Fred Van Den Anker*, UAS Northwestern Switzerland, Olten, Switzerland Julia Klammer, UAS Northwestern Switzerland, Olten, Switzerland Track: Research Presentation Topic: co-Creation in health Presentation Type: Oral presentation Submission Type: Single Presentation Building: MECC Room: 0.8 Rome Date: 2010-11-30 01:00 PM – 02:30 PM Last modified: 2010-09-21

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Background and Objectives
In this contribution we report on a research and development project aiming at the identification and design of remote video consultation services for paraplegics. Through synchronous video communications paraplegics should be able to call in the help from a physician or nurse at a distance for remote diagnostics, consultancy and instruction. Ultimately the project aims at raising overall quality and efficiency of patient treatment and care and promoting a more independent way of living for the paraplegics. The project is carried out in close collaboration with the Swiss Paraplegic Centre, a rehabilitation clinic for paraplegics, and is based on a participatory design approach. The potential positive effects of participatory design on both the commitment of those involved and the quality of solutions are well-known. However, a disadvantage with traditional participatory design methods is that they often are singular, short-term events that require face-to-face interaction. It was our aim to create a participation process that is more continuous, enabling users to contribute to service design and innovation in an active and ongoing way. This also requires that distributed participatory design is supported enabling users to generate, discuss and work out design ideas for new health services at any place and at any time. In our project we provided our users with the means of observing and reflecting their daily practice as a basis for collaboratively developing service scenarios.

Methods and Results
In a first stage we identified potentially useful application areas and target users of video consultation services through interviews with nurses, therapists, physicians and patients and through field observations in all parts of the rehabilitation process. The resulting detailed model of the context of use and the treatment and care processes involved served as a basis for defining and discussing application areas for video consultation together with the potential users. Areas that were found to be useful were, for example, tele-diagnosis of skin lesions (decubitus ulcers) and remote wound management, remote support in respiratory care, e.g. remote instruction for handling technical failures in artificial respiration equipment, and remote assistance in "abilities of daily living" (ADL). To get a more detailed view on the potential contribution of video consultation in these areas, we let healthcare professionals and patients document situations from their daily practice they thought the application of video consultation would be useful for. For this purpose the participants received a flip video camera to make video recordings of concrete situations. Furthermore, they had access to a platform to share and discuss their recordings and their ideas with other community members.
In summary, this process allowed us to specify the concrete user needs and requirements that have to fulfilled by both the technology and the context of use to ensure a successful implementation.