Fabian Okeke
ABSTRACT
Home health aides (HHAs) increasingly being used by adults with heart failure for long-term assistance and post-hospitalization care. Despite being heavily involved in numerous aspects of heart failure management, most HHAs have not received heart failure training. They also struggle to get in touch with supervising nurses or other members of the care team when they have clinical questions, which may result in unnecessary visits to the emergency room. In addition, despite serving as a backbone in the health system for patients, HHAs, who are mostly women and minorities, are a marginalized and vulnerable group of frontline caregivers, enduring erratic employment, low wages, discrimination, and high levels of burnout. Although digital technologies could help to address many of the challenges HHAs face, little is known about the current impact of technology on HHAs work practices. To this end, we conducted a multi-stakeholder qualitative study with 38 participants in New York City using semi-structured interviews and focus groups. We uncover the ways in which technology is used, the complex socio-technical factors that underpin heart failure care, and stakeholder suggestions for how technology could improve HHAs work. Building on these insights, we synthesize design opportunities for researchers and designers interested in developing tools that support the delivery of home health care for patients suffering from life-threatening diseases like heart failure.
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