A Digital Health Service for Elderly People with Balance Disorders and Risk of Falling: A Design Science Approach.

Luís Velez Lapão,Andréa Gomes Martins Gaspar

doi:10.3390/ijerph19031855

Luís Velez Lapão, Andréa Gomes Martins Gaspar

Open Access

https://doi.org/10.3390/ijerph19031855

Copy DOI

Abstract

In this study, a design science research methodology was used aiming at designing, implementing and evaluating a digital health service to complement the provision of healthcare for elderly people with balance disorders and risk of falling. An explanatory sequential mixed methods study allowed to identify and explore the dissatisfaction with electronic medical records and the opportunity for using digital health solutions. The suggested recommendations helped to elaborate and develop “BALANCE”, a digital service implemented on the METHIS platform, which was recently validated for remote monitoring of chronic patients in primary healthcare. “BALANCE” provides clinical and interactive data, questionnaire pre and post-balance rehabilitation, tutorial videos with balance exercises and patient-recorded videos of the exercises. This digital service was demonstrated, including five elderly patients with clinical recommendations for balance rehabilitation at home. Finally, the authors conducted two focus groups with the participants and their caregivers as well as with physicians. The focus groups aimed at exploring their satisfaction level, needs of adjustment in the “BALANCE” service and strategies for applicability. The digital healthcare service evaluation revealed a significant potential for clinical applicability of this digital solution for elderly people with balance disorders and risk of falling.

Highlights

In most countries, the life expectancy growth rate has not been met by an increase in healthy life years [1,2,3,4,5]
This study identified the clinical practice difficulties, the relevance of using digital solutions and the strategic options to develop a digital service targeting this profile of patients (Activities 1 and 2 of the Design Science Research Methodology (DSRM))
The previous mixed methods study confirmed a dissatisfaction with the current medical data relative to the elderly with balance disorders and risk of falling as well as the dissatisfaction with lack of system interoperability, which led to multiple emergency visits and uncoordinated diagnostics and treatments

Summary

Introduction

The life expectancy growth rate has not been met by an increase in healthy life years [1,2,3,4,5]. A growing prevalence of multiple comorbidities, chronic diseases, balance disorders and falls affecting the independence of the elderly has been observed [6,7,8,9,10,11]. Even in the presence of disease, healthy ageing means living well with the disease under control and with functional ability, which is seldom observed [3]. The dearth of healthy ageing among the elderly has led to inappropriate use of physical and human resources, to multiple medical visits, diagnosis tests and treatments [11,12,13]. The ageing process has challenged the sustainability of the healthcare systems, including the Portuguese health system [1,5]

Objectives

Methods

Results

Discussion

Conclusion