We\Visit E-Health: helping patients to keep in touch with their families

‘Covid-19 is not only throwing up all sorts of medical challenges, it’s also the cause of a lot of mental stress for both patients and their families,’ says Elif Özcan, who heads both the Critical Alarms Lab at the Faculty of Industrial Design at Delft University of Technology, and Care Technology at the Intensive Care department of the Erasmus Medical Centre (MC).

Tekst: Gert-Jan van den Bemd | Translated by Tony Parr | 17 april 2020

5 minutes

‘Covid-19 patients are quarantined when they’re admitted to hospital and most of them aren’t allowed visits. Some hospitals allow their patients to receive one brief visit a day, which means that many family members don’t have a chance to come in and comfort them. The rules in intensive care units (ICUs) are even stricter: you’re often not even allowed to send cards, flowers, video messages or voicemails.’ Elif Özcan decided to get in touch with colleagues at two faculties in Delft: Industrial Design and Electrical Engineering, Mathematics and Computer Science, as well as the Reinier de Graaf hospital in Delft and the Erasmus MC. The birth of the We\Visit platform was the result of these contacts. The idea behind the platform is to enable patients and their families to remain in touch in difficult times such as these. ‘It’s an online platform that uses a secure connection to facilitate social contacts and provide emotional support. We realise, of course, that there are already solutions such as FaceTime and WhatsApp, but they’re not practical in many cases. You’ve got to remember that the majority of Covid-19 patients are over 65. Not all of them have a smartphone and many of them are not experienced users. Another problem is that many patients are admitted very suddenly – they’re brought in by ambulance, often without their phones. Some hospitals don’t allow any smartphones in their Covid-19 units. And not all the existing video links are secure, which means that there are no guarantees about the protection of privacy.’

Urgent need

We\Visit is being designed for use on a tablet. Users are divided into three categories: patients and their families wishing to make a video call, staff who need to manage the platform, and volunteers who operate the tablet on the patients’ behalf. ‘There’s been a need for a secure platform for some time now,’ Elif Özcan explains. ‘It’s something that two charities working with ICU patients have called for on many occasions. The coronavirus outbreak has only served to make the need even more urgent.’ ‘The video link is our main priority,’ says Elif Özcan. ‘It instantly solves the problem of the lack of contact between patients and their families. We’re also planning to develop other functions, such as a one-way line of communication from families to patients, or from nurses to patients’ families. One thing that our system is not designed to do, by the way, is to share medical data.’

'ICU patient whose first contact with his family brought tears to his eyes'

Token

Protecting the privacy of patients and their families during this incredibly stressful period of their lives is paramount. The need to protect the system against malware and cyber attacks also requires sophisticated technical and digital security procedures. One way of securing the system is by using a ‘token’, i.e. a numerical code that can protect the integrity of regular contacts between patients and their families. Elif Özcan: ‘Our platform is suited for use by all healthcare centres where patients are held in quarantine: university medical centres, regional hospitals, nursing homes, care homes, care hotels, hospices, and so on. We’ve almost completed the work on the video link. The next step will be to design a one-way line of communication. The year 2020 is going to be our pilot test year. If all goes well, we’re planning to expand and refine the system in 2021, with the help of a team of experts in design, communications and digital security.’ The Reinier de Graaf hospital is the first hospital to trial the platform. ‘They’re delighted with the initial results. They told me about an ICU patient whose first contact with his family brought tears to his eyes. The Erasmus MC is also planning to start using We\Visit. We’re now looking for young volunteers who are less susceptible to the coronavirus and who can help ICU patients to use the tablets. This is not something that we want to ask the nurses to do.’

Teamwork

Elif Özcan: ‘We first need to measure the effectiveness of We\Visit. Does it do what we want it to do? Does it help to reassure patients and their families and strengthen their emotional bonds?’ Elif Özcan reckons that We\Visit is a supreme example of convergence: ‘Designers, psychologists, computer scientists, engineers, doctors and nurses, experts in funding and policy-making, lawyers, former ICU patients – it’s all about putting their assembled expertise to work in order to tackle an urgent, critical problem. It’s an amazing example of transdisciplinary teamwork.’