27 September 2018 • Gideon Wille
FAST@HOME: rehabilitation at home with the e-health project
In an increasingly digitising society, where the population is greying and rising health care costs hang like the sword of Damocles above every state budget, e-health is a very appealing concept. But there are also very many pitfalls. FAST@HOME, a four year e-health Rehabilitation research group project, researches how e-health can best be used. It is a blueprint in the making.
E-health is already being used in all sorts of ways in our society – just think of the step counter on your smartphone. Technology has so much potential: for example, sensors that measure movement and the body’s temperature are becoming cheaper and more accurate, and the excellent internet coverage in the Netherlands makes it possible to deliver good care from a distance.
E-health is very promising. More efficient care – if only because there is no more travel time between the patient and the carer. More effective care because patients can follow customised programmes at home while health care professionals monitor progress at a distance. And people have more control over their healing process and this, coupled with attractively designed apps, is motivating.
At the same time, there is a plethora of health apps. The problem is which one to choose? And there are hurdles in terms of internet use. The computer skills of potential e-health users such as senior citizens and recovering patients can be below par because of physical limitations or limited knowledge of computers. And then there are the security and privacy aspects.
FAST@HOME is a project in which the Rehabilitation Research Group and its partners such as Sophia Revalidatie are researching how the potential of e-health can best be used. As part of its work, the project partners have built an internet platform of health apps. The platform is intended for rehabilitating stroke (CVA) patients.
The research project started in October 2015. The first year was spent researching the wishes of rehabilitating patients, family carers and health care professionals. You may make it technically fabulous, but if the apps are not aligned with treatments, are not in tune with each other or are not user-friendly, you may as well just stop.
After a period of building and testing, the platform was used by 150 rehabilitating patients. The process of collecting data started and the data is now being processed. The researchers are further developing the platform on the basis of the data collected. The new features include the addition of video calls and improved movement monitoring.
Delivering a blueprint
FAST@HOME plans to deliver a blueprint for other health care institutions in the Netherlands. IT developments are moving fast, the potential is huge, organisations are enthusiastically jumping onto a fast moving train. The result in many specialisations is that there are no standards, which undermines the efficiency advantages of IT, and that the wheel is constantly being reinvented.
One success factor for the blueprint is a flexible IT platform whose architecture must allow for future developments and which can be used by other branches than just rehabilitation care. The Rehabilitation Research Group is therefore working with former professor, Bert Mulder, who is developing a type of Lego base where new blocks can be added at any time.
With the rise of the participation society, health care institutions have to start working differently. A research project like FAST@HOME enables health care institutions to make the change from a health care institution in a building to a virtual digital network health care institution.
Leo de Kok has had a brain haemorrhage. In the film below, he talks about what FAST@HOME has meant to him.
Research and education
What does a research project like FAST@HOME mean for education? Monique Berger, researcher at FAST@HOME and head lecturer, had first year students of Human Kinetic Technology carry out a research project connected to FAST@HOME. For various reasons, including privacy considerations, Berger was not able to do the research with FAST@HOME participants (from Sophia Revalidatie). The students were thus the answer. Equipped with step counters they tested whether the differences between day and evening, weekdays and weekends were measurable and whether a step counter or an app on a smartphone was more accurate. The students learned to write a research plan, carry out the research, write an article and present the results (to the health care professionals of Sophia Revalidatie).
Arend de Kloet, professor of Rehabilitation “This is a good example of how to set up e-health, starting with the end-user in mind.”