A data-driven but person-centered assessment framework for sustainable
rehabilitation services
Authors: Ihara Masayuki , Tokunaga Hiroko , Murakami Hiroki , Saruwatari Shinpei , Takeshita Kazuki , Koga Akihiko , Yukihira Takashi , Hisano Shinya , Maeda Ryoichi , Motoe Masashige 
Published: February 2023

Utilization of data and information technologies is one of the
expectations for the future in a health care domain. Although electronic
health records are used in decision making for medical prescription in many
hospitals, small nursing care providers are not able to effectively utilize
data. We aim at development of an online rehabilitation service that
utilizes data both for designing a rehabilitation plan for each patient and
for a sustainability of the service. This paper presents a framework for the
assessment of the rehabilitation that is data-driven but
person-centered.According to the International Classification of
Functioning, Disability and Health (ICF), in designing a rehabilitation
plan, it is important to consider not only the maintenance and improvement
of physical functions of a patient's body, but also his/her activities
related to tasks and actions in a daily life and the participation or
involvement in his/her life situation. Each patient has his/her own
background in needs for the rehabilitation thus we focus on the
person-centered care approach where a health care should be based on the
unique person's needs. The rehabilitation plan should focus on the abilities
of the person and encourage activity even though the data is actively
used.The proposed assessment framework consists of a part for evaluating the
effect of rehabilitation and that for extracting problems in operation of
the online rehabilitation service. The part of rehabilitation effect
evaluation is based on Japanese version of the Cardiovascular Health Study
frailty index: weight loss, slow gait speed, low physical activity,
exhaustion, and low grip strength. The part also includes
questionnaire-based indices of subjective happiness and willingness for
social activities. On the other hand, the part of the problem extraction for
a sustainable operation of the service includes an interoperability between
the nursing facility site and the patient's home in terms of an online
service connecting them for a video-based rehabilitation exercise. The part
is based on the questionnaires and interviews for workers at the nursing
facility as well as those for the patient and family.In this case study, we
introduce an example of the proposed framework at the step of a service
design and discuss how to apply it to the service operation step. In a
rehabilitation service domain, neither the data distribution platform nor
the data bank is currently in operation. However, a rehabilitation
assessment system utilized the platform and data bank would be in service in
the future. For a sustainability of the service, it is important to
successfully integrate data, technologies, and human as a stakeholder. In
this paper, we also discuss a person-centered design for the integration
with a focus on considering life backgrounds and sense of values of the
patient as well as his/her home environment and risk management for the
rehabilitation exercise.