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Economic sustainability of person- centred technology; why is it so difficult?

Explore the difficulties faced in implementing person-centred technology despite its effectiveness and added value. Understand stakeholder perspectives and align interests for successful innovation.

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Economic sustainability of person- centred technology; why is it so difficult?

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  1. Economic sustainability of person-centred technology; why is it so difficult? Luc de Witte University of Sheffield President of AAATE

  2. The problem • Many of the companies I have worked with don’t survive • Most of the projects I worked on do not lead to implementation of the product/service studied, despite evidence of their effectiveness and added value • What is going wrong?

  3. An example: It’s Life! • A smartphone app to support people with a chronic disease to develop and maintain an active lifestyle • Designed together with patients and healthcare professionals • Extensive evaluation of usability with very positive results • Extensive evaluation of effectiveness in a large RCT with positive effects, published in top journals • GPs were very positive and wanted to implement it, but nothing happened: health insurance companies did not want to finance it, business stopped….

  4. Another example: e-health in primary care • A large study in 7 GP practices, trying to implement 10 proven effective e-Health solutions • Long meetings with all GPs, the companies behind the solutions, patient representatives: much enthusiasm • We developed a IT-platform that combined all the solutions behind one password, integrated in the work system of the GP practice • After 3 years we had to stop: we were not able to implement anything at any relevant scale

  5. My analysis: what is the problem? • Stakeholders all have their own perspective and interest: these do not easily align! • There are at least 4 key parties: • Patients (and people around them) • Healthcare professionals (with many individual opinions) • Enterprises (with all their own business models, governance and investors) • Those responsible for policy (insurers, funders, policy makers) • All stakeholders need to ‘want’ the innovation and it must align with their interests. If not, it will fail.

  6. Recommendations • Analyse very carefully what is already available: why 175 apps for hypertension management? • When you want to develop a new product of service, do it TOGETHER with ALL RELEVANT STAKEHOLDERS • Not just in an advisory board but as part of the team • Make sure that your product/service ‘ticks all the boxes’ and analyse this upfront • Only start when you have a ‘long breath’ • Involve independent evaluators (usability, effectiveness, added value)

  7. Contact details and references l.p.dewitte@sheffield.ac.uk • SwinkelsICS, Huygens MWJ, Schoenmakers TM, Oude Nijewene-d’Hollosy W, van Velsen L, Vermeulen J, Schoone-Harmsen M, Jansen YJFM, van Schayck OCP, Friele RD, de Witte LP. Lessons learned from a living lab on broad adoption of eHealth in primary health care. JMIR, 2018, 20(3), e83. • Weegen, S. van der, Verwey, R., Spreeuwenberg, M., Tange, H., Weijden, T. van der, & Witte, L. de. It's LiFe! Mobile and Web-Based Monitoring and Feedback Tool Embedded in Primary Care Increases Physical Activity: A Cluster Randomized Controlled Trial. JMIR, 2015, 17(7), e184.

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