Scalable Technology to Support Sustainable Health Behavior Change. Department of Medical Informatics, OHSU

1. Consumer-Centric Health
Models for Change ‘11

2. Scalable Technology to Support
Sustainable Health Behavior Change
Holly Jimison, PhD
Department of Medical Informatics, OHSU

3. Scalable Approach to Delivering
Interventions to the Home
Chronic conditions require sustained and
dynamically tailored interventions
 Remote, just-in-time, continuous care
 Incorporate principles of health behavior change
 Optimal use of lower cost personnel
 Integrate family & informal caregivers into the
health care team (untapped resource)
 Platform for testing sustained interventions in the
home

4. Oregon Center for Aging & Technology
ORCATECH
• Oregon Health & Science Univ • Industry Partners
– Neurology Intel
– Biomedical Engineering Spry Learning Co.
– Medical Informatics • Service Partners
EliteCare, Inc
– Point of Care Laboratory
Pacific Retirement Services
– Aging & Alzheimer's Disease
Center
• Other Partners
• Academic Partners AARP
– Oregon State University Oregon State Government
– Portland State University CAST
– University of Oregon

6. Home Monitoring Data

7. Continuous Unobtrusive Monitoring
Fusion

8. Platform to Deliver a Scalable
Coaching Intervention to the Home
 System to facilitate a single coach in
managing a large number of clients
 Semi-automated tailored messaging based on
home monitoring and self-report data
 User assessment  user model  tailored
data sharing, action plan, coaching messages
 Multiple modules – not single condition or
approach

9. Modular Software for Multiple Protocols
 Cognitive Exercise (computer game format)
 Novelty exercise
 Physical Exercise
 Sleep Management
 Socialization
 Medication Management
 Mood Management

10. Health Coaching Platform Architecture

11. Participant Home Page
Participant home page
• Messages from coach
• Featured story
• Weekly goals
– Activities
– Surveys
• Access modules
– Physical Activity
– Sleep
– Socialization
– Novelty Mental Exercises
– Cognitive Games
• Coaching Process
• Participant Materials
11

12. Cognitive Computer Games
- embedded monitoring algorithms

13. Socialization Protocols for Cognitive Health
 Web cams and Skype software given to
participants and their remote family partner
 Frequent spontaneous use among participants

14. Physical Activity Module
14

15. Sleep Module
15

16. Coach Interface
• All participant tasks assigned through this interface.
16

17. Health Coaching Platform Architecture
Family Interface
• Safety monitoring
• Soft alerts
•Team-based care
• Socialization

18. In-Home Cognitive Health Coaching Studies
 Needs Assessment
 Foundational Studies
 Adaptive Cognitive Games – 30 subjects
 Activity Home Monitoring – 250 subjects
 Coach Messaging Study
 Ongoing Usability Testing
 Feedback on Cognitive Games and Novelty Exercise
 Current Coaching Study
 20 participants in the ORCATECH Living Lab
 20 additional participants from larger monitoring study
 Average age 78.3 7.8 years
 70% female
ORCATECH 18

19. Lessons Learned: Important Software Issues
 User centered design – ease of use
 Inference algorithms for assessing patient state and
context
 Sophisticated User Models
 Privacy / Security – tailored privacy models for
the sharing of home monitoring data
 User models for tailoring interventions and
coaching messages
• Intelligent Interoperability

20. Summary:
Benefits of Technology for Remote Coaching
 Scalable approach to delivering interventions to the
home
 Extends the reach of lower cost professionals
 Community-based culturally-specific coach
 Timely and continuous
 Aim to keep people independent ( QoL &  costs)
 Integrates untapped resource of family and informal
caregivers into the care team
 Tailors interventions to individuals
 Integrates health and wellness interventions

21. Thank You
Questions?
Suggestions?
Contact:
Holly Jimison
jimisonh@ohsu.edu
21