Collaboration with Dr. Catherine Doogan at St. Georges (WOCRS)

Matthew Jamieson and Catherine Doogan

Matthew Jamieson and Catherine Doogan

February 29, 2024

We have been working with Dr. Catherine Doogan and staff at St George’s University Hospitals NHS Foundation Trust on a Health Foundation funded project.

This collaboration has allowed us to visit the Wolfson Outpatient Cognitive Rehabilitation Service (WOCRS) and their Vocational Rehabilitation service and speak to staff and patients, and come to a better understanding of the needs of those working in brain injury rehabilitation services. 

The project focus is understanding the patient and caregiver journey, key challenges and opportunities and the current use of technology. This collaboration has been incredibly valuable and is informing the development of the neumind technology and ensuring that what we are making is going to have real impact for those recovering from a brain injury or neurological condition.

Between October and December 2023 we completed over 60 hours of observations and interviews with staff and patients. This included the opportunity for Ellis and Rufus, along with Catherine, to observe the ICAT (Intensive Compensatory Aid Training) group that is run at WOCRS. This was supplemented by ‘problem’ interviews with family members, support workers and clinicians from other UK NHS neuro-services.

We were able to gather key insights that are informing current development work:

ICAT is an effective model for tech-enabled care: 

The ICAT is run 2-3 days per week over 8 weeks. It focuses on training individuals to use compensatory aids that allow them to live a more independent life aligned with their values and goals. 

  • High-level of clinical input (close to a 1:1 patient to clinician ratio).
  • Smartphones are the primary compensatory aid as they’re “always available” with tech-enabled functionality to support a wide range of impairments.
  • Thematically driven with an emphasis on compensatory strategies, incremental and supervised training, with meaningful ‘homework’ (tasks to complete outside the session).

Establishing an emotional connection: A surprising finding was the critical importance of establishing an emotional connection to assistive technology for motivation and long-term adoption. Effective methods include; emotional salience, reflecting on progress and setting meaningful tech-enabled tasks and goals.

Key Challenges with current technologies: During observations and interviews we found that significant staff time and effort goes into helping patients use features from various apps. It was also difficult for staff to monitor patients’ progress outside of sessions. The ICAT illustrated that being part of a peer community improves understanding and motivates use of aids and strategies. This social encouragement can also come from carers, but it can be difficult to ensure they are upskilled in assistive technology and kept ‘in-the-loop’. 

These key challenges inform the development and testing we now plan to undertake.  For example, we know the technology will need to incorporate different features like reminders, tracking and note taking. It is important that clinicians can monitor the use of aids through the app or linked software as this feedback to their patients is vital for recovery. It is also clear that social engagement from a community, and linking the app to informal caregivers is important.