Technology-assisted healthcare: exploring the use of mobile 3D visualisation technology to augment home-based fall prevention assessments

Abstract

Falls often cause devastating injuries which precipitate hospital and long-term care admission and result in an increased burden on health care services. Fall prevention interventions are used to overcome fall risk factors in an ageing population. There is an increasing need for technology-assisted interventions to reduce health care costs, whilst also lessening the burden that an ageing population increasingly has on health care services. Research efforts have been spent on reducing intrinsic fall risk factors (i.e. functional ability deficits and balance impairments) in the older adult population through the use of technology-assisted interventions, but relatively little effort has been expended on extrinsic risk factors (i.e. unsuitable environmental conditions and lack of assistive equipment use), considering the drive for healthcare outside of the clinical setting into the patients’ home. In the field of occupational therapy, the extrinsic fall-risk assessment process (EFAP) is a prominent preventive intervention used to promote independent living and alleviate fall risk factors via the provision of assistive equipment prescribed for use by patients in their home environment. Currently, paper-based forms with measurement guidance presented in the form of 2D diagrams are used in the EFAP. These indicate the precise points and dimensions on a furniture item that must be measured as part of an assessment for equipment. However, this process involves challenges, such as inappropriate equipment prescribed due to inaccurate measurements being taken and recorded from the misinterpretation of the measurement guidance. This is largely due to the poor visual representation of guidance that is provided by existing paper-based forms, resulting in high levels of equipment abandonment by patients. Consequently, there is a need to overcome the challenges mentioned above by augmenting the limitations of the paper-based approach to visualise measurement guidance for equipment. To this end, this thesis proposes the use of 3D visualisation technology in the form of a novel mobile 3D application (Guidetomeasure) to visualise guidance in a well-perceived manner and support stakeholders with equipment prescriptions. To ensure that the artefact is a viable improvement over its 2D predecessor, it was designed, developed and empirically evaluated with patients and clinicians alike through conducting five user-centred design and experimental studies. A mixed-method analysis was undertaken to establish the design, effectiveness, efficiency and usability of the proposed artefact, compared with conventional approaches used for data collection and equipment prescription. The research findings show that both patients and clinicians suggest that 3D visualisation is a promising development of an alternative tool that contains functionality to overcome existing issues faced in the EFAP. Overall, this research makes a conceptual contribution (secondary) to the research domain and a software artefact (primary) that significantly improves practice, resulting in implications and recommendations for the wider healthcare provision (primary).