Providing equitable access to specialist palliative care, regardless of diagnosis or geographical location, with relatively limited resources and an ageing population, will become increasing difficult for all hospice services. This paper describes the development of a Design Brief for a Virtual Hospice using design tools and methods. The project began by observing Hospice staff and their interactions with patients. Three User Personas were then created based on data gathered through interviews with a small number of patients and professionals. Each Persona’s progress through the Highland Hospice service was visualised on a User Journey Map in the form of insights and opportunities, with five key themes emerging. The final step involved producing a Design Brief that synthesised the research findings in the form of a plan for creating, prototyping, and testing the Virtual Hospice. < Return to resources Developing a Design Brief for a Virtual Hospice Using Design Tools and Methods: a preliminary exploration Taylor, Andrea and French, Tara and Lennox, Jeni and Keen, Jeremy Providing equitable access to specialist palliative care, regardless of diagnosis or geographical location, with relatively limited resources and an ageing population, will become increasing difficult for all hospice services. This paper describes the development of a Design Brief for a Virtual Hospice using design tools and methods. The project began by observing Hospice staff and their interactions with patients. Three User Personas were then created based on data gathered through interviews with a small number of patients and professionals. Each Persona’s progress through the Highland Hospice service was visualised on a User Journey Map in the form of insights and opportunities, with five key themes emerging. The final step involved producing a Design Brief that synthesised the research findings in the form of a plan for creating, prototyping, and testing the Virtual Hospice. View resource Previous item Next item Developing a Design Brief for a Virtual Hospice Using Design Tools and Methods: a preliminary exploration Paper 2015 Start Now

Digital health innovations often struggle to scale beyond pilot stages due to a lack of understanding regarding the evidence needed to convince decision-makers to adopt them sustainably. This paper, based on interviews with decision-makers engaged in digital health innovations in Scotland, presents a heuristic service readiness level (SRL) framework to capture the evolving evidence needed for scaling digital health innovation projects. By analysing what evidence is required and how data accumulates over time, this framework assists project teams in building a compelling case for scaling digital health innovations. < Return to resources Scaling digital health innovation: developing a new 'service readiness level' framework of evidence Hughes, J., Lennon, M., Rogerson, R. & Crooks, G. Digital health innovations often struggle to scale beyond pilot stages due to a lack of understanding regarding the evidence needed to convince decision-makers to adopt them sustainably. This paper, based on interviews with decision-makers engaged in digital health innovations in Scotland, presents a heuristic service readiness level (SRL) framework to capture the evolving evidence needed for scaling digital health innovation projects. By analysing what evidence is required and how data accumulates over time, this framework assists project teams in building a compelling case for scaling digital health innovations. View resource Previous item Next item Scaling digital health innovation: developing a new 'service readiness level' framework of evidence Article 2021 Start Now

The Covid-19 pandemic accelerated the digital transformation of health and care, emphasizing the necessity of a skilled workforce. Consequently, there has been a surge in published frameworks globally aimed at supporting healthcare staff in digitally enabled work contexts, with this study focusing on understanding their intended purposes and shared elements. This Summary Booklet summarises an International Review and Analysis of Frameworks Used to Support Digital Working by Frontline Healthcare Staff. < Return to resources How to navigate the digital shift in healthcare? An international review and analysis of frameworks used to support digital working by frontline healthcare staff The Covid-19 pandemic accelerated the digital transformation of health and care, emphasizing the necessity of a skilled workforce. Consequently, there has been a surge in published frameworks globally aimed at supporting healthcare staff in digitally enabled work contexts, with this study focusing on understanding their intended purposes and shared elements. This Summary Booklet summarises an International Review and Analysis of Frameworks Used to Support Digital Working by Frontline Healthcare Staff. View resource Previous item Next item How to navigate the digital shift in healthcare? An international review and analysis of frameworks used to support digital working by frontline healthcare staff Executive summary 2024 Start Now

Summary of the TITTAN project to date. < Return to resources TITTAN Project Update and Workshop 2 Overview of Best Practices Rooney, Laura Summary of the TITTAN project to date. View resource Previous item Next item TITTAN Project Update and Workshop 2 Overview of Best Practices Report 2016 Start Now

Experience Labs are design-led spaces for co-creating preferable futures by bringing academic, business, and civic stakeholders to work together with citizens using a participatory design approach. Differing value systems of stakeholders, however, can pose challenges when working collaboratively. Experience Labs support exchange and co-production of values among diverse stakeholders by making them articulate and visible through design, to resolve conflict and to support meaningful decision-making towards progressing ideas whilst integrating a multiplicity of perspectives. In this paper, we discuss the creation of an ‘ethical imagination space’ to explore preferable futures with diverse stakeholders; the core values of the Experience Labs which support the creation of this space; and the key qualities that support the exchange and co-production of shared values to enable collective decision-making. We propose that the ‘next thinking’ for design involves consideration of the ways in which we engage with values in cross-sectoral collaborations to enable collective decision-making. < Return to resources Design-led approach to co-production of values for collective decision-making Raman, Sneha and French, Tara and Teal, Gemma Experience Labs are design-led spaces for co-creating preferable futures by bringing academic, business, and civic stakeholders to work together with citizens using a participatory design approach. Differing value systems of stakeholders, however, can pose challenges when working collaboratively. Experience Labs support exchange and co-production of values among diverse stakeholders by making them articulate and visible through design, to resolve conflict and to support meaningful decision-making towards progressing ideas whilst integrating a multiplicity of perspectives. In this paper, we discuss the creation of an ‘ethical imagination space’ to explore preferable futures with diverse stakeholders; the core values of the Experience Labs which support the creation of this space; and the key qualities that support the exchange and co-production of shared values to enable collective decision-making. We propose that the ‘next thinking’ for design involves consideration of the ways in which we engage with values in cross-sectoral collaborations to enable collective decision-making. View resource Previous item Next item Design-led approach to co-production of values for collective decision-making Paper 2017 Start Now

This project designed and evaluated a Diabetes Prevention Information App as part of a scalable, digitally enabled service model integrated into primary care to support individuals at risk of Type 2 diabetes. < Return to projects Living Lab 2C: Prevent Progress of Diabetes App Project impact The intervention significantly improved users’ knowledge, confidence, and motivation to adopt healthier lifestyle behaviours, with 94% reporting increased knowledge and 88% reporting improved confidence. A blended model combining digital tools with brief professional (dietitian) support enhanced engagement and enabled more effective access to preventative services. The project demonstrated a scalable, cost-effective approach to diabetes prevention that can reduce demand on healthcare services while improving population-level health outcomes. This project designed and evaluated a Diabetes Prevention Information App as part of a scalable, digitally enabled service model integrated into primary care to support individuals at risk of Type 2 diabetes. This project developed and tested a diabetes prevention app integrated into primary care, using a person-centred model tailored to individuals’ digital confidence. An 8-week pilot with high-risk patients showed strong engagement, improved knowledge, and increased motivation for lifestyle change, with many participants making or planning healthier behaviour changes. Summary This project demonstrates a scalable, cost-effective digital approach to diabetes prevention that can be delivered within existing NHS infrastructure. By supporting early intervention and self-management, it has the potential to reduce long-term demand on healthcare services. The model provides an equitable and flexible approach, accommodating different levels of digital literacy, while enhancing patient engagement and service uptake through the integration of digital tools with professional support. Impact & value The app content was co-designed through a series of workshops and developed on the Right Decision Service platform. A pilot was then implemented within a GP practice in Moray, targeting patients identified as being at high risk of developing diabetes. An eight-week evaluation demonstrated strong engagement, with 63% of participants actively using the app and 92% rating it as easy to use. Positive behavioural outcomes were also observed, with most participants reporting lifestyle changes or intentions to make changes. The integration of professional support was successfully tested, with 79% of participants taking up dietitian support. Building on these encouraging findings, the next phase will focus on scaling the approach across NHS settings, enhancing app functionality, and expanding evaluation to larger and more diverse populations. Progress to date Next steps Partners Project staff Resources Developing a Digitally Enabled Universal Service Model to Reduce Type 2 Diabetes Risk Previous project Projects index page Next project

Providing access to hospice services will become increasingly difficult due to the pressures of an ageing population and limited resources. To help address this challenge, a small number of services called Virtual Hospice have been established. This paper presents early-stage design work on a Virtual Hospice to improve access to services provided by a hospice (Highland Hospice) serving a largely remote and rural population in Scotland, UK. < Return to resources Developing design principles for a Virtual Hospice: improving access to care. Taylor, Andrea and French, Tara and Raman, Sneha Providing access to hospice services will become increasingly difficult due to the pressures of an ageing population and limited resources. To help address this challenge, a small number of services called Virtual Hospice have been established. This paper presents early-stage design work on a Virtual Hospice to improve access to services provided by a hospice (Highland Hospice) serving a largely remote and rural population in Scotland, UK. View resource Previous item Next item Developing design principles for a Virtual Hospice: improving access to care. Paper 2017 Start Now

Co-design is becoming a well-known term outside of the design domain, reflecting a growing awareness of the potential and value of applying a design-led process to address complex social and systemic issues. However, an increase in the adoption of ‘co-design’ methods has also led to multiple and sometimes conflicting understanding of what it means and how it is enacted in practice. ‘What does genuine co-design mean? What does it look like? And how does it make a difference?’ – we have been exploring these questions through our participatory design practice and research spanning over seven years. In this chapter, we share our learnings and reflections on genuine co-design, using examples to articulate characteristics of co-design and conditions for enabling genuine participation in the co-design process. We invite further dialogue with the wider practice and research communities to develop a shared understanding of what is (and what is not) genuine co-design. < Return to resources Towards a shared understanding of genuine co-design with people with lived experience: reflections from co-designing for relational and transformational experiences in health and social care in the UK Raman, Sneha and French, Tara Co-design is becoming a well-known term outside of the design domain, reflecting a growing awareness of the potential and value of applying a design-led process to address complex social and systemic issues. However, an increase in the adoption of ‘co-design’ methods has also led to multiple and sometimes conflicting understanding of what it means and how it is enacted in practice. ‘What does genuine co-design mean? What does it look like? And how does it make a difference?’ – we have been exploring these questions through our participatory design practice and research spanning over seven years. In this chapter, we share our learnings and reflections on genuine co-design, using examples to articulate characteristics of co-design and conditions for enabling genuine participation in the co-design process. We invite further dialogue with the wider practice and research communities to develop a shared understanding of what is (and what is not) genuine co-design. View resource Previous item Next item Towards a shared understanding of genuine co-design with people with lived experience: reflections from co-designing for relational and transformational experiences in health and social care in the UK Paper 2022 Start Now

The World Health Organisation defines Healthy Ageing as maintaining functional ability for well-being in older age. The Aging 2.0 Grand Challenges report identifies 8 key challenges, including Brain Health, Care Coordination, and Financial Wellness. This report aims to provide Scottish-specific data on these challenges to inform innovative digital health solutions explored by the Scottish Healthy Ageing Innovation Cluster. < Return to resources Report on Health Ageing 2.0 Key Challenges: High-Level Review of the Scottish Context Tatsi, Athina The World Health Organisation defines Healthy Ageing as maintaining functional ability for well-being in older age. The Aging 2.0 Grand Challenges report identifies 8 key challenges, including Brain Health, Care Coordination, and Financial Wellness. This report aims to provide Scottish-specific data on these challenges to inform innovative digital health solutions explored by the Scottish Healthy Ageing Innovation Cluster. View resource Previous item Next item Report on Health Ageing 2.0 Key Challenges: High-Level Review of the Scottish Context Report 2019 Start Now

This project aimed to rapidly develop and test the Care Homes Assessment Tool (CHAT) in at least two Health Boards/HSCP areas. CHAT supports staff in assessing, triaging, and accessing specialist clinical input for resident treatment. < Return to projects Care 'In Place' (CIP) Care Home Assessment Tool (CHAT) Stages 1 & 2 Project impact Development of an adaptable clinical assessment tool for Care Homes and a service wraparound model Assets developed to support sharing of information between health and social care This project aimed to rapidly develop and test the Care Homes Assessment Tool (CHAT) in at least two Health Boards/HSCP areas. CHAT supports staff in assessing, triaging, and accessing specialist clinical input for resident treatment. This was a partnership project led jointly by DHI and Scottish Care, involving NES, NHS Lanarkshire, NHS Greater Glasgow & Clyde, DaySix and a number of care homes in the Lanarkshire and Glasgow areas. The principal objective was to rapidly develop and test a live implementation of the CHAT in at least two Health Board/HSCP areas to improve local operational decision-making in Care Homes, aid communication in situations where external clinical support is required and provide early notification of a potential viral outbreak within this sector. This project developed a care home assessment tool that supported staff to assess, triage and where appropriate access specialist clinical input for treatment of their residents during COVID-19. Stage 1 of the project was a Test of Change which produced a wireframe of a digital tool which was co-designed with citizens, service and clinical staff and stakeholders. This could be used to develop a web-based application (based on a Clinical Assessment Tool already developed by NES). Stage 2 was formally launched in July 2020 and involved the trial of the tool in a number of care homes in NHS Lanarkshire and Glasgow. Summary Impact & value A working prototype was implemented in two health boards, NHS GG&C and NHS Lanarkshire, with the tool initially being implemented in Cartvale Care Home (NHS GG&C) and Greenhills Care Home (NHS Lanarkshire) and later more care homes in NHS Lanarkshire. The number of assessments undertaken was low due to a number of factors including staff levels being impacted by COVID-19; outbreaks of COVID within the Care Home; staff recruitment and retention; prioritisation of the vaccine programme over symptom detection. The learning around the use of the assessment tool in care home settings and the sharing of information between health and care services was trailblazing at the time, and has produced a number of useful assets for future work around the challenges of care homes working collaboratively with NHS services. Furthermore, staff were very positive about the application’s capabilities and usefulness within the care homes and this was also recognised by the associated GP’s. Progress to date Next steps Covid-19 Projects The Digital Health & Care Innovation Centre (DHI) was commissioned and remains actively engaged in supporting the Scottish Government’s national response to the challenges of the Covid-19 pandemic through various related projects View Projects Partners Project staff Resources Care Homes Assurance Tool (CHAT) Previous project Projects index page Next project

This report details the activity and outcomes of a series of design led workshops involving stakeholders of Gastroenterology services in the NHS Scotland. Participants came from 20 specialists’ areas and 9 different NHS Board areas, giving both a broad geographic and functional reach. The first step for the workshops was to identify common Gastroenterology patient symptoms, noting their importance. Issues were mapped for each symptom and areas to focus on agreed. Further discussion around these focus areas led to suggestions for sustainable improvement to Gastroenterology services. These ranged from better support for patient self-management, the suggestion of a more dynamic relationship between primary and secondary care to better use of community dietetics. Future work will involve national support to ensure the Gastroenterology community, along with primary care partners are supported to make the necessary changes to ensure efficient and effective patient pathways are achieved. < Return to resources Scottish Access Collaborative: Gastroenterology Report Porteous, A., Blank, L., Schauberger, U., Smith, P., Brooks, E. This report details the activity and outcomes of a series of design led workshops involving stakeholders of Gastroenterology services in the NHS Scotland. Participants came from 20 specialists’ areas and 9 different NHS Board areas, giving both a broad geographic and functional reach. The first step for the workshops was to identify common Gastroenterology patient symptoms, noting their importance. Issues were mapped for each symptom and areas to focus on agreed. Further discussion around these focus areas led to suggestions for sustainable improvement to Gastroenterology services. These ranged from better support for patient self-management, the suggestion of a more dynamic relationship between primary and secondary care to better use of community dietetics. Future work will involve national support to ensure the Gastroenterology community, along with primary care partners are supported to make the necessary changes to ensure efficient and effective patient pathways are achieved. View resource Previous item Next item Scottish Access Collaborative: Gastroenterology Report Report 2019 Start Now

This Executive Summary presents findings from the End of Stage Report for the Care Homes Assessment Tool Proof of Concept (CHAT Stage 2), conducted by DHI and Scottish Care. Initiated in response to the escalating effects of the coronavirus pandemic in Scotland in March 2020, CHAT Stage 2 aimed to further develop the digital Care Homes Assessment Tool (CHAT) for Covid-19, building upon positive results from a Stage 1 Test of Change conducted in June 2020. The report shares key learnings, reports to the Scottish Government Digital Health & Care Directorate, and outlines recommendations for next steps. < Return to resources Care Homes Assessment Tool Proof of Concept: Stage 2 Report MacKenzie, M., Lillie, A., Kendall, B., Morrison, C., Welisch, G. & Raman, S. This Executive Summary presents findings from the End of Stage Report for the Care Homes Assessment Tool Proof of Concept (CHAT Stage 2), conducted by DHI and Scottish Care. Initiated in response to the escalating effects of the coronavirus pandemic in Scotland in March 2020, CHAT Stage 2 aimed to further develop the digital Care Homes Assessment Tool (CHAT) for Covid-19, building upon positive results from a Stage 1 Test of Change conducted in June 2020. The report shares key learnings, reports to the Scottish Government Digital Health & Care Directorate, and outlines recommendations for next steps. View resource Previous item Next item Care Homes Assessment Tool Proof of Concept: Stage 2 Report Report 2022 Start Now

This is a short research report on the economic cost of low back pain. Back pain can arise suddenly or gradually, often due to work-related factors like fixed positions or repetitive movements. Poor posture, uncomfortable positions, and awkward movements can also contribute. Low back pain, or lumbago, is the most prevalent type, with 95% affecting the lower back. Chronic low back pain is a frequent complaint in pain clinics. < Return to resources Cost of Low Back Pain Rimpiläinen, Sanna This is a short research report on the economic cost of low back pain. Back pain can arise suddenly or gradually, often due to work-related factors like fixed positions or repetitive movements. Poor posture, uncomfortable positions, and awkward movements can also contribute. Low back pain, or lumbago, is the most prevalent type, with 95% affecting the lower back. Chronic low back pain is a frequent complaint in pain clinics. View resource Previous item Next item Cost of Low Back Pain Report 2016 Start Now

This webinar explores how Scotland and Norway are using innovation, smart housing, and technology-enabled care to support people with long-term conditions to live safely and independently in their own homes and communities. Speakers share practical examples including Scotland’s Smart Home Blueprint, Norway’s University Nursing Home concept, and real-world use of consumer technology in care settings. < Return to resources Innovation in Long-Term Care and Smart Homes This webinar explores how Scotland and Norway are using innovation, smart housing, and technology-enabled care to support people with long-term conditions to live safely and independently in their own homes and communities. Speakers share practical examples including Scotland’s Smart Home Blueprint, Norway’s University Nursing Home concept, and real-world use of consumer technology in care settings. View resource Previous item Next item Innovation in Long-Term Care and Smart Homes Video Start Now

The DHI joined the Digital Lifelines programme in March 2022 with the aim of working with delivery partners, organisations delivering services, and people who use drugs, to collaboratively produce a future vision for digitally enabled services to better support people who use drugs. The final report presents an overview of activities and findings from the integrated ‘Discover and Define’ workstream. The report concludes with a synthesis of emerging insights and themes from different perspectives (lived experience, service, sector, policy and digital); and highlights key opportunities for digitally enabled services to support people who use drugs and have multiple, complex, and enduring needs to reduce risk of harm and live well in the community. This will inform the ‘Develop’ phase, to co-design future digital solutions and services. < Return to resources Digital Lifelines: DHI Discover and Define Raman, Sneha., Simms, Harriet. The DHI joined the Digital Lifelines programme in March 2022 with the aim of working with delivery partners, organisations delivering services, and people who use drugs, to collaboratively produce a future vision for digitally enabled services to better support people who use drugs. The final report presents an overview of activities and findings from the integrated ‘Discover and Define’ workstream. The report concludes with a synthesis of emerging insights and themes from different perspectives (lived experience, service, sector, policy and digital); and highlights key opportunities for digitally enabled services to support people who use drugs and have multiple, complex, and enduring needs to reduce risk of harm and live well in the community. This will inform the ‘Develop’ phase, to co-design future digital solutions and services. View resource Previous item Next item Digital Lifelines: DHI Discover and Define Report 2023 Start Now

In current medical literature, there's widespread mention of citizen empowerment and person-centered care, yet implementing these concepts poses a significant challenge. Amid rising demand and limited resources in healthcare, the realization is dawning that technology-enabled care could offer sustainable solutions. While consumer electronics companies have long prioritized customer satisfaction through hassle-free, personalized interactions, the healthcare system lags behind in adopting similar approaches, prompting reflection on this disparity. < Return to resources Thoughts on Citizen Empowerment and Person-centred Care Crooks, George In current medical literature, there's widespread mention of citizen empowerment and person-centered care, yet implementing these concepts poses a significant challenge. Amid rising demand and limited resources in healthcare, the realization is dawning that technology-enabled care could offer sustainable solutions. While consumer electronics companies have long prioritized customer satisfaction through hassle-free, personalized interactions, the healthcare system lags behind in adopting similar approaches, prompting reflection on this disparity. View resource Previous item Next item Thoughts on Citizen Empowerment and Person-centred Care Blog post 2018 Start Now