Bedfordshire, Luton and Milton Keynes Integrated Care Board (BLMK ICB) has been awarded more than £1 million in funding through the Department of Health and Social Care’s Digitising Social Care programme (Adult Social Care Technology Fund) to implement two artificial intelligence (AI) based technologies (Robopets and PainChek) to support adults in receipt of social care across their region.
Background
Increasingly, technology is being used by health and social care practitioners with the aim of enhancing the wellbeing of care home residents and people drawing on home care. BLMK ICB received funding to implement two technologies (Robopets and PainChek) across a range of different community-based care settings with people living with dementia or a learning disability, experiencing some of the following challenges:
• Communication difficulty
• Symptoms of cognitive impairment
• Low mood/ anxiety
• Behaviours that are causing concern
The use of the technologies is anticipated to support people to live independently, improve quality of life, reduce avoidable hospital admissions/ readmissions and improve care quality and safety.
Robopets such as a robotic cat or dog, use artificial intelligence (AI) technology to respond to voice commands and interact with the user through realistic movements. They are designed to provide a calming influence, give people greater independence and confidence, and improve mental health and wellbeing. Robopets are intended to be companions for older adults, people living on their own, or anyone who is unable to have a pet of their own. They are becoming commonplace in the UK care system, as well as being purchased by private individuals, with the aim of reducing loneliness and anxiety among at-risk older people.
PainChek is a digital pain assessment tool that uses AI via a smartphone app to automatically recognise and measure slight changes in facial expressions and voice to quantify a pain score and guide carers to provide the right support. PainChek is a validated AI device with evidence of concurrent validity, inter-rater agreement, and internal consistency, indicating it to be a safe and reliable tool to identify pain in the cohort identified within this project. PainChek is intended to support effective medication use for those who are unable to verbalise pain and as a result risk being left in discomfort or distress, which could also lead to behaviours that cause concern such as increased agitation.
This study is one of 8 projects nationally to have received funding through the Adult Social Care Technology Fund. This evaluation, in conjunction with the other projects, will help inform spread and scale of technology implementation within adult social care in England.
The University of Hertfordshire (UH) is the evaluation partner for this project. The evaluation aims to understand the acceptability, usability, cost-effectiveness and impacts of PainChek and Robopets as implemented and adopted in BLMK care homes and as part of the domiciliary care offer, to inform the development of an evidence-based plan for scale and spread across BLMK ICB.
Project Aims
- The objectives of the evaluation are:
To understand the technology implementation processes and outcomes, including adoption, acceptability, usability, and sustainability of PainChek and Robopets; - To assess the effectiveness of the technologies against the intended benefits, including outcomes for those receiving the intervention, their families and staff involved in their care;
- To estimate the resource use and cost changes associated with the adoption of the implemented technologies.
Project Activity
The evaluation is taking a mixed-methods approach with quantitative and qualitative data collected at key touch points during the implementation of the technologies. Emphasis is on an overarching knowledge mobilisation approach whereby relationships with key stakeholders will be established at the outset and drawn on throughout the project to help determine required data collection and analysis, as well as to ensure buy-in to the evaluation across the Integrated Care System (ICS) and ensure the usefulness of findings.
The evaluation consists of 4 overlapping work packages (WP) with data collection and analysis underpinned by the NASSS framework, which is an evidence-based technology implementation and evaluation framework.
WP1: is the pre-implementation set-up, establishing governance arrangements, and scoping exercises to understand the current context and initial requirements for implementation. Activities include:
• rapid evidence review;
• document analysis;
• logic model development through stakeholder workshops.
WP2: encompasses the qualitative data collection and analyses, focusing on the impact of the technologies on the experiences and outcomes of service users, carers, and staff; and the collection of quality-of-life data using Adult Social Care Outcomes Toolkit (ASCOT) questionnaires. It will also be concerned with identifying the challenges and enablers to implementation in the specific social care settings (i.e. domiciliary care and care homes). WP2 includes the following data collection methods:
• Focus groups;
• Interviews;
• Observations of the technologies in use;
• Review of care notes;
• ASCOT self-completion and proxy-completion questionnaires.
WP3: comprises the quantitative and cost-consequence analysis to estimate the resource use and cost changes associated with the adoption of the implemented technologies. The primary quantitative analysis will adopt a pre-post design, with observation at baseline and follow-up to analyse benefits based on administrative data that can be collected both prospectively and retrospectively. The selection of outcomes has been guided by the findings from WP1 and include, for example, changes in: effective prescribing, levels of pain, hospital admissions, safeguarding incidents and incidences of concerning behaviours.
WP4: includes knowledge mobilisation activities and dissemination. A knowledge mobilisation approach enables sense-checking with stakeholders and a continuous feedback loop throughout the project. This involves, for example, the logic model workshops in WP1 to ensure there is a mutual understanding and organising vision for the technology implementation and evaluation. Throughout there will be commitment to meaningful involvement of public members and those assumed to benefit from the implementation of these new technologies. Two knowledge mobilisation workshops will be held at the midpoint (March 2025) and at the end of year two (February 2026) to present draft findings and get feedback from attendees on recommendations.
Anticipated or actual outputs
- Academic papers
- Reports for funders
- Reports for BLMK ICB, participating care providers and their service users
- Presentations at Academic and Practitioner Conferences
Creative outputs, such as infographics
All dissemination activity will be conducted in collaboration with experts by experience (e.g. through co-presenting and co-authoring).
Who is involved?
- Dr Jenni Lynch / Reader in Social Care, Technology and Knowledge Mobilisation, University of Hertfordshire (PI)
- Dr Alison Tingle / Research Fellow, University of Hertfordshire
- Dr Krystal Warmoth/ Senior Research Fellow, University of Hertfordshire
- Dr Melanie Hadley / Associate Professor, University of Hertfordshire
- Dr Jane Fry / Senior Research Fellow, University of Hertfordshire
- Dr Chris Sampson / Consultant Health Economist, Office of Health Economics
- Health Innovation East
- Bedfordshire, Luton and Milton Keynes ICB
Contact
Dr Jenni Lynch - j.lynch5@herts.ac.uk
