Table 3.

Storyboard narratives.

Home Health Connector. ‘Mrs Smith, aged 75, with co-morbidities, has come to the end of her prescription and repeats of medication and needs to see her GP for a new script. She is alerted by the device. Mrs Smith uses the device to book telehealth consultation with GP. GP confirms appointment for 3 pm and calls Mrs Smith and conducts telehealth review of Mrs Smith’s conditions. GP writes a new script. Script is sent to Mrs Smith’s pharmacy where script is verified and filled at 4 pm. Pharmacist finds issue with potential drug interaction on one of Mrs Smith’s OTC [over-the-counter] meds. Contacts GP to resolve. GP and pharmacist resolve issue and a new script is written and re-sent to the pharmacy. Pharmacy delivers med to Mrs Smith’s home and refills dose administration and within device and also refills any other authorised repeat medications. All activity is then recorded and reconciled on Mrs Smith’s My Health Record. All other notifications for medication delivery are re-set. Confirmation message sent to Mrs Smith’s GP when the device has completed the tasks.’

Supersize Me. The text in this storyboard was: ‘Born/pre-birth. Blood drawn. Genome sequenced and shared, stored. Predisposition, risk profile established. Get sick. Genome used (shared securely) for pharmacogenomic prescribing.’ [Problems are:] ‘Personalised pharmaceuticals facilitate complete decadence and hyper-indulgence. Gattaca?! Breaking the mind/body connection. White/worried/well.’

Better Social Connection and Health Via Technology. No text was supplied with this storyboard – the narrative was conveyed by graphics and accompanying dialogue. These showed an individual dealing with a bad day and wanting to talk to someone to receive emotional support. The person considers who s/he might be able to trust and feel safe to talk to, but knows that ‘I get to choose what and when I share’. The person uses a smartphone to talk to peers, knowing that ‘I can decide what action to take’ based on their advice. The story ends with the person living ‘happily ever after’.

Nanites/Nanobots. The drawings show a cancer patient injected with nanites [robots at the nano scale], that then attack the cancer and stay in the body to attack any new cancers. Questions raised in the accompanying text included: ‘What is the energy source for these nanites? What if the nanites go rogue or become contagious? iRobot 2.0. Who develops the technology, injects them, and talks to the individual? Who is responsible for the maintenance/fixes? Who funds/pays for this expensive technology? How do we decide which cancers get treated by nanites? If you engage in risk behaviour, do you get excluded from access to this treatment?’.

Predict My Health. This storyboard included a diagram showing an end-user with implants and a wearable device, with data emanating from the devices, integrated and then returned to the user, as well as shared with healthcare providers. The text gave the following details: ‘Smart use of data. Connecting siloed health providers. Effective feedback on health issues. Wearables/implants/devices (smart) send data to central hub. Using predictive technology, they are monitored, analysed and distributed. Alerts and warning are delivered to the individual and health providers, [leading to] recommendations and appropriate action. Risks [include] security, privacy, misuse, non-use, excluded users, affordability. [Benefits include] preventive measures and healthy lifestyle and cost savings’.

Too Much Information. This storyboard showed a person whose head hurts. S/he uses a smartphone to conduct a ‘full body scan’. ‘The report from the phone says: 30% risk of stroke, 50% chance of brain tumour, 75% chance of Alzheimer’s in the future, 25% chance of diabetes, 60% chance of cancer, 50% chance of brain damage, 10% chance of headache.’ This person decides that ‘There doesn’t seem much point in living’, and commits suicide by leaping off a bridge.

Dr Toilet. In this storyboard, the ‘smart’ toilet idea is used. The graphics show a man with a stomach ache. The man visits the toilet and receives a message on his smartphone: ‘Go see your doctor soon. Love, Dr Toilet.’ He visits his GP, who already has received his test results and is ready to discuss them with the man.

Companion Robots. The idea of the companion robot is included in a narrative. The robot is shown interacting with an elderly person in the home, performing cleaning duties and sending health data to other parties. A medical problem is detected and the person is taken by ambulance to hospital. Benefits identified are a ‘focus on elderly, keep at home for as long as possible, quality of life, social interactions, sensing health states – raising alarm, providing services’.

Personal Health Assistant. This storyboard details how a personal health-monitoring device used on a smartphone or smartwatch can be used. The images show the device monitoring the user’s blood pressure, weight, physical activities and blood glucose levels, sending the data to My Health Record and hospital CIS [Clinical Information System]. The user receives notifications about the preventive actions they should be taking and lives to 101 years. The accompanying text provides further details: ‘Selection of health/wellness inputs enabled by the IoT [Internet of Things]. Devices, wearables are contributing big data about your health, shopping, lifestyle, work/attendance, genomic info. The information is combined with datasets held with your permission, e.g. My Health Record, hospital CIS and community that you access/control. The personal health assistant integrates and analyses your information – AI, machine learning. Presents information to you tailored to the areas of interest to you and prompts for care of existing health conditions and preventive care. Medicines/treatment, shopping, activity/exercise. Healthier, happier lives. Regulatory framework – who owns [the data], who ensures safety and quality?’.

Allocation of Resources in a Digitised World. In this storyboard, issues of ‘information equity’ are raised. A person is shown ‘challenging the norm’ (wearing boxing gloves ready to strike a punching bag labelled ‘Norms’) and society is shown as being divided into ‘the healthy and unhealthy people’. This leads to an ‘ethical debate’ in which questions are raised relating to ‘fair and cost-effective allocation of resources’.

Monitoring Pregnancy. A digital device for monitoring pregnancy is shown in this storyboard. The text explains: ‘Women at home, universal extension of what is already happening – monitoring and surveillance. Gets rapid support and early intervention from midwife. Becomes pre-occupied with machine rather than with baby. Anxiety/stress, hypervigilance. Medicalised, technologized, disconnected from own body.’