Presentation at the 2nd International Symposium: ICF Education. 30 June 2017 (Cape Town). http://www.icfeducation.org

1. @icfmobile
”I would use it, if it was
connected to many services”
Report in Finnish:
Anttila, H, Kokko K, Hiekkala S, Weckström P, Paltamaa
J. Asiakaslähtöinen Toimintakykyni-sovellus. Kehittäminen ja
käytettävyystutkimus. Helsinki: Kela, Työpapereita 119, 2017.
http://hdl.handle.net/10138/187061
Anttila et al. 201730.6.2017

2. @icfmobile
ICanFunction prototype -
users' experiences from a
feasibility study
yypistä
Heidi ANTTILA, Kaisa KOKKO, Jaana PALTAMAA, Petteri
WECKSTRÖM, Sinikka HIEKKALA
with
The International mICF Partnership
Social Insurance Institution (Kela), Finland
KKRL 12 § funded project DNRO 147/331/2015
30.6.2017 Anttila et al. 2017

3. Why to develop mICF?
• Many people experience
frustrations in getting
their voice and needs
heard in social and
health systems
• These steps are time
consuming and
repeated in every health
visit
• Recent developments in
digitalisation could enable
mobile collection of
data directly from user
for utilization in health
information systems.
30.6.2017 Anttila et al. 2017
Photo:FinnishAssociationforPeoplewithPhysicalDisabilities

4. @icfmobile
Aim
1. To develop a person-centered mobile
prototype to assess functioning
(ICanFunction, mICF)
 Based on descriptive and structured data (ICF)
 Reliable and valid patient reported outcomes
measures: PROMIS with population references
2. To evaluate the user experience of the
prototype
Anttila et al. 201730.6.2017

5. @icfmobile
Methods
1. Agile
• The user interface was designed with adults (n=47) and
children (n=11) in several iterative service design workshops
• The ’lay language’ content was gathered from several
sources
• The PROMIS Adult Physical Function 8-item short form was
chosen (translated into Finnish)
• A content metadatabase ’FunctionMapper’ was taken into
use: it mappes the lay content and measures into ICF
2. UX testing and feasibility evaluation
• Children (n=11), youth and adults (n=19) downloaded the
prototype app into their phones and tables and tested it for a
week. Then they were interviewed.
30.6.2017 Anttila et al. 2017

6. Need for social
and health
services
Knowledge
about the app
Installing
the app
Starting
the self-
report
Customizing
settings
Continuing
self-report
Sending a
summary
Connection to
PHR
Using the data in
services
Continuing to do
self-report
App
registration
See the whole mICF Adult User’s Path in Slideshare
The mICF user path for adult
users
@ICFmobile 6

7. SCREENSHOTS FROM THE
PROTOTYPE
Kuva: Invalidiliitto
30.6.2017 Anttila et al. 2017

8. Scroll to choose topics
The adult’s
version included
19 topics.
The children’s
version had 11
topics.
30.6.2017 Anttila et al. 2017

9. Describe issues, that
are important to you
The issues (ICF
categories in lay
language) were
organised by ICF
chapters.
• The adult’s
version had
170 different
issues on
functioning and
environmental
factors
• 39 issues in the
children’s
version.
30.6.2017 Anttila et al. 2017

10. Three ways to answer
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11. Example: PROMIS measure
The PROMIS short forms
are based on a calibrated
and standardised item
banks.
The prototype included
Adult Physical Function
8-item short form.
30.6.2017 Anttila et al. 2017

12. My data summary
Descriptive data
For each topic & issue
(if populated):
• date
• answer
• written/spoken text
• photo
Measured data
The PROMIS
• total score,
• interpretation
regarding to the
population
reference,
• list of items and
reponses
30.6.2017 Anttila et al. 2017
PROMIS Physical
function
Your score: 33
Moderate impairment.
20 % of the population
receive scores under 40.
Answered items:
Household schores much
difficulty
Run errands and shop
little difficulty
Walk for 15 minutes
Some difficulty

13. The content is brought from
the FunctionMapper
• TheTerm Editor is software tool, developed in THL for
editing and publishing information structures, ontologies
and terminologies.
• FunctionMapper is the tool for mICF content editor. It is
built in Term editor. It’s relation model links user needs,
natural language and instruments to the ICF.
@ICFmobile 13

14. How I could describe
”my life situation”- user experience
• The user could well describe their current
situation
• The app was very concrete
• The user found relevant issues
Anttila et al. 2017
I felt that - to illustrate the whole picture -
it is important to get data on all issues not
just on those which are difficult.
I selected issues that
are meaningful for
me rigth now.
I filled in all
my issues at
once.
I evaluated my situation
slowly during a week.
15 min - 6 h
30.6.2017

15. Usefulness – user experience
• I would use it if it were connected to many
services!
The patient history for health
checks would be easy to do
this way, no need to write.
I could use it for long term
monitoring! During a year or longer I
could just click those issues to see
how my situation is changing in time.
Hey, these are the very
questions that are posed to me
in every single health care visit.
It would be good if the answers
were readily available for the
physician. In the PHR or
something.
30.6.2017 Anttila et al. 2017

16. @icfmobile
• The children were exited! More colors and pictures!
Children’s experiences
Just
nice!
Nice!
It was easy!
Not difficult.
I did not
understand
some words.
I understood
everything.
I did not
need
help.
30.6.2017 Anttila et al. 2017

17. Ease of use – user experience
• All users said it was easy to use, nobody needed
any help!
• I would use, but it need to be developed more!
Anttila et al. 2017
A preselection of issues
would be nice, so that I
could find all relevant
questions to myself.
There should
have been a
possibility to
compare days
I wish more
functionalities to
the summary, e.g.
visual traking on
how many items
one has answered.
But, days can be different: in
one day some questions are
relevant, but next day other
questions.
Or to be able to report the
same issue in several days
e.g. pain may fluctuate daily.
30.6.2017

18. Acceptability
• They would use it if…
• there was a short introduction or tutorial
• the social and health workers would ask to use it
• it was utilized in many different places
7,6 8
Would you recommend to your friend?
0=no, I don’t recomment to anybody, 10=I would definitively recommend
Yes!
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19. Described issues by
ICF domains
• The adults chose and used 124 different
issues.
Body functions (50%) Activities and participation (43%)
Environmental factors (7%)
30.6.2017 Anttila et al. 2017

20. What did the adults
describe?
• The adults described 4-37 issues (mean 22,8)
• 29% no difficulty; 20% great difficulty/cannot do.
Described issues
by ICF categories
Mental functions Moving Pain, senses Musculoskeletal
Interaction and relationships Self care
Cardiovascular, respiratory
30.6.2017 Anttila et al. 2017

21. What did the children
describe?
• Children described
6-25 issues
(mean 17/child)
– Only one issue was not
used at all: medication
• 83% goes well or
very well
Goes well (83%) I need help (17%)
30.6.2017 Anttila et al. 2017

22. @icfmobile
Conclusions
• The users accepted the mICF idea - it is
worth to develop further
• Need to be connected to services so that…
• Patients can easily and clearly describe their
own individual life situation.
• Professionals get a structured summary for
shared desicion making, goal setting and
service planning
30.6.2017

23. @icfmobile
Next steps
• The prototype need to be developed to fully
functional and audited application for users and
professionals.
– Development needs identified by the users
– Content understandability
– More languages and PROMs
– Connections to PHR and health information
systems
• Sustainable business case development to utilize
open source code
– Availability for users (Appstore, Playshop)
– Maintenance & continuous development
30.6.2017 Anttila et al. 2017

24. @icfmobile
Thank you!
More information: www.ICFmobile.org
Partners
Collaborators
Funding
International mICF
partnership
www.ICFmobile.org
30.6.2017 Anttila et al. 2017