Development and Usability Testing of An Intelligent and Integrated Older Care Model (SMART System) to Promote Integrated Home-based Older Care

Abstract

Background: Although integrated care has been proposed as a promising approach to actively responding to the global population aging, there is still no exploration of the meticulously integrated care model for older adults living at home. This study aimed to develop an Intelligent and Integrated Older Care Model (SMART System) and evaluate its usability among older individuals. Methods: The development of our SMART system was guided by the knowledge-based Clinical Decision Support System architecture and the principle of neural reflexes, which included 5 phases: (1) functional design; (2) architecture and database design; (3) security measures design; (4) user interface and visualization design; (5) prototypes development and iteratively testing. We then conducted a cross-sectional study to evaluate the usability of the SMART system among older individuals by using the Health Information Technology Usability Evaluation Scale (Health-ITUES). Results: The SMART system consisted of a Care Receiver App, a Professional Care Provider App, and a Cloud Platform. According to the assessment results and daily monitoring data, the SMART system can provide a comprehensive diagnosis of care problems and tailor interventions and implementation approaches to address the multifaceted care needs of older individuals. The interventions and implementation approaches generated by the SMART system, after being reviewed and adjusted by professional nurses, will be sent to the corresponding care providers to promote coordinated care services. The SMART system was perceived as useful and acceptable among older individuals with the mean scores for each item of the Health-ITUES (Older People Version) exceeding 3.00. Conclusions: This study developed the SMART system to facilitate integrated home-based older care. The SMART system was demonstrated to be satisfactory and useful among older individuals.