FW-HTF-RM: The Future of Home Care Work: Designing Technologies for Trust, Privacy, and Empowerment

家庭保健助理是一线卫生工作者的重要群体，也是美国劳动力中增长最快的部门之一。家庭健康助理主要受雇于公共机构（医疗保险和医疗补助），目前照顾着4800万美国人。然而，这些工人面临着许多挑战，因为他们为患有严重疾病的人提供家庭护理，如心力衰竭、糖尿病、痴呆等。尽管与病人在一起的时间比其他任何护理人员都多，但家庭保健助理（主要是妇女和少数民族）工作过度，报酬微薄，承受着高度的压力和倦怠。他们现有的工具和技术生态系统已经过时，难以使用，而且主要围绕着监控家庭健康助手的工作，而不是支持他们的工作。家庭健康助理发现病人健康状况的变化令人恐惧，当他们需要临床帮助时，很难通过电话联系到监督他们的临床医生。最后，家庭保健助理在很大程度上是在孤立的情况下进行日常工作，没有能力得到同伴和主管的指导，也没有能力提高自己的技能和进步。本项目通过五项互补性研究活动解决了家庭保健助理面临的一些挑战，这些活动旨在提高家庭保健助理的工作满意度、患者接受的护理以及护理团队的整合。前两项活动为家庭健康助手提供了新的机制，通过多模式对话代理（提供语音、视频和文本指导，以安全完成任务）协助日常护理任务，从而获得与护理相关的信息和支持，并通过对话代理（提供医学验证信息）为临床问题提供决策支持。与此同时，迫切需要建立新的机制，使家庭保健助理与护理团队的其他成员之间能够进行可靠和及时的沟通和协调。接下来的两项活动通过开发一种将家庭保健助理直接与临床工作人员联系起来的异步通信工具来应对这一挑战；并通过新的多利益相关者和多时间尺度数据收集和报告机制，实现数据驱动的协同工作和护理协调。总的来说，这些创新为家庭健康护理人员提供了丰富的机会来学习和实践新技能，展示他们的专业知识，获得认可，并有意义地塑造患者护理。最后一项活动是通过新的培训项目创造学习和职业发展的机会，在提高患者治疗效果的同时保持进步和进步的感觉。这个项目作为一个整体，将提高未来家庭保健助理的技能、福利和职业。该奖项反映了美国国家科学基金会的法定使命，并通过使用基金会的知识价值和更广泛的影响审查标准进行评估，被认为值得支持。

Home health aides are an important group of frontline health workers and one of the fastest-growing sectors of the U.S. workforce. Largely employed by public agencies (Medicare and Medicaid), home health aides currently care for 48 million Americans. However, these workers face numerous challenges as they provide in-home care for people with serious illnesses such as heart failure, diabetes, dementia, and others. Despite spending more time with patients than any other care provider, home health aides, who are mostly women and minorities, are overworked, poorly compensated, and experience high levels of stress and burnout. Their existing tools and technology ecosystems are outdated, hard to use, and largely revolve around monitoring home health aides' labor rather than supporting their work. home health aides find changes in patients' health conditions frightening and struggle to reach supervising clinicians by phone when they need clinical help. Finally, home health aides largely operate day-to-day in isolation, without the ability to be mentored by peers and supervisors, or to grow their skills and advance. This project addresses some of the challenges home health aides face via five complementary research activities that aim to improve the work satisfaction of home health aides, the care received by patients, and the integration of the care team. The first two activities provide new mechanisms for home health aides to obtain care-related information and support by assisting with routine care tasks via multi-modal conversational agents that provide voice-, video-, and text-based guides for completing tasks safely, and providing decision support for clinical questions via a conversational agent that delivers medically-verified information. In parallel, there is a critical need for new mechanisms that enable reliable and timely communication and coordination between home health aides and the rest of the care team. The next two activities engage with this challenge by developing an asynchronous communication tool that connects home health aides directly with clinical staff; and enables data-driven cooperative work and care coordination via new multi-stakeholder and multiple timescale data collection and reporting mechanisms. Taken together, these innovations provide rich opportunities for home health aides to learn and practice new skills, demonstrate their expertise, receive recognition, and meaningfully shape patient care. The final activity creates opportunities for learning and career advancement via new training programs that sustain a sense of progress and advancement while improving patient outcomes. This project, taken as a whole, will improve the skills, well being, and careers of home health aides of the future.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.