Perspectives and Preferences on Developing a Digital Human System for Intrinsic Capacity Monitoring Underpinned by World Health Organization’s Integrated Care for Older People Guideline: Qualitative Study

TL;DR

This study explores how older adults and healthcare professionals view a digital human system for monitoring functional capacity in older people, based on the WHO's care guidelines.

Contribution

The study provides new insights into the acceptance and design preferences for a digital human system to support intrinsic capacity monitoring in older adults.

Findings

Participants believed digital humans could enhance monitoring effectiveness and support self-management of functional capacity.

Challenges include accessibility, interaction difficulties, and trustworthiness of the system for older adults.

The system could reduce health worker workload and improve monitoring adherence through predictive and simulation functions.

Abstract

The Integrated Care for Older People (ICOPE) pathway, based on an assessment of intrinsic capacity (IC), aims to achieve dynamic monitoring of the functional capacity of older adults and to provide personalized care in the community. Digital human technology, incorporating multisensory interaction, has the potential to assist older adults in self-monitoring their IC, thereby alleviating the burden of longitudinal monitoring on community health workers.

This study aimed to explore the perspectives and preferences of older adults and health care professionals on developing a digital human system for IC monitoring. The focus of the study was on the degree of acceptance, potential functionality, and application environments to provide design solutions for system development.

A qualitative descriptive study design was conducted in Beijing, China, with purposively selected older adults (n=20) and health care professionals (n=17) who participated in 31 semistructured individual interviews and 1 focus group interview between August 2024 and January 2025. The health information technology acceptance model (HITAM) was used to develop the interview outline, and an inductive-deductive content analysis approach was adopted to analyze the collected data.

The interviews yielded 4 themes with associated 11 subthemes: (1) take stock of IC: perception and response to the decline of IC, current limitations of IC monitoring; (2) measurement factors for system acceptance and adoption: efficiency expectation, effort overload, and foundation of trust; (3) perceived value of the digital human in the system: function enhances monitoring effect, style promotes the execution ability of monitoring, and attitude soothes for emotional regrets; and (4) promote ecology of the system: linkage between community scenes, establishing health responsibility, and promoting equity in digital health. Most participants believed that the functions and advantages of digital humans would enhance the convenience and effectiveness of IC monitoring and support older adults to self-manage IC. However, the accessibility, interaction challenges, and trustworthiness of such digital human systems for older adults would require system developers and community health care workers to make efforts in terms of technology and interpersonal relationship building.

The digital human system for IC monitoring could potentially reduce the workload of community health workers while providing older adults an accessible way to objectively understand functional abilities. The digital human would be uniquely valuable in improving monitoring effectiveness and adherence, creating emotional connections with older adults, and predicting functional abilities. Additionally, the system's predictive and simulation functions could optimize the implementation of ICOPE by coordinating community scenarios and enhancing the professional capacity of health workers. However, challenges such as geographical and functional segregation, cognitive changes, and limited digital literacy, which may exacerbate digital health inequalities, still need to be addressed.

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