Collaborating with the Wolfson Outpatient Cognitive Rehabilitation Service

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

The project focus is on understanding the patient and caregiver journey, identifying key challenges and opportunities, and observing the current use of technology. This collaboration has been incredibly valuable; it is directly informing the development of the neumind technology to ensure that what we build will have a real impact for those recovering from a brain injury or neurological condition.

The Research Phase

Between October and December 2023, we completed over 60 hours of observations and interviews with staff and patients. This included the opportunity for Ellis, Rufus, and Catherine to observe the ICAT (Intensive Compensatory Aid Training) group that is run at WOCRS.

We supplemented this onsite research with ‘problem’ interviews with family members, support workers, and clinicians from other UK NHS neuro-services.

Key Insights

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

1. 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. The core pillars of this success include:

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

2. The importance of 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 leveraging emotional salience, reflecting on progress, and setting meaningful tech-enabled tasks and goals.

3. Challenges with current technologies

During observations and interviews, we found that significant staff time and effort is spent helping patients navigate features across various apps. It was also difficult for staff to monitor a patient's progress outside of sessions.

The ICAT illustrated that being part of a peer community improves understanding and motivates the use of aids and strategies. While this social encouragement can also come from carers, it can be difficult to ensure they are upskilled in assistive technology and kept ‘in-the-loop’.

Looking Ahead

These key challenges are informing the development and testing we now plan to undertake. For example, we know the technology will need to incorporate specific 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 vital for long-term success.