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Walking on Sunshine

A Wellness Plan Prescription app and internet access to help prevent post-fracture depression by encouraging movement and socializing.

Photo of R. K. Holmes

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What challenges or opportunities are you trying to address within the problem? (200 characters or less)

Many seniors are isolated or shut-in, let alone post-fracture. A prescribed Wellness Plan and app that connects them to health care providers and physical therapists could greatly improve outcomes.

The loss of mobility post-fracture can come as a shock to anyone, especially for an older person living alone.  The solution I imagine is twofold: 1) a prescribed wellness plan using a one-stop-shop app, WalkShine and 2) provision of the hardware needed (recycled and refurbished smartphones to access the app.  WalkShine is primarily focused on helping seniors who are ALONE to keep depression and feelings of futility at bay post-fracture so that they feel encouraged to continue on their healing journey and prevent future fractures.   

Obviously care from a loving and capable family member is best.  But for those who don't have anyone at all, accessing the app for contact with health care providers, physical therapists, long-distance family members and a community peers experiencing the same issues can make a difference. 

The WalkShine app and a refurbished phone is provided to anyone who reports living alone and is coded with any fracture during a hospital or doctor's visit.  The WalkShine app can help fill in the gaps when the patient is unable to afford DAILY home health aide visits or get to DAILY physical therapy.   

The average American home has 2.8 TVs and 2.4 smartphones.  However, where a patient does not have either, the app hospitals and other agencies will work with e-recyclers to provide the electronic equipment needed for patient's use during recovery.  Once eligibility has been determined, the program will help the patient connect their own smartphone to their television for optimal viewing or provide both to the patient as needed.  

Old devices are often collected, refurbished and given to people who need them for various reasons.  Yet enormous amounts of electronic waste from phones shows that we are still not doing enough.  Perhaps more concerted efforts to collect phones for healthcare would be well-received.  This program has the added benefit of putting e-waste to good use.  

Finally, the user would need Internet Service which can be cost-prohibitive. WalkShine would partner with hospitals, Senior Citizen consumer advocate groups and Internet Service Providers to provide WalkShine App-ONLY internet service 100% free to post-fracture patients.  While the patient would be responsible for their already existing phone plans (if they have one), time spent utilizing the Walkshine app Wellness Plan would come at no cost to them.

The WalkShine app Wellness Plan would include: 

  1.  Live long distance Home Health Aide Video chat feature (direct and immediate human contact if the patient is experiencing increasing lonliness or physical pain.)
  2. Guided meditation/prayer/gratitude practice/visualizations (guided virtual walking tours through the woods, along a beach, on a busy street of a selected tourist destination, etc.)
  3. Education ("science of falling" (i.e. "Did you know that the biggest predictor of falls for seniors is the actual fear of falling?!"), the psychology of falling and what to expect during a loss of mobility, osteoporosis prevention, DEXA scan information, nutrition, cooking, bathing and doing daily tasks with an injury, health literacy and self-advocacy, anatomy and bio-mechanics, communicating effectively with your caregivers and health care providers, etc.
  4. Movement and daily prescribed Physical Therapy with therapist monitoring by video, chair aerobics, body resistance training, chair yoga, chair tai chi, specially tailored physical therapy videos, practice videos for navigating the home/stairs, etc.
  5. Socializing -  Chat rooms, live interactive webinars and classes with other seniors about bone health, virtual dance parties, opportunities to cultivate an active social life offline, advocating for self and other seniors, participate in social justice issues for seniors.
  6. Progress Tracking - Tools to measure patient's adherence to prescribed Wellness plan AND progress toward pre-set goals personal goals.


The changing landscape of the senior demographic will soon no longer be dominated by the internet illiterate older person.  With each passing year, more and more people of all ages will see the Internet and smart devices as just a regular part of everyday life.  The challenge perhaps lies more in access to people in communities which are still lagging behind in this respect, particularly in poor communities and communities of color. In communities of color, osteoporosis is rarely discussed.  While it is a lesser risk, it is still a significant one: when fractures do happen, whether due to osteoporosis, the mortality rate is twice as high in these communities. This is not surprising and it speaks to the urgent need to educate about osteoporosis and fractures in general and also redouble preventative measures to decrease this glaring health disparity.  

The WalkShine app can tailor its messaging for patients with any risk factors for osteoporosis or higher mortality rates due to a fall or fracture.  

It is my hope that the WalkShine App will include seniors as staff members who are highly visible and present in managing, maintaining and facilitating activities.  Studies have shown these types of online senior communities have the most longevity.   Messaging will also be very clear that aging does not have to mean a drastic loss in quality of life.  The WalkShine app will speak to being confident and strong rather than being hyper-vigilant about the "dangers" of living at every turn.   As with any healthcare issue nothings beats having a well-thought out plan of action.  


Resources


1.  Sustaining Online Communities Involving Seniors: https://pdfs.semanticscholar.org/a122/c1953b86d09a95b932bd5da6abb38e99f358.pdf


2. View of What Seniors Value About Online Community: http://www.ci-journal.net/index.php/ciej/article/view/545/880

3.  Virtuality Improves the Well Being of Seniors through Increasing Social Interaction: https://link.springer.com/content/pdf/10.1007/978-3-642-15479-9_12.pdf




Who is your target end user and why will they be interested? (650 characters or less)

Post-fracture older adults, especially those living alone, health care workers, physical therapists, hospitals, social service agencies, senior homes and retirement communities, government agencies, and faraway family and friends will find this holistic approach useful. This program is another tool in the toolkit of both the person who has just suffered a fracture as well as their caregivers and healthcare team. It allows the patient to take charge of the most important aspects of their recovery through this app at any time day or night that they choose. They can essentially log into a portal specially tailored to their physical therapy, health and wellness needs, rather than finding dubious information on the internet or doing nothing at all.

How is your idea scaleable? (650 characters or less)

My idea is implementable because it utilizes tools that most people already have and use widely: TVs and phones The challenge would be in setting up access for more impoverished seniors. Online courses and access to 'live' people remotely would allow for greater reach with fewer staff. Also it would allow those who have no one to shuttle them to physical therapy, the opportunity to log on and have a therapist guide them remotely. It is not a replacement for in-person care from family and health aides and medical professionals but a supplement that can fill in gaps, perhaps prevent ER visits, expedite healing and stay ahead of depression.

What do/will you measure to know if your solution worked? (500 characters or less)

1. Length of patient recovery time post-fracture 2. Improvement in patient's future outlook and desire to participate in life. 3. Highly-rated patient app experience

What is the current stage of development of your idea?

  • Prototype: We have done some small tests or experiments with prospective users to continue developing the idea.

If you were to become a Top Idea, would you want to actively participate in piloting your idea?

  • I want my idea piloted, and I prefer to do my own piloting in collaboration with the health system and with assistance from the Challenge partner

Company / Organization Name, if applicable (140 characters or less)

WalkShine

Tell us about yourself or your team (500 characters or less)

I am the daughter of a very spry, independent septuagenarian who had a hard landing on her ankle after missing the last step on her way to do laundry. I am also very interested in patient/doctor relationships and the impacts of stigma on patients from the medical community. I believe that health literacy and the ability to communicate effectively with health care providers is an important component of wellness. Two months ago, I would not have believed you if you said that I would be contributing my thoughts to an osteoporosis challenge. My Mom's fracture was relatively minor in the scheme of things but it was so life-altering for that brief period of time that I think it has changed both of our outlooks forever. My Mom feels very lucky and grateful that even though I live far away, I was able to come to her right away. She is over-the-moon that I entered this challenge because she hopes that her experience can help those who have no one to come to them in their time of need.

Location (50 characters)

Philadelphia, Pennsylvania, USA

What is your legal / organizational structure?

  • We are individuals

Innovator/Organizational Characteristics

  • Female-led organization
  • Women’s health/rights focused organization
  • Locally/community-led organization
  • Communities of color

How did you hear about the Challenge?

  • OpenIDEO announcement email
  • I originally was interested in the books for children challenge but received this announcement too.

Why are you participating in this Challenge?

My mother fractured her ankle and fell into a depression. We made a list of daily things she would like to do while healing: make the bed, call me, call a friend, online gratitude meditation, online chair exercises, read the book I gave her, Dynamic Aging, etc. Mom LOVED having a plan laid out and followed it to the letter. She healed in a few weeks to her doctor's amazement and is back to her busy self. Right after Mom's experience, this challenge opened and I felt called to participate.

How does your idea help more people who have had a first fracture either 1) discover they have osteoporosis or 2) access/navigate care?

The WalkShine app will prompt people to have conversations with their doctor about osteoporosis as a built-in part of their recovery plan. It will also allow them to access the information they need in one place as well as keep in contact with their healthcare team. Conversely, the healthcare team can monitor the patient's progress more frequently and cost-effectively for the patient and the healthcare system.

How is your idea new in the world or how does it build on existing interventions?

My idea builds on existing health monitoring apps and the Electronic Health Records systems. Where my idea may differ from other interventions is that it places the highest priority on the patient's emotional well-being throughout recovery and tailors their wellness plan on a day-to-day basis to how motivated or demotivated they are feeling.

Please upload your journey map. Be sure your journey map shows when your user is introduced to the idea and when/how they access it, and illustrates which moments in the Challenge Journey Map your journey map touches.

Who did you test your idea with, what did you learn, and how did you evolve your concept?

I interviewed my Mom, an older friend who is debilitated by bone health issues and a friend who is a social worker and helps older patients navigate the health system. My conversations with my Mom were most influential as she was fairly adamant that it was her emotional state, not the physical pain from her fracture that was scariest. She simply wished she had been told what to expect about the psychology of a fracture. My older friend, also in her late 70s has a physical therapist come to her home once a week but she admits that on the other six days, she totally neglects her exercises. Her mobility has been negatively impacted by her pain and her lack of motivation to do her physical therapy on her own. I asked her would she do exercises with a remote physical therapist through a video chat and she responded with an emphatic, "Yes!" Finally, my Social Worker friend shared that the vast majority of the time she is having conversations with caretakers of the elderly and so it is very important that they (the caretakers) be educated as well, not just about their loved ones condition(s) but also how they can be encouraging and helpful in their loved ones recovery. Having a plan and follow-up was an important component in recovery for everyone that I interviewed.

(Optional) Share documentation of your solution prototyping and testing, such as photos.

WalkShine App 2

Please upload your Business Model Canvas

Please upload your team video.

https://drive.google.com/file/d/1pl-zFN0wxMcozJ2zf-2d6Enat1gUT8sk/view?usp=sharing

20 comments

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Photo of Heribert Schiegl
Team

I think you did some amazing work there. How did it turn out in the end?

Photo of R. K. Holmes
Team

Thank you, Heribert, for your kind words. We are still in the finals phase. If selected, I hope to continue developing this idea. We shall see!

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