In the Valencia pilot in Spain the aim is to improve the quality of life of both older people (over 65 years) with frailty, and that of their families. It also aims to improve staff satisfaction and greater efficiency in the use of resources and coordination of care.
METHODS From October 2020 to February 2021, the Valencia pilot researchers conducted a process of co-design to develop the integrated value-based concept and digital solution to support a personalised care pathway for frail older people. A total of 52 participants were engaged in 28 different co-design activities. All agents participating in the delivery of care were involved (older people, formal and informal caregivers, social and health care professionals, ICT experts, hospitals Managers, municipal social care services, among others). Co-design activities were adapted to the Covid-19 situation, combining in-person and virtual meetings with a reduced number of participants, as for example, online focus groups with professionals, mixed focus groups with older people and professionals, in-person interviews with older people, deep interviews with informal caregivers, just to mention a few. All activities were recorded.
RESULTS The results of the co-design activities were analysed to define the value-based integrated care concept and requirements for the ICT solution. Regarding the value-based concept, specific outcomes for frailty were discussed with professionals. Frailty is a syndrome of complex and multifactorial etiopathogenesis, so ValueCare aims to address its multidimensional nature by intervening in 4 areas: nutrition, physical exercise, adherence to pharmacological treatment and psychosocial aspects. Older people’s psychosocial needs are not being met under the current siloed health and social care systems, due to lack of coordination and personnel. A stronger emphasis should be placed on preventative actions and patient empowerment. An integrated social and health care system would minimise the effort and time needed to receive a more personalised and improved care plan.
CONCLUSIONS An integrated intervention plan for frail older people and a supportive ICT solution have been developed based on the co-design results. Both will be tested during 12-months in a group of 120 older people (plus 120 control group). The co-design results can be used to develop other digital solutions for integrated care in other settings addressing the same target group (frail older people). Moreover, the methods applied to engage agents during the pandemic can be transferred to other researchers willing to develop co-design with the current social restrictions.
IMPLICATIONS FOR APPLICABILITY Regarding the ICT solution, for the older person, the solution must be intuitive, easy to manage, with minimum text and more use of images and icons, voice controlled, and friendly. For professionals, the solution must not imply a duplication of tasks and its benefits.
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