The Fitbit
family motivates you to stay active,
live better, and reach your goals...
We'll help you achieve what you set
out to do, by sharing a full picture of
your progress over time.”
(fitbit.com)
Also see http://www.quanttus.com/
The Fitbit Flex mobile tracker
www.gdewbury.com: Enabling independence for older and disabled people through personcentred design technologies

8. Supporting Personalisation?
The idea of personalisation
is central to the UK’s response to the
ageing society.
People should have control
over their own health (Maintenance
and Choice).
Technologies have been
developed to support health
promotion... For the able fit.
www.gdewbury.com: Enabling independence for older and disabled people through personcentred design technologies

9. Personal Health
Your health is ...Your
responsibility.
Your illness is... Your
responsibility.
Your Health condition
is... Your responsibility.
It is Your responsibility
to obtain/purchase what ever
technology would be beneficial
to maintaining Your health.
www.gdewbury.com: Enabling independence for older and disabled people through personcentred design technologies

10. Health at Home
Telecare and telehealth
enable a person to manage their
health remotely from their home.
Telecare alerts others when
something happens.
Telehealth alerts health
professional and the person when
their health condition changes.
These technologies enable
people to remain at home rather
than go to hospital.
Telehealth allows for
remote health management.
www.gdewbury.com: Enabling independence for older and disabled people through personcentred design technologies

11. Health at Home
The rise of the virtual nurse
and virtual ward are implicit in the
rise of these technologies’ use.
Currently their are no
criteria for the use or uptake of these
technologies.
This means anyone can
obtain them and this is where the
issues start...
www.gdewbury.com: Enabling independence for older and disabled people through personcentred design technologies

12. Health at Home
In precious research (e.g.
Sommerville I & Dewsbury G (2007)
‘Dependable Domestic Systems Design: A
Socio- Technical Approach’. Interacting with
Computers. 19 (4): 438-456) many of the
issues with using technology to
support vulnerable people were
outlined.
These include the poor
design of homes specifically
designed to support disabled people
in the community.
www.gdewbury.com: Enabling independence for older and disabled people through personcentred design technologies

13. Health at Home
Technologies to support
health tend to not consider the nonstandard user.
Assumptions such as having
access to a computer; Being able to
open and modify documents; have
access to a range of movements; be
sighted and fully hearing are all
implicit in many of the current
designs.
Take one example: the Alert
Call button in telecare assumes the
person can press at a certain
pressure.
www.gdewbury.com: Enabling independence for older and disabled people through personcentred design technologies

14. Health at Home
Telehealth monitors
assume the person speaks and reads
English.
They also assume the
person will read the instructions and
act on them.
They also assume the
person knows how to correctly
attach medical devices and to
accurately take a reading for upload
to the remote computers.
www.gdewbury.com: Enabling independence for older and disabled people through personcentred design technologies

15. Health at Home
Just as the Fitbit assumes a
certain level of ability to move,
many current technologies being
used in health and social care .
Smart homes, smart
devices, smart technology, pervasive
systems, ubiquitous systems,
ambient systems are often
developed without the user in mind.
www.gdewbury.com: Enabling independence for older and disabled people through personcentred design technologies

16. Health at Home
As a result I co-developed:
MDDS: The Method for Dependable
Domestic Systems
and
DTA: The Dependability Telecare
Assessment tool.
Both were developed as a
result of ethnography, using cultural
probes with older and disabled
people. MDDS was developed at
Lancaster University as part of my
PhD and DTA was piloted whilst I
was at Barnet Council .
www.gdewbury.com: Enabling independence for older and disabled people through personcentred design technologies

17. Person - Centred Design
Person - Centred Design
(PCD) is a methodology I developed
in designing systems for older and
disabled people.
PCD embodies and
incorporates the person in the
design.
What it tries to avoid is over
simplification of data and responses.
PCD deals with ‘People’,
Not ‘Humans’ or ‘Users’.
People have emotions and
do not think in linear lines.
www.gdewbury.com: Enabling independence for older and disabled people through personcentred design technologies

18. DTA
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19. Person - Centred Design
People are obtuse and
every person has different needs.
People are not things
Take two people with
dementia, they might share the
same medical condition but their
lived experience of the condition is
different and their needs are
different.
This difference in need is
attempted to be captured in DTA
and MDDS.
www.gdewbury.com: Enabling independence for older and disabled people through personcentred design technologies

20. Person - Centred Design
When we design for people
we design for the whole of them,
including their activity patterns, and
the technology should fit into their
lives not them fit to the technology.
This means we have to take
into account the variety of
stakeholders (such as friends, family,
relatives, support groups) into the
design.
Similarly, we should take
their activities and levels of isolation
into account.
www.gdewbury.com: Enabling independence for older and disabled people through personcentred design technologies

21. Person - Centred Design
Most importantly although
we can develop a generic design, we
have a design that is fluid enough to
incorporate the needs and wishes of
people and their future needs and
wishes.
Through a deep
understanding of a person’s needs
and their stakeholder needs any
design should have better stickvalue, and be less likely to eb
rejected.
Most importantly it is
something that will be used.
www.gdewbury.com: Enabling independence for older and disabled people through personcentred design technologies

22. Technological Responses to Health
Although technology is
possibly the best response to the
health crisis, poorly designed
technology will only exacerbate
conditions and could actually prove
lethal, if not used appropriately.
Technologies designed for
people, whether they live at home or
are more mobile must reflect the
divergence of the individuals who
will use them.
Standardisation is fine if
there is also customisation possible.
www.gdewbury.com: Enabling independence for older and disabled people through personcentred design technologies

23. Future Trends and Possibilities
The future is now, as
technology develops so fast.
We see apps appear that
encourage healthy lifestyles but rely
on able bodied people to use them.
We have fitness devices
that rely on a number of
presuppositions in their use.
We have robots entering
hospitals and homes but their are
designed for the able bodied.
We have a world that omits
people who are not standard.
www.gdewbury.com: Enabling independence for older and disabled people through personcentred design technologies

24. Conclusion
Design needs to lose the
age/ability bias and UD has taken
steps to achieve this.
Technologies should be a
part of a person’s life and
complement their lifestyle rather
than be an adjunct.
Technologies that support
people should be person-centred
and responsive to the changes in
people as their abilities change.
Let us design for real
people with real people.
www.gdewbury.com: Enabling independence for older and disabled people through personcentred design technologies

25. Questions?
Contact Guy
Thanks for listening
guy.dewsbury@gmail.com
or go to
www.gdewsbury.com
www.gdewbury.com: Enabling independence for older and disabled people through personcentred design technologies