Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Apr 18, 2025
Date Accepted: Sep 17, 2025
Perspectives and preferences on developing a digital human system for intrinsic capacity monitoring underpinned by WHO-ICOPE guideline: a qualitative study
ABSTRACT
Background:
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 multi-sensory interaction, has the potential to assist older adults in self-monitoring their IC, thereby alleviating the burden of longitudinal monitoring on community health workers.
Objective:
This study aimed to explore the perspectives and preferences of older adults and healthcare professionals on developing a digital human system for intrinsic capacity monitoring. The focus of the study was on degree of acceptance, potential functionality, and application environments to provide design solutions for system development.
Methods:
A qualitative descriptive study design was conducted in Beijing, China, with purposively selected older adults (n=20) and healthcare professionals (n=17) who participated in 31 semi-structured individual interviews and one focus group interview between August 2024 and January 2025. The health information technology acceptance model was employed to develop the interview outline, and an inductive combined with deductive content analyze approach was adopted to analysis the collected data.
Results:
The interviews yielded 4 themes with associated 11 subthemes, including (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 deficiencies; (4) Promote ecology of the system: linkage between community scenes, establishing health responsibility, and promoting equity in digital health.
Conclusions:
The digital human system for IC monitoring can reduce the workload of community health workers while providing an accessible way for older adults to objectively understand functional abilities. The digital human is uniquely valuable in improving monitoring effectiveness, creating emotional connections with older adults, and predicting functional abilities. Additionally, the system is expected to optimize the implementation of ICOPE by coordinating multiple contexts within the community and the professional responsibilities of community health workers. However, geographical and functional segregation, cognitive changes and digital literacy, which may exacerbate digital health inequalities, still need to be addressed.
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