This document discusses a research program evaluating an interactive mobile reminder system called RemindMe. The program aims to build knowledge around ICT tools that support independent self-care for older adults with long-term conditions. An initial evaluation of RemindMe involved 22 older adults and found that while some struggled with technology, most were able to learn the system and found the active reminders beneficial. Health professionals also saw potential for RemindMe to streamline their work, but wanted flexibility to add reminders on smartphones. Further studies will test RemindMe's effects on independence and health economics in 100 clients with cognitive impairments.

1. ICT and self care - an
example of an interactive
mobile reminder support
Helena Hemmingsson, Professor, Linköping
University

2. Outline
• Research program
• Digital reminder support
• First evaluation with elderly people

3. Supporting self-care by
information and communication
technology for older people
with long-term condition
Program funded by FORTE/VR 2015-2018

4. Objectives
To build evidence-based knowledge and practice about
innovative person-centred ICT tools for support to older
people with long-term conditions and their family carers in
order to manage self-care independently and stay healthy,
independent and socially active for as long as possible,
delay/avoid institutionalisation and improve quality of life.

5. Partners
• Researchers at LiU, LU, JU
• International collaborators
• Patient organisations
• Office of Innovation at LiU
• SMEs
– 21st Century Mobile AB (http://www.cqmobil.se).
– Monkey Dancers http://monkeydancers.com.
– Linkovi AB https://www.linkura.se

6. Mobile phone symptom
monitoring system during
postoperative recovery
Reminder support for
self-care in people with
cognitive impairment
Exergaming to improve
physical activity
Interactive web-site
for family carers
Participatory framework involving co-design with patients, carers, organisations, health care professionals and SMEs
Transverse evaluations of social selectivity and cost-effectiveness

7. RemindMe –an interactive web-based
mobile reminder calender
Helena Hemmingsson, Professor Occupational Therapy, Linköping University, Sweden
Vedrana B. Baric, PhD student, Valérie Tegelström, research assistant and Erik Ekblad, Occupational Therapist

8. Memory limitations due to cognitive
impairments in diagnosis such as autism spectrum disorder,
ADHD, stroke, high age and stress-related disorders - may cause difficulties with
everyday activities
Examples:
-Forget appointments
-Fail to initiate planned activities
-Fail to carry out planned activities
-Fail to complete planned activities
2016-06-09 8

9. Assistive technology
To support performance of activities in everyday life
(compensate for difficulties with initiating, planning, structuring and executing
everyday activities)
-Low-tech assistive technology, passive reminders
-High-tech assistive technology, active reminders
2016-06-09 9

10. RemindMe - A new web-based mobile
reminder support
-Easy and interactive scheduling of
activities and reminders
- Active conformation of reminders
- Interactive self-monitoring
information
2016-06-09 10

11. 2016-06-09 11
Active conformation of reminders

12. The web-based calender 2016-06-09 12

13. Interactive self-monitoring information
2016-06-09 13

14. Initial evaluation of the usability of
RemindMe
- From the perspective of people over 65 years of age and
professionals in community services

15. • Usability – “extent to which a product can be used by
specified users to achieve specified goals with
effectiveness, efficiency and satisfaction in a specified
context of use” (ISO, 1998).
• Useworthiness - the user’s assessment of to what extent
the AT meets the user’s own high priority needs (Efring,
1989).
2016-06-09 15Title/Lecturer

16. ICT implementation - Challenges in health care
• Patient/Client
• Related persons
• Staff
COOPERATION

17. Use of ICT and people over 65
Young people - native language, have habits related to
technology
Older people - learn a second language – already have
habits how to handle tings thus have to develop new habits
when using technology
2016-06-09 17Title/Lecturer

18. Usability for people over 65 years?
• Included older people through retirement associations
• 22 persons between 65 -85 years of age (four groups)
• Some had experience of ICT other quit inexperienced of
using computers, mobile phones etc
• Course how to use the digital calendar (2 h) including
individual support how to assign activities with reminders
• Use for six weeks / telephone support 10 min /week
• Focus groups interviews

19. Results
• Curios on new technology – wanted to contribute to the
development
• All could learn and used the DRS during 6 weeks
• Example of activities with reminders: meetings, social
events, medicine, health visits, physical activities
2016-06-09 19Title/Lecturer

20. Difficulties
• Sight and hearing
• Seize
• Lack of mobile and computer habits
• Do not need a calendar
• Satisfied with earlier method (paper and pencil calendar)
2016-06-09 20Title/Lecturer

21. ”I think it is doubble work. First I am writing thing up in my calender (put
at the fridge) and I go there and look at it all the time and then I have to
write it up in the computer and then answer the SMS. For me, I think it is
more work than it is benefits.”
Woman 73
”I am often outside home and then I am used to have my phone in the
back pocket of my trousers and I had problems with hearing the signal.
So I think it should have a higher signal. If it is blowing it is impossble to
hear the signal. Well it became better when I put the phone in the jacket
pocket.”
Woman 72, Active retiree
2016-06-09 21Title/Lecturer

22. Benefits
• Easy to schedule activities by the computer
• Easy to monitoring activities on the computer
• Repeated activities
• Reminder signal alerted
• Mobility
• Feed-back loop - Safety
• Diary
2016-06-09 22Title/Lecturer

23. 2016-06-09Title/Lecturer 23
”I am tired as I have had a couple of minor strokes. It is because of that…
well this have been perfect to me. It has reminded me when I forget and
so. I think that its has been supreme.”
Woman 65, at home after a stroke.
”I like this calendar a lot and you could not compare it with an ordinary
calendar because it does not talk to you like this one do. You can write up
a lot of things in a calendar but if you do not look in it – it is useless. With
this calendar there is someone that talks to you and tells me when it is
time to do something.”
Man 66 years, active retiree .

24. Health professionals
 Actively responding to reminders through SMS was the most
beneficial feature of RemindMe.
 Potential to save time and streamline everyday work.
 RemindMe’s interactive feedback was considered as a novel tool for
professionals to provide feedback and keep track of clients using
automated information based on the user’s interaction with the
system.
 Limitation – did not have the flexibility to enter reminders through
the smartpones.


25. Implementation
• Patient/klient
• Anhörig
• Personal
To succed with a change
Patient/client
Attitude, motivation, computer
habits, abilities, life habits -
useworthiness
Staff
Relative
Useworthiness Increased independence, safety,
effectiveness, participation

26. Conclusion
DRS is potentially useful to professionals who provide support to individuals with
cognitive limitations.
Elderly people without cognitive impairments could learn to use the DRS with
limited amount of support
Those with memory difficulties considered the DRS as effective and appreciated the
easiness and safety
FUTURE PLANS
An RCT study involving 100 clients with cognitive impairment (stroke, MS) in
community based rehabilitation starts after summer. Social selectively and health
economics involved.
In addition - experience of using DRS from the perspective of elderly individuals
with cognitive impairments.

27. www.liu.se
Helena Hemmingsson
Professor in Occupational therapy
Department of Social and Welfare Studies
Linköpings University
helena.hemmingsson@liu.se