[ { "_model": "Human reference standard", "themes": [ { "label": "Personalisation versus Standardisation in Care", "codes": [ { "label": "Desire for personalisation", "definition": "Participants desire personalisation despite the role of AI in healthcare", "instances": [ { "id": "T023", "quote": "you can have more directed support and check in more appropriately" }, { "id": "T037", "quote": "We as individuals monitor how we respond. I mean, there are at least three of us in this room who've gone against standard medical practice because it hasn't suited us." }, { "id": "T039", "quote": "I'd also add on top of that that in terms of people knowing themselves better and knowing their condition better." }, { "id": "T056", "quote": "It's actually speaking to someone who's going to get to know." }, { "id": "T127", "quote": "You might be happy to just have a phone call, but you might refer to actually go in and." } ] }, { "label": "Need for flexibility and adaption", "definition": "Participants expressed a need for flexibility in AI implementations", "instances": [ { "id": "T042", "quote": "for fluctuating conditions, can it change like that?" } ] }, { "label": "NHS lack of personalisation", "definition": "Participants expressed a lack of personalisation in the health service", "instances": [ { "id": "T010", "quote": "I found that The NHS approach to it is a blanket. It's a blanket approach" } ] }, { "label": "Desire for personalisation in AI interactions", "definition": "Participants reacted negatively to generic implementations of AI tools", "instances": [ { "id": "T037", "quote": "Everybody is different and so consequently, whatever comes in to AI, whatever is on The app, should be filtered through The experiences of that individual." } ] } ] } , { "label": "Information Reliability and Consequences of Poor Guidance", "codes": [ { "label": "Truth and misinformation", "definition": "Participants are wary of incorrect information", "instances": [ { "id": "T002", "quote": "you can often read things and then you do a little bit of research around it and you find that actually the truth is perhaps even the opposite." }, { "id": "T034", "quote": "Not with The best intention, but not make people worse just because it's based on like old evidence." }, { "id": "T113", "quote": "No, just fake news. Like all this, you know, fake stuff that's out there is just crazy. And I think people just need to be steered away from worrying" } ] }, { "label": "Harm from generic advice", "definition": "Participants desire personalisation when dealing with health services", "instances": [ { "id": "T006", "quote": "Absolutely, completely The wrong thing for me." }, { "id": "T028", "quote": "Complete wrong advice. I ended up osteopenic and when I googled osteopenia, what was I meant to be doing? Impact based. I was 10 years lost, not doing any of that." }, { "id": "T029", "quote": "The same as The nutrition thing, isn't it? If it's based on old information," } ] } ] }, { "label": "Barriers to Access and Continuity of Care", "codes": [ { "label": "Difficulty accessing healthcare", "definition": "Participants encountered difficulty in accessing face to face healthcare", "instances": [ { "id": "T018", "quote": "Of The problem is accessing health professionals. It's difficult to get you a GP" }, { "id": "T019", "quote": "Most of mine do like 80% phone consults in my area. You can't see anyone face to face for a lot of money." } ] }, { "label": "Care continuity/fragmentation", "definition": "Fragmentation in healthcare services was commonly reported", "instances": [ { "id": "T021", "quote": "it kept being a different nutritionist every time. And then I kept getting different advice on The same thing, depending on" }, { "id": "T069", "quote": "I think The problem might be The integration. So just take The NHS app. Not every NHS entity uses it, so I can see that as a problem." } ] } ] }, { "label": "Human Connection, Community, and Support", "codes": [ { "label": "Need for human and social interaction", "definition": "Despite increasing AI use, participants wanted to retain human interaction", "instances": [ { "id": "T040", "quote": "The community aspect of it, about people being able to connect with people locally, maybe with The same condition or maybe just with The same exercise routines. But The whole community thing with your condition as well has really helped me with one of my conditions, just being an online support group and all." }, { "id": "T049", "quote": "Because I like talking to people, whether it be on Zoom or in person or anything." }, { "id": "T052", "quote": "I think having The options to have a weekly or a fortnightly check in," } ] }, { "label": "Opinions of communities and peer support", "definition": "Mixed opinions were expressed surrounding communities and peer support", "instances": [ { "id": "T041", "quote": "Hate these communities. That's just me. I can't stand that. Stay away from them." }, { "id": "T040", "quote": "Also, I know what you said about The community aspect of it, about people being able to connect with people locally, maybe with The same condition" } ] }, { "label": "Peer support", "definition": "Participants expressed peer support during the focus group", "instances": [ { "id": "T174", "quote": "I was just thank you , it’s an amazing project, and it's been an honour to be here seriously." }, { "id": "T040", "quote": "just being an online support group and all. able To share our experiences and our treatments and The different treatments that people are being offered." } ] } ] }, { "label": "Trust, Transparency, and Skepticism", "codes": [ { "label": "Feedback on AI development", "definition": "Participants offered feedback on AI implementations with regards to language", "instances": [ { "id": "T084", "quote": "It's just The word compliance. It's not just to change The word target or something else." }, { "id": "T091", "quote": "I don't think there's any need to say that short sentence in The third paragraph. So then I encourage The positivity." } ] }, { "label": "Scepticism surrounding security", "definition": "Participants expressed concern over data sharing with third parties. Participants wanted to be informed and explicit consent given for AI use.", "instances": [ { "id": "T114", "quote": "Who is The data going to be shared? What's The security of your data? Should you know there's some hacking going on maybe with The NHS?" }, { "id": "T116", "quote": "Infos going in there, particularly about your own health conditions. Yeah, kind of want to know how secure The app is and then which health professionals are able to log in and." }, { "id": "T118", "quote": "The doctor didn't ask for my consent and The first I knew that AI had listened in on T" }, { "id": "T120", "quote": "they're just not telling The patients that they're recording it because they thought all The patients are going to get anxiety." }, { "id": "T135", "quote": "And also people agree to things. They don't realise what they're agreeing to. I think in the terms and conditions they haven't read through it all. Do we really know what we're handing over?" } ] }, { "label": "Scepticism of medical experts", "definition": "Participants expressed mistrust of medical experts and research", "instances": [ { "id": "T160", "quote": "there's a lot of mistrust with researchers." } ] } ] } ] }, { "codes": [ { "label": "Nutrition_Complexity_vs_Exercise", "definition": "Perception that nutrition guidance is more complex and contradictory compared to exercise recommendations", "instances": [ { "id": "T002", "quote": "Yeah, it is more complex as well, I think the nutrition side. So you're saying about things being debunked, you can often read things and then you do a little bit of research around it and you find that actually the truth is perhaps even the opposite." }, { "id": "T004", "quote": "Whereas that probably isn't The case much with exercise quite so much, and how it can even be quite the opposite." } ] }, { "label": "Personalized_Treatment_Necessity", "definition": "Strong emphasis on the need for individualized approaches rather than blanket treatments", "instances": [ { "id": "T006", "quote": "But there's nothing that comes alongside it saying this just works for me. So my protocol that I'm following now, my health practitioner wants me to eat 3500 calories a day, but then burn it off." }, { "id": "T010", "quote": "There'll be somebody else in The same clinic as me for melanoma that's got stage 4 melanoma, but it's different. It's completely different. And it's it's got to be tailored. I found that The NHS approach to it is a blanket." }, { "id": "T037", "quote": "We as individuals monitor how we respond. I mean, there are at least three of us in this room who've gone against standard medical practice because it hasn't suited us." } ] }, { "label": "Dangerous_Generic_Protocols", "definition": "Experiences where following generic health protocols led to harmful outcomes", "instances": [ { "id": "T006", "quote": "So when I was first diagnosed, I bought a juicing protocol from a guy that had beaten Stage 4 bowel cancer and I thought I've got a stage 4 cancer, I want to be it. So I bought his protocol... Absolutely, completely The wrong thing for me. So I had progression, nearly died" }, { "id": "T028", "quote": "Because what I'm a bit wary about was so a year rheumatology from when I got diagnosed, you said just tell me just do swimming or cycling. Don't put any pressure on your jobs. Complete wrong advice. I ended up osteopenic" } ] }, { "label": "Outdated_Professional_Knowledge", "definition": "Concern that healthcare professionals are providing advice based on outdated information", "instances": [ { "id": "T028", "quote": "But it's The completely wrong advice that The professionals in that field are giving for exercise. And I'm just worried if I went on this app and put in our arthritis, it'll instantly just send me towards all The exercises that are non impact and then it just making those people worse." }, { "id": "T029", "quote": "The same as The nutrition thing, isn't it? If it's based on old information," }, { "id": "T031", "quote": "So many of The experts are completely uninformed." } ] }, { "label": "Individual_Body_Awareness", "definition": "Patients developing deep understanding of their own bodies and conditions through experience", "instances": [ { "id": "T032", "quote": "I was told when I was diagnosed with long term inflammatory arthritis, they're not sure what kind. That's I couldn't ride (her horse). I used to be some professional rider and I couldn't play tennis... I do that, which is high impact and I I still run, not competitively anymore and I do occasionally not brand on The tennis court and my arthritis has improved immeasurably if I'm using it, not using it." }, { "id": "T037", "quote": "And I think that's something I'm actually really passionate about and what brought me into PPI anyway was people taking responsibility for The their own health, their own welfare, their own improvement. And for making The best of their own bodies." } ] }, { "label": "Trust_in_AI_Recommendations", "definition": "Skepticism about whether AI-generated exercise recommendations can be trusted", "instances": [ { "id": "T033", "quote": "Trust, it sounds like can we trust The recommendations? Where are these actually coming from? And because we do know it's so complicated with long term conditions, but really trusting that process of how that's been calculated" }, { "id": "T034", "quote": "yeah, because you don't want something that's going to make. Not with The best intention, but not make people worse just because it's based on like old evidence." } ] }, { "label": "AI_Learning_Potential", "definition": "Recognition that AI systems can learn and improve from user data over time", "instances": [ { "id": "T036", "quote": "So AI learns. So as Jake was saying in well in The video, The more people that use it, we don't want people to be giving these either. So we. There is a lot of pretty well established stuff that's in this, so not a scary one. But The more people that do use it, The more people that actually check in. How is that going? What's been going on? Am I right in thinking, Jake, The system will learn and that's what AI can do and it can readjust." } ] }, { "label": "Healthcare_Professional_Coaching_Role", "definition": "Understanding that health coaches facilitate rather than direct, working with individual knowledge", "instances": [ { "id": "T037", "quote": "We are The central member of that team. Everybody is different and so consequently, whatever comes in to AI, whatever is on The app, should be filtered through The experiences of that individual. And that's why The one to one coaching is so important." }, { "id": "T038", "quote": "Not necessarily that The coach knows more than The individual, but The coach in true coaching practice. This can get from The individual what that individual knows and work together with that knowledge." } ] }, { "label": "Community_Support_Benefits", "definition": "Positive experiences with peer support and knowledge sharing in health management", "instances": [ { "id": "T040", "quote": "Also, I know what you said about The community aspect of it, about people being able to connect with people locally, maybe with The same condition... But The whole community thing with your condition as well has really helped me with one of my conditions, just being an online support group and all. able To share our experiences and our treatments" }, { "id": "T074", "quote": "And I did a an 8 week weight loss program with an online coach which was in a community environment with our own Facebook group... You can constantly bouncing ideas off each other with regards to your training, The nutrition side of things we all you know." } ] }, { "label": "Community_Support_Concerns", "definition": "Negative views about online health communities and their potential drawbacks", "instances": [ { "id": "T041", "quote": "I know people like that, and I Hate these communities. That's just me. I can't stand that. Stay away from them. Yes, and it just always seems turns into a bit of a... Personally, I would find it turns into a bit of a bone fest of people trying to outdo who's got more pain" }, { "id": "T041", "quote": "As you say, some people give good advice, but you can't always figure out what's The good advice and what's The bad advice because there's kind of no medical moderation going on." } ] }, { "label": "Daily_Condition_Fluctuation", "definition": "Recognition that health conditions vary significantly from day to day, requiring adaptive approaches", "instances": [ { "id": "T042", "quote": "Thing, you know, like it has a certain exercise it gives you, but can it like regularly change and modify? So like with me, I can be having one particularly bad one day and then it's a completely different choice. So I've had to learn over The years just in my own head how to adapt." }, { "id": "T047", "quote": "But yeah, if you've got like, it can be there as well. Of a cyclical thing. My condition is also cyclical based on my menstrual cycle" } ] }, { "label": "NHS_Access_Barriers", "definition": "Difficulties in accessing healthcare professionals and services within the NHS", "instances": [ { "id": "T018", "quote": "Of The problem is accessing health professionals. It's difficult to get you a GP and they all The trainees that they they always say go A/E and then you can't cope with it." }, { "id": "T019", "quote": "Most of it's very odd. Most of mine do like 80% phone consults in my area. You can't see anyone face to face for a lot of money." }, { "id": "T024", "quote": "And then The other thing with this social prescribing, so in my area. They don't fund it because I've asked The GP many times, they said we don't fund it, these sort of things." } ] }, { "label": "Exercise_Equipment_Variety", "definition": "Interest in having diverse exercise options including different types of physical activities", "instances": [ { "id": "T026", "quote": "Yeah, I think was so I've got movement for arthritis. And are The exercises all Strength based, cardio based, there's other things. Is there a wide variety?" }, { "id": "T027", "quote": "Yeah, so we have 3 categories. So we have daily activity, which is that get moving, cleaning down, it's not really structure, it's just a spread, you know? And focus on The 20 minutes or 15 minutes today. We have a cardiovascular activity, which is your swimming, cycling, running, jogging and anything that you are capable of doing that. And then we have The strength sessions which are home based, gym based." } ] }, { "label": "Personal_Touch_Importance", "definition": "Strong preference for maintaining human interaction alongside digital tools", "instances": [ { "id": "T049", "quote": "Yeah, I do. I love it. I think. I wondered if there was a risk of you taking. You said you were going to bring AI into it, so if you were going to then take people away from it. Because I like talking to people, whether it be on Zoom or in person or anything." }, { "id": "T051", "quote": "I think it's key not to take people away from it." }, { "id": "T055", "quote": "Actually get with The in person appointments and you're saying you like that as well. Yeah, so The fact is hybrid almost. So it's not here's an app off you go, it's with you." } ] }, { "label": "Integration_Challenges", "definition": "Concerns about implementing new technology across the complex NHS system", "instances": [ { "id": "T069", "quote": "I think it's a brilliant idea. I think The problem might be The integration. So just take The NHS app. Not every NHS entity uses it, so I can see that as a problem." }, { "id": "T071", "quote": "Yeah, I'm getting all the departments, you know, on board. That's why I think that again, because I do think it's got it's a fantastic. That's The idea. It's got great potential. There's loads of ideas from everybody about it could have this, it could have that, it can enhance it this way. But it's just The The buy in, I think from The NHS" } ] }, { "label": "Digital_Exclusion_Concerns", "definition": "Worry about leaving behind those who are not digitally literate or lack access to technology", "instances": [ { "id": "T100", "quote": "So someone who doesn't have a special expensive phone, how would they access it?" }, { "id": "T123", "quote": "It's the testing thing - is this the thing where you're going to test it on elderly people and those who aren't as digitally literate? Not even do any of the GP stuff that requires apps and my sister has to manage patient stuff online." }, { "id": "T129", "quote": "yeah. And like a telephone helpline for some people with my mum, she she won't do online chat. Yeah, it has to be a person that she talks to. That's it." } ] }, { "label": "AI_Data_Privacy_Concerns", "definition": "Concerns about data security, privacy, and consent when using AI in healthcare", "instances": [ { "id": "T114", "quote": "Who is The data going to be shared? What's The security of your data? Should you know there's some hacking going on maybe with The NHS?" }, { "id": "T116", "quote": "Infos going in there, particularly about your own health conditions. Yeah, kind of want to know how secure The app is and then which health professionals are able to log in and. View what you're doing on there." }, { "id": "T118", "quote": "it's even like at The hospital now. So last time I saw my rheumatologist, he asked for my consent to record our console using AI and then it generates The clinic letter. But then when I went to The emergency clinic 2 weeks ago. The doctor didn't ask for my consent and The first I knew that AI had listened in on The conversation" } ] }, { "label": "AI_Understanding_Gap", "definition": "Limited understanding of what AI actually means and how it works in healthcare contexts", "instances": [ { "id": "T110", "quote": "It's a very, very broad term and that a lot of people are quite nervous about it or don't really understand what that means or how it's going to be used." }, { "id": "T121", "quote": "I'm not always necessarily sure how much health professionals know about what AI actually is. I remember because The problem is The definition of AI, it's. And again, as I said to you, I didn't know anything about this last year and I've had to really wrap my head around what actually makes it AI it continues to learn." } ] }, { "label": "Language_Preferences", "definition": "Preference for positive, empowering language over medical terminology", "instances": [ { "id": "T080", "quote": "Yeah, because I don't like this. I know it's used a lot in health care, but it just makes you feel as a patient and somehow painful, especially when you write your notes." }, { "id": "T084", "quote": "That's fine. It's just The word compliance. It's not just to change The word target or something else. So then I encourage The positivity. I think goal is probably a goal." }, { "id": "T085", "quote": "Yeah, something like that. Yeah, it's just compliance. It's sort of very medical. It's making... And people feel judged. And if you start goal word." } ] }, { "label": "Face_to_Face_Value", "definition": "Strong preference for in-person interactions over online consultations and meetings", "instances": [ { "id": "T149", "quote": "So I this is the first in person PPI. You know, but since COVID, everything went completely online and nothing I've been involved with has returned to face to face. But this is actually the first place we've played something about. Really. And that's partly why I wanted to take part because I've really missed." }, { "id": "T151", "quote": "Yeah, yeah, I I thought just as a one of there's something actual face to face that makes it strange, you know, and you can also read the body language." } ] }, { "label": "Recruitment_Strategy_Diversity", "definition": "Recognition of the need for diverse recruitment strategies to reach underrepresented groups", "instances": [ { "id": "T156", "quote": "The charities, I don't know what it's like for lots of charities, but I know specifically that there's a very specific demographic. Of patients who work in volunteer those charities and obviously The people that can afford it. So they tend to be elderly, white, retired, you know, middle class" }, { "id": "T160", "quote": "Or contact someone who works back for them to promote it. Because if people hear someone they know they trust, particularly with ethnic minorities, there's a lot of mistrust with researchers. So if they have someone like their Imam, someone they know, they trust." } ] }, { "label": "Accountability_Benefits", "definition": "Recognition that regular check-ins and accountability support help maintain exercise routines", "instances": [ { "id": "T076", "quote": "I think it certainly helps having that feedback, whether it be weekly or not every fault in that way, but I think it massively helps with The accountability as well, which is always my issue. I'll left to me one and I asked to look at my voice to Jim today. I'm going to Kirk instead, so I'm going to get to a Sunday." } ] }, { "label": "Cost_Effectiveness_Evidence", "definition": "Interest in demonstrating economic benefits and cost-effectiveness of the intervention", "instances": [ { "id": "T061", "quote": "That's what I was going to ask is if you can use The data to show improved outcomes to actually just find better funding. Yeah, and that's it. So yeah, it was updated in 20, I think it was 2014 and 2018 and 2022. But they basically said that we don't know how well exercise works as social prescribing. We can't add more funding or do anything else with it because The data collection hasn't been there." } ] }, { "label": "Wearable_Technology_Integration", "definition": "Interest in integrating fitness trackers and wearable devices with the exercise app", "instances": [ { "id": "T177", "quote": "I was going to ask, so if my watch that tells him all sorts of profession has sleep scores and heart rate, he uses it when he's exercising as well. Is there a way for build that in in or how much benefit would you actually have?" }, { "id": "T178", "quote": "Everything we do is successful at The moment. We link to strava and we can link to garmin and polar watches. So that if you wanted to do a you can log in and unload straight away The data collection that's beneficial for us." } ] } ], "themes": [ { "label": "Personalization_vs_Standardization", "definition": "The tension between providing standardized healthcare solutions and the critical need for individualized approaches based on personal experience and unique condition presentations", "codes": [ "Personalized_Treatment_Necessity", "Dangerous_Generic_Protocols", "Individual_Body_Awareness", "Daily_Condition_Fluctuation" ], "evidence": [ { "id": "T006", "quote": "But there's nothing that comes alongside it saying this just works for me. So my protocol that I'm following now, my health practitioner wants me to eat 3500 calories a day, but then burn it off." }, { "id": "T010", "quote": "There'll be somebody else in The same clinic as me for melanoma that's got stage 4 melanoma, but it's different. It's completely different. And it's it's got to be tailored. I found that The NHS approach to it is a blanket." }, { "id": "T037", "quote": "We as individuals monitor how we respond. I mean, there are at least three of us in this room who've gone against standard medical practice because it hasn't suited us." }, { "id": "T042", "quote": "Thing, you know, like it has a certain exercise it gives you, but can it like regularly change and modify? So like with me, I can be having one particularly bad one day and then it's a completely different choice." } ] }, { "label": "Trust_and_Evidence_Quality", "definition": "Concerns about the reliability of health recommendations, particularly regarding outdated professional knowledge and the need for trustworthy AI-generated advice", "codes": [ "Trust_in_AI_Recommendations", "Outdated_Professional_Knowledge", "AI_Learning_Potential" ], "evidence": [ { "id": "T033", "quote": "Trust, it sounds like can we trust The recommendations? Where are these actually coming from? And because we do know it's so complicated with long term conditions, but really trusting that process of how that's been calculated" }, { "id": "T028", "quote": "But it's The completely wrong advice that The professionals in that field are giving for exercise. And I'm just worried if I went on this app and put in our arthritis, it'll instantly just send me towards all The exercises that are non impact and then it just making those people worse." }, { "id": "T031", "quote": "So many of The experts are completely uninformed." } ] }, { "label": "Human_Connection_in_Digital_Health", "definition": "The importance of maintaining human interaction and support alongside digital health tools, emphasizing the irreplaceable value of personal relationships in healthcare", "codes": [ "Personal_Touch_Importance", "Healthcare_Professional_Coaching_Role", "Face_to_Face_Value", "Community_Support_Benefits", "Community_Support_Concerns" ], "evidence": [ { "id": "T049", "quote": "Yeah, I do. I love it. I think. I wondered if there was a risk of you taking. You said you were going to bring AI into it, so if you were going to then take people away from it. Because I like talking to people, whether it be on Zoom or in person or anything." }, { "id": "T038", "quote": "Not necessarily that The coach knows more than The individual, but The coach in true coaching practice. This can get from The individual what that individual knows and work together with that knowledge." }, { "id": "T149", "quote": "So I this is the first in person PPI. You know, but since COVID, everything went completely online and nothing I've been involved with has returned to face to face. But this is actually the first place we've played something about. Really." } ] }, { "label": "Digital_Inclusion_and_Access", "definition": "Challenges around ensuring equitable access to digital health tools, including concerns about digital literacy, technology access, and maintaining inclusive approaches", "codes": [ "Digital_Exclusion_Concerns", "NHS_Access_Barriers", "Integration_Challenges", "Recruitment_Strategy_Diversity" ], "evidence": [ { "id": "T100", "quote": "So someone who doesn't have a special expensive phone, how would they access it?" }, { "id": "T018", "quote": "Of The problem is accessing health professionals. It's difficult to get you a GP and they all The trainees that they they always say go A/E and then you can't cope with it." }, { "id": "T156", "quote": "The charities, I don't know what it's like for lots of charities, but I know specifically that there's a very specific demographic. Of patients who work in volunteer those charities and obviously The people that can afford it. So they tend to be elderly, white, retired, you know, middle class" } ] }, { "label": "AI_Transparency_and_Privacy", "definition": "Concerns about understanding what AI means in healthcare contexts, data privacy, security, and the need for transparent communication about AI use", "codes": [ "AI_Data_Privacy_Concerns", "AI_Understanding_Gap" ], "evidence": [ { "id": "T114", "quote": "Who is The data going to be shared? What's The security of your data? Should you know there's some hacking going on maybe with The NHS?" }, { "id": "T110", "quote": "It's a very, very broad term and that a lot of people are quite nervous about it or don't really understand what that means or how it's going to be used." }, { "id": "T118", "quote": "it's even like at The hospital now. So last time I saw my rheumatologist, he asked for my consent to record our console using AI and then it generates The clinic letter. But then when I went to The emergency clinic 2 weeks ago. The doctor didn't ask for my consent" } ] }, { "label": "Implementation_and_Sustainability", "definition": "Practical considerations for successfully implementing and sustaining digital health interventions, including system integration, cost-effectiveness, and ongoing support mechanisms", "codes": [ "Cost_Effectiveness_Evidence", "Accountability_Benefits", "Language_Preferences", "Wearable_Technology_Integration" ], "evidence": [ { "id": "T061", "quote": "That's what I was going to ask is if you can use The data to show improved outcomes to actually just find better funding. Yeah, and that's it. So yeah, it was updated in 20, I think it was 2014 and 2018 and 2022. But they basically said that we don't know how well exercise works as social prescribing." }, { "id": "T076", "quote": "I think it certainly helps having that feedback, whether it be weekly or not every fault in that way, but I think it massively helps with The accountability as well, which is always my issue." }, { "id": "T084", "quote": "That's fine. It's just The word compliance. It's not just to change The word target or something else. So then I encourage The positivity. I think goal is probably a goal." } ] } ] }, { "_model": "Human analyst 1", "themes": [ { "label": "Value of human-human interaction", "codes": [ { "label": "Personable approach", "definition": "Preference for a human, personalised touch that accounts for individual factors.", "instances": [ { "id": "T057", "quote": "You know, there's so many personal factors there. I'd like to be having the weather ..." }, { "id": "T058", "quote": "yeah, you react to hormones." }, { "id": "T059", "quote": "Yeah. And there's just so many factors that I think that personal touch is almost going to be. Yeah, it sounds like this." } ] }, { "label": "Continuity of care", "definition": "Value placed on consistent check-ins and ongoing relationships with the same person.", "instances": [ { "id": "T074", "quote": "I like the idea of it. I love the community aspects of it. But just on that, you know, in January this year with everything else, I took on a massive lifestyle changes, started looking after myself." }, { "id": "T052", "quote": "I think having the options to have a weekly or a fortnightly check in," }, { "id": "T056", "quote": "It's not just put in what's hurting that day or what's the problem. It's actually speaking to someone who's going to get to know." }, { "id": "T023", "quote": "…you can have more directed support and check in more appropriately…that same health coach checking in every two weeks, 4 weeks." } ] } ] }, { "label": "Experiences within healthcare", "codes": [ { "label": "Inconsistencies in access/treatment", "definition": "Perceived ‘postcode lottery’ and uneven access to appropriate or effective care.", "instances": [ { "id": "T040", "quote": "It's almost like a postcode lottery… some of the people are being offered treatments that is known to make it worse… advise them towards other treatments… perhaps experimental treatments that aren't being offered everywhere." } ] }, { "label": "Inconsistent information", "definition": "Concerns that guidance is outdated or experts are uninformed.", "instances": [ { "id": "T029", "quote": "The same as the nutrition thing, isn't it? If it's based on old information," }, { "id": "T030", "quote": "yes, yeah, because that's out of date." }, { "id": "T031", "quote": "So many of the experts are completely uninformed." } ] } ] }, { "label": "Integrating AI", "codes": [ { "label": "Use of portable modalities of technology", "definition": "Interest in (and questions about) integrating wearables and activity platforms.", "instances": [ { "id": "T177", "quote": "…if my watch… has sleep scores and heart rate… Is there a way… how much benefit would you actually have? … I don't know how beneficial they are." }, { "id": "T178", "quote": "We link to Strava and we can link to Garmin and Polar watches… data collection… heart rate zones… optimize." } ] }, { "label": "Apprehension of new technology", "definition": "Hesitancy or resistance toward adopting new tech.", "instances": [ { "id": "T182", "quote": "I must. I'm not sure. I tend to resist technology." } ] } ] }, { "label": "User experience", "codes": [ { "label": "Compliance/accountability", "definition": "Feedback loops and accountability help adherence; sensitivity to ‘compliance’ framing.", "instances": [ { "id": "T076", "quote": "I think it certainly helps having that feedback… it massively helps with the accountability as well…" } ] }, { "label": "Change in users’ behaviour", "definition": "Self-reported lifestyle or behaviour change linked to support/community.", "instances": [ { "id": "T074", "quote": "…in January this year… I took on a massive lifestyle changes, started looking after myself." } ] } ] }, { "label": "Role of healthcare staff", "codes": [ { "label": "Appropriate/inappropriate use of AI by healthcare staff/in healthcare", "definition": "Understanding of AI’s learning nature, consent, and trustworthy use in clinical settings.", "instances": [ { "id": "T121", "quote": "…what actually makes it AI — it continues to learn… the minute your data is in the system, it's being used to learn and adapt… once it's in, you can't get it back out." }, { "id": "T118", "quote": "…rheumatologist asked for my consent to record… AI… doctor didn't ask for my consent… first I knew… was on the discharge summary…" }, { "id": "T120", "quote": "…they're just not telling the patients that they're recording it because they thought all the patients are going to get anxiety." } ] } ] }, { "label": "Diversity, equity and inclusion", "codes": [ { "label": "Reaching underrepresented/marginalised groups", "definition": "Using trusted community messengers and settings to build trust and engagement.", "instances": [ { "id": "T160", "quote": "…particularly with ethnic minorities, there's a lot of mistrust with researchers… if they have someone like their Imam… doing the recruiting… they're more likely to show interest." } ] } ] } ] }, { "_model": "Human Analyst 2", "themes": [ { "label": "Patients as Individuals", "codes": [ { "label": "Accessibility", "definition": "Integration of AI systems in a way that caters to patients limitations in regards to accessing such software", "instances": [ { "id": "T129", "quote": "And like a telephone helpline for some people with my mum, she she won't do online chat." }, { "id": "T154", "quote": "I think not every person would be you couldn't drive. Not everyone could come on a weekday because they're working" }, { "id": "T156", "quote": "I know specifically that there's a very specific demographic. Of patients who work in volunteer those charities and obviously The people that can afford it. So they tend to be elderly, white, retired, you know, middle class" } ] }, { "label": "Patient Ownership", "definition": "Discussion of patient’s ownership of health conditions and own knowledge around its impact and management.", "instances": [ { "id": "T028", "quote": "They need to be impacting their joints and and I get worried that it's going to go down that route that The moment you say y ou've got arthritis you’ll just be confined to chair based exercises" }, { "id": "T037", "quote": "We as individuals monitor how we respond. I mean, there are at least three of us in this room who've gone against standard medical practice because it hasn't suited us." }, { "id": "T039", "quote": "I'd also add on top of that that in terms of people knowing themselves better and knowing their condition better" } ] } ] }, { "label": "Healthcare Perceptions", "codes": [ { "label": "Conflicting Information/ Misinformation", "definition": "Relating to information already given to patients, and how this often conflicts with other sources.", "instances": [ { "id": "T002", "quote": "you can often read things and then you do a little bit of research around it and you find that actually the truth is perhaps even the opposite" }, { "id": "T006", "quote": "Absolutely, completely The wrong thing for me. So I had progression, nearly died, then decided" }, { "id": "T007", "quote": "Because you say it's unique to each person and yeah, and so many different types of treatments and The medications" } ] }, { "label": "Healthcare System Limitations", "definition": "Discussion around current limitations of the healthcare system.", "instances": [ { "id": "T018", "quote": "It's difficult to get you a GP and they all The trainees that they they always say go A/E" }, { "id": "T019", "quote": "Most of mine do like 80% phone consults in my area. You can't see anyone face to face for a lot of money" }, { "id": "TXXX", "quote": "It's almost like a postcode lottery and that some of The people are being offered treatments" } ] } ] }, { "label": "Role of AI in Healthcare", "codes": [ { "label": "System Integration", "definition": "Opinions on how AI should be integrated into existing healthcare systems", "instances": [ { "id": "T083", "quote": "which I feel like that should be a choice thing because I'd appreciate it" }, { "id": "T099", "quote": ". It's being made so that everyone has a fair chance to use it, even if they don't have special expensive phones" }, { "id": "T146", "quote": "Who? Whose voices should be there? I guess what section?" } ] }, { "label": "AI Interactions In Healthcare", "definition": "AI Interactions in healthcare. (slightly different in that not comparing human vs AI, feels like it fits with more of the transcript).", "instances": [ { "id": "T118", "quote": "it's even like at The hospital now. So last time I saw my [doctor][redacted], he asked for my consent torecord our console using AI" }, { "id": "T120", "quote": "she's a GP and now they're starting to record The consults at their surgery" } ] }, { "label": "Patient Involvement/Expertise in Development", "definition": "Discussion focusing on involvement of users of AI in a healthcare setting and how such individuals may want AI systems to function.", "instances": [ { "id": "T074", "quote": "The only reason obviously because that's obviously underdeveloped, obviously it'd be very easy to integrate The nutrition side of things as well" }, { "id": "T086", "quote": "about The mental health aspect of things and how your physical health and your mental health is so tied together, that encouraging that positivity rather than judgment would be" }, { "id": "T127", "quote": "And some people will be more independent and that can be built into it." } ] } ] }, { "label": "Concerns of AI Integration", "codes": [ { "label": "Consent and Transparency", "definition": "Concerns around consent/ the lack of in the use of AI tools, as well as transparency that such tools are being used.", "instances": [ { "id": "T114", "quote": "Who is The data going to be shared? What's The security of your data" }, { "id": "T117", "quote": "Yeah, and understanding that if AI is being used, when you enter your data in, not then withdraw that even though it's anonymized" }, { "id": "T118", "quote": "The hospital now. So last time I saw my [doctor][redacted], he asked for my consent to record our console using AI" } ] }, { "label": "Privacy and Data Concerns", "definition": "Concerns surrounding handling of data and privacy for sensitive healthcare data.", "instances": [ { "id": "T110", "quote": "And there's already been a bit of a discussion about, you know, it's actually more from The data side of things than from" }, { "id": "T114", "quote": "Who is The data going to be shared? What's The security of your data" }, { "id": "T116", "quote": "Yeah, kind of want to know how secure The app is and then which health professionals are able to log in and. View what you're doing on there" } ] } ] }, { "label": "Social Support", "codes": [ { "label": "Peer Support", "definition": "Discussion around peer involvement within management of health conditions.", "instances": [ { "id": "T040", "quote": "But The whole community thing with your condition as well has really helped me with one of my conditions" }, { "id": "T065", "quote": "I I used to take maybe 8 or 10 people from there because they used to come. We had a centre, they used to come." }, { "id": "T074", "quote": ". So it was it wasn't just a case of getting on and being left on your own. You can constantly bouncing ideas off each other" } ] } ] } ] }, { "_model": "InductiveAnalysis-GPT 5", "_run_id": "run_20240221_001", "codes": [ { "label": "Nutrition complexity and misinformation", "definition": "Participants describe nutrition as more complex and subject to misinformation than exercise.", "instances": [ { "id": "T002", "quote": "Yeah, it is more complex as well, I think the nutrition side... you find that actually the truth is perhaps even the opposite." }, { "id": "T004", "quote": "Whereas that probably isn't the case much with exercise quite so much, and how it can even be quite the opposite." } ] }, { "label": "Individualised health approaches", "definition": "The need for health recommendations tailored to an individual’s conditions and circumstances.", "instances": [ { "id": "T005", "quote": "and then how The truth applies to you and your particular multiple long -term conditions and The interaction of them all with The exercise, etcetera, etcetera." }, { "id": "T010", "quote": "And it's it's got to be tailored. I found that The NHS approach to it is a blanket... regardless of what The body's doing." } ] }, { "label": "Harmful experiences from generic advice", "definition": "Participants share examples of receiving advice or following protocols that worsened their condition.", "instances": [ { "id": "T006", "quote": "So I bought his protocol... Absolutely, completely The wrong thing for me. So I had progression, nearly died." }, { "id": "T028", "quote": "Don't put any pressure on your jobs. Complete wrong advice. I ended up osteopenic... lost 10 years." } ] }, { "label": "Challenges with calorie and diet management", "definition": "Struggles with balancing diet (calories, carbs, protein) while managing health.", "instances": [ { "id": "T007", "quote": "If if it's just my, it's an absolute minefield. If you're limited on carbs and protein..." }, { "id": "T009", "quote": "Basically, if you struggle to get your calories, you take a shot of olive oil." } ] }, { "label": "Burden of navigating conflicting advice", "definition": "Difficulty when given contradictory information from different health professionals or apps.", "instances": [ { "id": "T021", "quote": "I kept getting different advice on The same thing, depending on which nutritionist happened to be replying..." }, { "id": "T028", "quote": "But it's The completely wrong advice that The professionals in that field are giving for exercise." } ] }, { "label": "Need for continuity of care", "definition": "Desire for consistent support from the same health professional.", "instances": [ { "id": "T021", "quote": "I thought it was going to be like some ongoing sort of like almost one -to-one support. But... it was just different people." } ] }, { "label": "Access difficulties in health system", "definition": "Difficulty accessing GPs and health professionals.", "instances": [ { "id": "T018", "quote": "Of the problem is accessing health professionals. It's difficult to get you a GP..." }, { "id": "T019", "quote": "Most of mine do like 80% phone consults in my area. You can't see anyone face to face for a lot of money." } ] }, { "label": "Concerns about limited NHS support", "definition": "Frustrations with NHS’s blanket or limited approach to conditions and care.", "instances": [ { "id": "T010", "quote": "And it's it's got to be tailored. I found that The NHS approach to it is a blanket..." }, { "id": "T024", "quote": "They don't fund it because I've asked The GP many times, they said we don't fund it." } ] }, { "label": "Trust in evidence and keeping up to date", "definition": "Concerns about whether recommendations are based on accurate and up-to-date evidence.", "instances": [ { "id": "T029", "quote": "The same as The nutrition thing, isn't it? If it's based on old information," }, { "id": "T034", "quote": "you don't want something... not make people worse just because it's based on like old evidence." }, { "id": "T035", "quote": "everyone getting the same information... being constantly updated with the latest." } ] }, { "label": "AI learning and adaptation", "definition": "Expectations and uncertainties regarding AI adapting recommendations over time.", "instances": [ { "id": "T036", "quote": "The more people that use it... the system will learn and that's what AI can do and it can readjust." } ] }, { "label": "Self-responsibility and body awareness", "definition": "Participants emphasise their responsibility to monitor their own bodies and health practices.", "instances": [ { "id": "T037", "quote": "We as individuals monitor how we respond... our bodies are ours and we are responsible..." }, { "id": "T038", "quote": "Not necessarily that The coach knows more than The individual... work together with that knowledge." } ] }, { "label": "Value of community support", "definition": "Peer community seen as valuable for sharing advice and moral support.", "instances": [ { "id": "T040", "quote": "That community aspect... being an online support group... able to share our experiences and our treatments." }, { "id": "T074", "quote": "I did a an 8-week weight loss program with an online coach... in a community environment with our own Facebook group." } ] }, { "label": "Skepticism toward online communities", "definition": "Dislike of peer groups due to negative or unreliable advice.", "instances": [ { "id": "T041", "quote": "I hate these communities. That's just me. I can't stand that. Stay away from them... no medical moderation going on." } ] }, { "label": "Need for flexible, adaptive programs", "definition": "Importance of plans that can adapt to bad days, cycles, and changing symptoms.", "instances": [ { "id": "T042", "quote": "So like with me, I can be having one particularly bad one day... can it change like that?" }, { "id": "T047", "quote": "My condition is also cyclical based on my menstrual cycle... under researched... that does affect my ability to exercise." } ] }, { "label": "Concerns about depersonalisation by AI", "definition": "Fear that AI might reduce human contact and support.", "instances": [ { "id": "T049", "quote": "I wondered if there was a risk... taking people away... I like talking to people." }, { "id": "T051", "quote": "I think it's key not to take people away from it." } ] }, { "label": "Importance of accountability and motivation", "definition": "Desire for ongoing check-ins and reminders to sustain motivation.", "instances": [ { "id": "T076", "quote": "I think it massively helps with The accountability as well... I'll left to me... I’m going to Kirk instead." } ] }, { "label": "Negative perceptions of compliance language", "definition": "Frustration with clinical language like 'compliance' that feels judgmental.", "instances": [ { "id": "T080", "quote": "Yeah, because I don't like this... it just makes you feel as a patient and somehow painful..." }, { "id": "T084", "quote": "That's fine. It's just The word compliance. It's not just to change The word target or something else." }, { "id": "T085", "quote": "Yeah, it's just compliance... people feel judged." } ] }, { "label": "Digital exclusion concerns", "definition": "Challenges for people unable or unwilling to use online tools.", "instances": [ { "id": "T123", "quote": "Are you going to test it on elderly people and those who aren't as digitally literate?" }, { "id": "T129", "quote": "Yeah. And like a telephone helpline... my mum... she won't do online chat. It has to be a person." } ] }, { "label": "Data privacy and consent worries", "definition": "Concerns about AI, surveillance, and lack of informed consent in health data use.", "instances": [ { "id": "T114", "quote": "Who is The data going to be shared? What's The security of your data?" }, { "id": "T118", "quote": "he asked for my consent to record our console using AI... The doctor didn’t ask for my consent." }, { "id": "T135", "quote": "And also people agree to things... Do we really know what we're handing over?" } ] }, { "label": "Integration challenges with NHS systems", "definition": "Concerns about difficulty embedding new tools into NHS structures.", "instances": [ { "id": "T069", "quote": "I think The problem might be The integration. So just take The NHS app. Not every NHS entity uses it." }, { "id": "T071", "quote": "But it's just The The buy in, I think from The NHS, which can be a bit." } ] } ], "themes": [ { "label": "Individualisation vs. Blanket Approaches", "definition": "Participants highlight the importance of tailored, adaptive interventions versus generic or standardised treatments.", "codes": [ "Individualised health approaches", "Harmful experiences from generic advice", "Need for flexible, adaptive programs" ], "evidence": [ { "id": "T005", "quote": "how The truth applies to you and your particular multiple long -term conditions..." }, { "id": "T006", "quote": "Absolutely, completely The wrong thing for me. So I had progression, nearly died." }, { "id": "T042", "quote": "can it change like that?" } ] }, { "label": "Trust and Evidence in Health Guidance", "definition": "Concerns about misinformation, outdated advice, and the trustworthiness of recommendations.", "codes": [ "Nutrition complexity and misinformation", "Trust in evidence and keeping up to date", "Burden of navigating conflicting advice" ], "evidence": [ { "id": "T002", "quote": "you can often read things... the truth is perhaps even the opposite." }, { "id": "T029", "quote": "If it's based on old information," }, { "id": "T021", "quote": "different advice on The same thing, depending on which nutritionist..." } ] }, { "label": "Systemic Barriers in Healthcare Access", "definition": "Challenges in navigating a fragmented or underfunded health system, including NHS limitations.", "codes": [ "Access difficulties in health system", "Concerns about limited NHS support", "Integration challenges with NHS systems" ], "evidence": [ { "id": "T018", "quote": "Of The problem is accessing health professionals. It's difficult to get you a GP" }, { "id": "T024", "quote": "They don't fund it..." }, { "id": "T069", "quote": "Not every NHS entity uses it, so I can see that as a problem." } ] }, { "label": "Human Support vs. Digital Tools", "definition": "Tension between desire for personal interaction and the shift toward digital/AI-driven support.", "codes": [ "Concerns about depersonalisation by AI", "Need for continuity of care", "Importance of accountability and motivation" ], "evidence": [ { "id": "T049", "quote": "I like talking to people, whether it be on Zoom or in person..." }, { "id": "T021", "quote": "I kept getting different advice... I thought it was going to be ongoing one-to-one support." }, { "id": "T076", "quote": "I think it massively helps with The accountability as well..." } ] }, { "label": "Ethics, Consent and Data Security", "definition": "Concerns about data privacy, informed consent, and the ethical implications of AI.", "codes": [ "Data privacy and consent worries", "AI learning and adaptation" ], "evidence": [ { "id": "T114", "quote": "Who is The data going to be shared? What's The security of your data?" }, { "id": "T118", "quote": "he asked for my consent... The doctor didn't ask my consent..." }, { "id": "T036", "quote": "The more people that use it... the system will learn and... readjust." } ] }, { "label": "Community and Peer Support – Benefits and Pitfalls", "definition": "Different perspectives on whether peer communities add support or confusion.", "codes": [ "Value of community support", "Skepticism toward online communities" ], "evidence": [ { "id": "T040", "quote": "That community aspect... sharing experiences and treatments." }, { "id": "T074", "quote": "8-week weight loss program... community environment with our own Facebook group." }, { "id": "T041", "quote": "I hate these communities... always seems... who's got more pain." } ] }, { "label": "Language and Psychological Safety", "definition": "How language used in apps or healthcare impacts patient perception and emotional response.", "codes": [ "Negative perceptions of compliance language", "Self-responsibility and body awareness" ], "evidence": [ { "id": "T080", "quote": "it just makes you feel as a patient and somehow painful" }, { "id": "T084", "quote": "change The word compliance... encourage The positivity" }, { "id": "T037", "quote": "Our bodies are ours and we are responsible..." } ] }, { "label": "Digital Divide and Accessibility", "definition": "Exclusion risks for people less confident with technology or preferring offline contact.", "codes": [ "Digital exclusion concerns", "Challenges with calorie and diet management" ], "evidence": [ { "id": "T123", "quote": "Are you going to test it on elderly people and those who aren't as digitally literate?" }, { "id": "T129", "quote": "my mum... won't do online chat. It has to be a person..." }, { "id": "T007", "quote": "it's an absolute minefield. If you're limited on carbs and protein..." } ] } ] }, { "_model": "claude-sonnet-4-20250514", "_run_id": "pace_mltc_001_2024_09_17", "codes": [ { "label": "Nutrition_Complexity_vs_Exercise", "definition": "Perception that nutrition guidance is more complex and contradictory compared to exercise recommendations", "instances": [ { "id": "T002", "quote": "Yeah, it is more complex as well, I think the nutrition side. So you're saying about things being debunked, you can often read things and then you do a little bit of research around it and you find that actually the truth is perhaps even the opposite." }, { "id": "T004", "quote": "Whereas that probably isn't The case much with exercise quite so much, and how it can even be quite the opposite." } ] }, { "label": "Personalized_Treatment_Necessity", "definition": "Strong emphasis on the need for individualized approaches rather than blanket treatments", "instances": [ { "id": "T006", "quote": "But there's nothing that comes alongside it saying this just works for me. So my protocol that I'm following now, my health practitioner wants me to eat 3500 calories a day, but then burn it off." }, { "id": "T010", "quote": "There'll be somebody else in The same clinic as me for melanoma that's got stage 4 melanoma, but it's different. It's completely different. And it's it's got to be tailored. I found that The NHS approach to it is a blanket." }, { "id": "T037", "quote": "We as individuals monitor how we respond. I mean, there are at least three of us in this room who've gone against standard medical practice because it hasn't suited us." } ] }, { "label": "Dangerous_Generic_Protocols", "definition": "Experiences where following generic health protocols led to harmful outcomes", "instances": [ { "id": "T006", "quote": "So when I was first diagnosed, I bought a juicing protocol from a guy that had beaten Stage 4 bowel cancer and I thought I've got a stage 4 cancer, I want to be it. So I bought his protocol... Absolutely, completely The wrong thing for me. So I had progression, nearly died" }, { "id": "T028", "quote": "Because what I'm a bit wary about was so a year rheumatology from when I got diagnosed, you said just tell me just do swimming or cycling. Don't put any pressure on your jobs. Complete wrong advice. I ended up osteopenic" } ] }, { "label": "Outdated_Professional_Knowledge", "definition": "Concern that healthcare professionals are providing advice based on outdated information", "instances": [ { "id": "T028", "quote": "But it's The completely wrong advice that The professionals in that field are giving for exercise. And I'm just worried if I went on this app and put in our arthritis, it'll instantly just send me towards all The exercises that are non impact and then it just making those people worse." }, { "id": "T029", "quote": "The same as The nutrition thing, isn't it? If it's based on old information," }, { "id": "T031", "quote": "So many of The experts are completely uninformed." } ] }, { "label": "Individual_Body_Awareness", "definition": "Patients developing deep understanding of their own bodies and conditions through experience", "instances": [ { "id": "T032", "quote": "I was told when I was diagnosed with long term inflammatory arthritis, they're not sure what kind. That's I couldn't ride (her horse). I used to be some professional rider and I couldn't play tennis... I do that, which is high impact and I I still run, not competitively anymore and I do occasionally not brand on The tennis court and my arthritis has improved immeasurably if I'm using it, not using it." }, { "id": "T037", "quote": "And I think that's something I'm actually really passionate about and what brought me into PPI anyway was people taking responsibility for The their own health, their own welfare, their own improvement. And for making The best of their own bodies." } ] }, { "label": "Trust_in_AI_Recommendations", "definition": "Skepticism about whether AI-generated exercise recommendations can be trusted", "instances": [ { "id": "T033", "quote": "Trust, it sounds like can we trust The recommendations? Where are these actually coming from? And because we do know it's so complicated with long term conditions, but really trusting that process of how that's been calculated" }, { "id": "T034", "quote": "yeah, because you don't want something that's going to make. Not with The best intention, but not make people worse just because it's based on like old evidence." } ] }, { "label": "AI_Learning_Potential", "definition": "Recognition that AI systems can learn and improve from user data over time", "instances": [ { "id": "T036", "quote": "So AI learns. So as Jake was saying in well in The video, The more people that use it, we don't want people to be giving these either. So we. There is a lot of pretty well established stuff that's in this, so not a scary one. But The more people that do use it, The more people that actually check in. How is that going? What's been going on? Am I right in thinking, Jake, The system will learn and that's what AI can do and it can readjust." } ] }, { "label": "Healthcare_Professional_Coaching_Role", "definition": "Understanding that health coaches facilitate rather than direct, working with individual knowledge", "instances": [ { "id": "T037", "quote": "We are The central member of that team. Everybody is different and so consequently, whatever comes in to AI, whatever is on The app, should be filtered through The experiences of that individual. And that's why The one to one coaching is so important." }, { "id": "T038", "quote": "Not necessarily that The coach knows more than The individual, but The coach in true coaching practice. This can get from The individual what that individual knows and work together with that knowledge." } ] }, { "label": "Community_Support_Benefits", "definition": "Positive experiences with peer support and knowledge sharing in health management", "instances": [ { "id": "T040", "quote": "Also, I know what you said about The community aspect of it, about people being able to connect with people locally, maybe with The same condition... But The whole community thing with your condition as well has really helped me with one of my conditions, just being an online support group and all. able To share our experiences and our treatments" }, { "id": "T074", "quote": "And I did a an 8 week weight loss program with an online coach which was in a community environment with our own Facebook group... You can constantly bouncing ideas off each other with regards to your training, The nutrition side of things we all you know." } ] }, { "label": "Community_Support_Concerns", "definition": "Negative views about online health communities and their potential drawbacks", "instances": [ { "id": "T041", "quote": "I know people like that, and I Hate these communities. That's just me. I can't stand that. Stay away from them. Yes, and it just always seems turns into a bit of a... Personally, I would find it turns into a bit of a bone fest of people trying to outdo who's got more pain" }, { "id": "T041", "quote": "As you say, some people give good advice, but you can't always figure out what's The good advice and what's The bad advice because there's kind of no medical moderation going on." } ] }, { "label": "Daily_Condition_Fluctuation", "definition": "Recognition that health conditions vary significantly from day to day, requiring adaptive approaches", "instances": [ { "id": "T042", "quote": "Thing, you know, like it has a certain exercise it gives you, but can it like regularly change and modify? So like with me, I can be having one particularly bad one day and then it's a completely different choice. So I've had to learn over The years just in my own head how to adapt." }, { "id": "T047", "quote": "But yeah, if you've got like, it can be there as well. Of a cyclical thing. My condition is also cyclical based on my menstrual cycle" } ] }, { "label": "NHS_Access_Barriers", "definition": "Difficulties in accessing healthcare professionals and services within the NHS", "instances": [ { "id": "T018", "quote": "Of The problem is accessing health professionals. It's difficult to get you a GP and they all The trainees that they they always say go A/E and then you can't cope with it." }, { "id": "T019", "quote": "Most of it's very odd. Most of mine do like 80% phone consults in my area. You can't see anyone face to face for a lot of money." }, { "id": "T024", "quote": "And then The other thing with this social prescribing, so in my area. They don't fund it because I've asked The GP many times, they said we don't fund it, these sort of things." } ] }, { "label": "Exercise_Equipment_Variety", "definition": "Interest in having diverse exercise options including different types of physical activities", "instances": [ { "id": "T026", "quote": "Yeah, I think was so I've got movement for arthritis. And are The exercises all Strength based, cardio based, there's other things. Is there a wide variety?" }, { "id": "T027", "quote": "Yeah, so we have 3 categories. So we have daily activity, which is that get moving, cleaning down, it's not really structure, it's just a spread, you know? And focus on The 20 minutes or 15 minutes today. We have a cardiovascular activity, which is your swimming, cycling, running, jogging and anything that you are capable of doing that. And then we have The strength sessions which are home based, gym based." } ] }, { "label": "Personal_Touch_Importance", "definition": "Strong preference for maintaining human interaction alongside digital tools", "instances": [ { "id": "T049", "quote": "Yeah, I do. I love it. I think. I wondered if there was a risk of you taking. You said you were going to bring AI into it, so if you were going to then take people away from it. Because I like talking to people, whether it be on Zoom or in person or anything." }, { "id": "T051", "quote": "I think it's key not to take people away from it." }, { "id": "T055", "quote": "Actually get with The in person appointments and you're saying you like that as well. Yeah, so The fact is hybrid almost. So it's not here's an app off you go, it's with you." } ] }, { "label": "Integration_Challenges", "definition": "Concerns about implementing new technology across the complex NHS system", "instances": [ { "id": "T069", "quote": "I think it's a brilliant idea. I think The problem might be The integration. So just take The NHS app. Not every NHS entity uses it, so I can see that as a problem." }, { "id": "T071", "quote": "Yeah, I'm getting all the departments, you know, on board. That's why I think that again, because I do think it's got it's a fantastic. That's The idea. It's got great potential. There's loads of ideas from everybody about it could have this, it could have that, it can enhance it this way. But it's just The The buy in, I think from The NHS" } ] }, { "label": "Digital_Exclusion_Concerns", "definition": "Worry about leaving behind those who are not digitally literate or lack access to technology", "instances": [ { "id": "T100", "quote": "So someone who doesn't have a special expensive phone, how would they access it?" }, { "id": "T123", "quote": "It’s the testing thing ” is this the thing where you’re going to test it on elderly people and those who aren’t as digitally literate? Not even do any of the GP stuff that requires apps and my sister has to manage patient stuff online." }, { "id": "T129", "quote": "yeah. And like a telephone helpline for some people with my mum, she she won't do online chat. Yeah, it has to be a person that she talks to. That's it." } ] }, { "label": "AI_Data_Privacy_Concerns", "definition": "Concerns about data security, privacy, and consent when using AI in healthcare", "instances": [ { "id": "T114", "quote": "Who is The data going to be shared? What's The security of your data? Should you know there's some hacking going on maybe with The NHS?" }, { "id": "T116", "quote": "Infos going in there, particularly about your own health conditions. Yeah, kind of want to know how secure The app is and then which health professionals are able to log in and. View what you're doing on there." }, { "id": "T118", "quote": "it's even like at The hospital now. So last time I saw my rheumatologist, he asked for my consent to record our console using AI and then it generates The clinic letter. But then when I went to The emergency clinic 2 weeks ago. The doctor didn't ask for my consent and The first I knew that AI had listened in on The conversation" } ] }, { "label": "AI_Understanding_Gap", "definition": "Limited understanding of what AI actually means and how it works in healthcare contexts", "instances": [ { "id": "T110", "quote": "It's a very, very broad term and that a lot of people are quite nervous about it or don't really understand what that means or how it's going to be used." }, { "id": "T121", "quote": "I'm not always necessarily sure how much health professionals know about what AI actually is. I remember because The problem is The definition of AI, it's. And again, as I said to you, I didn't know anything about this last year and I've had to really wrap my head around what actually makes it AI it continues to learn." } ] }, { "label": "Language_Preferences", "definition": "Preference for positive, empowering language over medical terminology", "instances": [ { "id": "T080", "quote": "Yeah, because I don't like this. I know it's used a lot in health care, but it just makes you feel as a patient and somehow painful, especially when you write your notes." }, { "id": "T084", "quote": "That's fine. It's just The word compliance. It's not just to change The word target or something else. So then I encourage The positivity. I think goal is probably a goal." }, { "id": "T085", "quote": "Yeah, something like that. Yeah, it's just compliance. It's sort of very medical. It's making... And people feel judged. And if you start goal word." } ] }, { "label": "Face_to_Face_Value", "definition": "Strong preference for in-person interactions over online consultations and meetings", "instances": [ { "id": "T149", "quote": "So I this is the first in person PPI. You know, but since COVID, everything went completely online and nothing I've been involved with has returned to face to face. But this is actually the first place we've played something about. Really. And that's partly why I wanted to take part because I've really missed." }, { "id": "T151", "quote": "Yeah, yeah, I I thought just as a one of there's something actual face to face that makes it strange, you know, and you can also read the body language." } ] }, { "label": "Recruitment_Strategy_Diversity", "definition": "Recognition of the need for diverse recruitment strategies to reach underrepresented groups", "instances": [ { "id": "T156", "quote": "The charities, I don't know what it's like for lots of charities, but I know specifically that there's a very specific demographic. Of patients who work in volunteer those charities and obviously The people that can afford it. So they tend to be elderly, white, retired, you know, middle class" }, { "id": "T160", "quote": "Or contact someone who works back for them to promote it. Because if people hear someone they know they trust, particularly with ethnic minorities, there's a lot of mistrust with researchers. So if they have someone like their Imam, someone they know, they trust." } ] }, { "label": "Accountability_Benefits", "definition": "Recognition that regular check-ins and accountability support help maintain exercise routines", "instances": [ { "id": "T076", "quote": "I think it certainly helps having that feedback, whether it be weekly or not every fault in that way, but I think it massively helps with The accountability as well, which is always my issue. I'll left to me one and I asked to look at my voice to Jim today. I'm going to Kirk instead, so I'm going to get to a Sunday." } ] }, { "label": "Cost_Effectiveness_Evidence", "definition": "Interest in demonstrating economic benefits and cost-effectiveness of the intervention", "instances": [ { "id": "T061", "quote": "That's what I was going to ask is if you can use The data to show improved outcomes to actually just find better funding. Yeah, and that's it. So yeah, it was updated in 20, I think it was 2014 and 2018 and 2022. But they basically said that we don't know how well exercise works as social prescribing. We can't add more funding or do anything else with it because The data collection hasn't been there." } ] }, { "label": "Wearable_Technology_Integration", "definition": "Interest in integrating fitness trackers and wearable devices with the exercise app", "instances": [ { "id": "T177", "quote": "I was going to ask, so if my watch that tells him all sorts of profession has sleep scores and heart rate, he uses it when he's exercising as well. Is there a way for build that in in or how much benefit would you actually have?" }, { "id": "T178", "quote": "Everything we do is successful at The moment. We link to strava and we can link to garmin and polar watches. So that if you wanted to do a you can log in and unload straight away The data collection that's beneficial for us." } ] } ], "themes": [ { "label": "Personalization_vs_Standardization", "definition": "The tension between providing standardized healthcare solutions and the critical need for individualized approaches based on personal experience and unique condition presentations", "codes": ["Personalized_Treatment_Necessity", "Dangerous_Generic_Protocols", "Individual_Body_Awareness", "Daily_Condition_Fluctuation"], "evidence": [ { "id": "T006", "quote": "But there's nothing that comes alongside it saying this just works for me. So my protocol that I'm following now, my health practitioner wants me to eat 3500 calories a day, but then burn it off." }, { "id": "T010", "quote": "There'll be somebody else in The same clinic as me for melanoma that's got stage 4 melanoma, but it's different. It's completely different. And it's it's got to be tailored. I found that The NHS approach to it is a blanket." }, { "id": "T037", "quote": "We as individuals monitor how we respond. I mean, there are at least three of us in this room who've gone against standard medical practice because it hasn't suited us." }, { "id": "T042", "quote": "Thing, you know, like it has a certain exercise it gives you, but can it like regularly change and modify? So like with me, I can be having one particularly bad one day and then it's a completely different choice." } ] }, { "label": "Trust_and_Evidence_Quality", "definition": "Concerns about the reliability of health recommendations, particularly regarding outdated professional knowledge and the need for trustworthy AI-generated advice", "codes": ["Trust_in_AI_Recommendations", "Outdated_Professional_Knowledge", "AI_Learning_Potential"], "evidence": [ { "id": "T033", "quote": "Trust, it sounds like can we trust The recommendations? Where are these actually coming from? And because we do know it's so complicated with long term conditions, but really trusting that process of how that's been calculated" }, { "id": "T028", "quote": "But it's The completely wrong advice that The professionals in that field are giving for exercise. And I'm just worried if I went on this app and put in our arthritis, it'll instantly just send me towards all The exercises that are non impact and then it just making those people worse." }, { "id": "T031", "quote": "So many of The experts are completely uninformed." } ] }, { "label": "Human_Connection_in_Digital_Health", "definition": "The importance of maintaining human interaction and support alongside digital health tools, emphasizing the irreplaceable value of personal relationships in healthcare", "codes": ["Personal_Touch_Importance", "Healthcare_Professional_Coaching_Role", "Face_to_Face_Value", "Community_Support_Benefits", "Community_Support_Concerns"], "evidence": [ { "id": "T049", "quote": "Yeah, I do. I love it. I think. I wondered if there was a risk of you taking. You said you were going to bring AI into it, so if you were going to then take people away from it. Because I like talking to people, whether it be on Zoom or in person or anything." }, { "id": "T038", "quote": "Not necessarily that The coach knows more than The individual, but The coach in true coaching practice. This can get from The individual what that individual knows and work together with that knowledge." }, { "id": "T149", "quote": "So I this is the first in person PPI. You know, but since COVID, everything went completely online and nothing I've been involved with has returned to face to face. But this is actually the first place we've played something about. Really." } ] }, { "label": "Digital_Inclusion_and_Access", "definition": "Challenges around ensuring equitable access to digital health tools, including concerns about digital literacy, technology access, and maintaining inclusive approaches", "codes": ["Digital_Exclusion_Concerns", "NHS_Access_Barriers", "Integration_Challenges", "Recruitment_Strategy_Diversity"], "evidence": [ { "id": "T100", "quote": "So someone who doesn't have a special expensive phone, how would they access it?" }, { "id": "T018", "quote": "Of The problem is accessing health professionals. It's difficult to get you a GP and they all The trainees that they they always say go A/E and then you can't cope with it." }, { "id": "T156", "quote": "The charities, I don't know what it's like for lots of charities, but I know specifically that there's a very specific demographic. Of patients who work in volunteer those charities and obviously The people that can afford it. So they tend to be elderly, white, retired, you know, middle class" } ] }, { "label": "AI_Transparency_and_Privacy", "definition": "Concerns about understanding what AI means in healthcare contexts, data privacy, security, and the need for transparent communication about AI use", "codes": ["AI_Data_Privacy_Concerns", "AI_Understanding_Gap"], "evidence": [ { "id": "T114", "quote": "Who is The data going to be shared? What's The security of your data? Should you know there's some hacking going on maybe with The NHS?" }, { "id": "T110", "quote": "It's a very, very broad term and that a lot of people are quite nervous about it or don't really understand what that means or how it's going to be used." }, { "id": "T118", "quote": "it's even like at The hospital now. So last time I saw my rheumatologist, he asked for my consent to record our console using AI and then it generates The clinic letter. But then when I went to The emergency clinic 2 weeks ago. The doctor didn't ask for my consent" } ] }, { "label": "Implementation_and_Sustainability", "definition": "Practical considerations for successfully implementing and sustaining digital health interventions, including system integration, cost-effectiveness, and ongoing support mechanisms", "codes": ["Cost_Effectiveness_Evidence", "Accountability_Benefits", "Language_Preferences", "Wearable_Technology_Integration"], "evidence": [ { "id": "T061", "quote": "That's what I was going to ask is if you can use The data to show improved outcomes to actually just find better funding. Yeah, and that's it. So yeah, it was updated in 20, I think it was 2014 and 2018 and 2022. But they basically said that we don't know how well exercise works as social prescribing." }, { "id": "T076", "quote": "I think it certainly helps having that feedback, whether it be weekly or not every fault in that way, but I think it massively helps with The accountability as well, which is always my issue." }, { "id": "T084", "quote": "That's fine. It's just The word compliance. It's not just to change The word target or something else. So then I encourage The positivity. I think goal is probably a goal." } ] } ] }, { "_model": "QualiGPT gpt-4o", "_run_id": "run_20250917_212954_b2162c3e", "codes": [ { "label": "Complexity of Nutritional Advice", "definition": "Challenges in discerning accurate nutritional information due to conflicting or misleading sources.", "instances": [ { "id": "T002", "quote": "you can often read things and then you do a little bit of research... the truth is perhaps even the opposite." }, { "id": "T006", "quote": "there's protocols out there that are available. But there's nothing that comes alongside it saying this just works for me." }, { "id": "T029", "quote": "The same as The nutrition thing, isn't it? If it's based on old information," } ] }, { "label": "Individualised Treatment Needs", "definition": "Participants stress that medical advice and treatment must be tailored to their unique conditions.", "instances": [ { "id": "T010", "quote": "it's got to be tailored... NHS approach to it is a blanket." }, { "id": "T026", "quote": "is there a wide variety?" }, { "id": "T037", "quote": "whatever comes in to AI, whatever is on the app, should be filtered through the experiences of that individual." } ] }, { "label": "Mistrust in Professional Guidance", "definition": "Skepticism towards medical professionals due to perceived outdated or incorrect advice.", "instances": [ { "id": "T028", "quote": "Complete wrong advice. I ended up osteopenic..." }, { "id": "T031", "quote": "So many of The experts are completely uninformed." }, { "id": "T034", "quote": "not make people worse just because it's based on like old evidence." } ] }, { "label": "Self-Education and Advocacy", "definition": "The importance of patients researching and making their own decisions based on personal health needs.", "instances": [ { "id": "T006", "quote": "I did that I needed to find out what was going on with my body." }, { "id": "T037", "quote": "we are responsible and we should be working with our medical team as a team." }, { "id": "T044", "quote": "you have to keep manually updating which joints in that day and then it will be calculated?" } ] }, { "label": "Variability in Health Conditions", "definition": "Day-to-day or cyclical changes in symptoms complicate standard treatment plans.", "instances": [ { "id": "T042", "quote": "I can do something one day and then I won't be able to do it the next day..." }, { "id": "T047", "quote": "My condition is also cyclical based on my menstrual cycle..." }, { "id": "T056", "quote": "How do you work and how things are going? Things are different at certain parts of a cycle or just a good day and bad day." } ] }, { "label": "Need for Consistent Support Personnel", "definition": "Frustration with constantly changing support staff leading to conflicting advice.", "instances": [ { "id": "T021", "quote": "it kept being a different nutritionist every time... kept getting different advice." }, { "id": "T056", "quote": "it's actually speaking to someone who's going to get to know how you work." } ] }, { "label": "Community-Based Knowledge Sharing", "definition": "Support from patient-led groups and peer experiences as valuable sources of health advice.", "instances": [ { "id": "T040", "quote": "online support group... able to advise each other on this group." }, { "id": "T074", "quote": "we all... bouncing ideas off each other... sharing recipe ideas." } ] }, { "label": "Critique of Blanket NHS Approaches", "definition": "Concerns that NHS treatment lacks flexibility or nuance for individual cases.", "instances": [ { "id": "T010", "quote": "the NHS approach to it is a blanket." }, { "id": "T024", "quote": "They don't fund it... these sort of things." }, { "id": "T071", "quote": "getting all the departments... on board... that's the buy in." } ] }, { "label": "AI Transparency and Ethics", "definition": "Need for clear communication about how AI is used in healthcare settings.", "instances": [ { "id": "T117", "quote": "once it's in, you can't get it back out... people should be aware of that." }, { "id": "T122", "quote": "It’s where it’s about transparency is needed" }, { "id": "T114", "quote": "What's The security of your data? Should you know there's some hacking going on..." } ] }, { "label": "Digital Literacy and Accessibility Concerns", "definition": "Apprehensions about access and usability of tech tools for people with low digital confidence.", "instances": [ { "id": "T100", "quote": "someone who doesn't have a special expensive phone, how would they access it?" }, { "id": "T129", "quote": "she won’t do online chat. It has to be a person that she talks to." }, { "id": "T126", "quote": "social prescriber... would type it in for them." } ] }, { "label": "Trust in Digital Tools", "definition": "Users' willingness to rely on or question technology-based health recommendations.", "instances": [ { "id": "T033", "quote": "can we trust The recommendations?" }, { "id": "T034", "quote": "you don't want something that's going to make... not with The best intention, but not make people worse" }, { "id": "T121", "quote": "I'm not always necessarily sure how much health professionals know about what AI actually is." } ] }, { "label": "Desire for Hybrid Support Models", "definition": "Preference for a blend of human support and digital tools in health management.", "instances": [ { "id": "T055", "quote": "So it's not here's an app off you go, it's with you." }, { "id": "T057", "quote": "I'd like to be having The weather ..." }, { "id": "T051", "quote": "I think it's key not to take people away from it." } ] }, { "label": "Concerns Over Medical Expertise", "definition": "Doubt in the accuracy or currency of healthcare professionals' knowledge.", "instances": [ { "id": "T028", "quote": "Complete wrong advice... then I googled osteopenia... what was I meant to be doing?" }, { "id": "T032", "quote": "my arthritis has improved immeasurably if I'm using it, not using it." } ] }, { "label": "Unrealistic Expectations and Language", "definition": "Pushback against terminology like 'compliance' and perfectionism in digital tools.", "instances": [ { "id": "T084", "quote": "it's just compliance. It's sort of very medical." }, { "id": "T083", "quote": "you've still done something, which I feel like that should be a choice thing." } ] }, { "label": "Digital Tools as Empowerment", "definition": "Recognition of how tech can help patients gain control and track progress.", "instances": [ { "id": "T074", "quote": "I have an app on my phone... it calculates all my protein, carbohydrates..." }, { "id": "T076", "quote": "that feedback... massively helps with The accountability" } ] }, { "label": "GP and System Barriers", "definition": "Frustrations around GP access, delays, or lack of coordinated care.", "instances": [ { "id": "T018", "quote": "trainees always say go A/E... can't cope with it." }, { "id": "T019", "quote": "Most of mine do like 80% phone consults in my area." } ] }, { "label": "Fluctuating Support Quality", "definition": "Inconsistent help from health professionals or apps due to rotating staff or variable advice.", "instances": [ { "id": "T021", "quote": "kept being a different nutritionist every time... different advice." }, { "id": "T120", "quote": "they decided... they're just not telling The patients that they're recording it" } ] }, { "label": "Ethical Concerns Around Data and Consent", "definition": "Concerns around how data is used, stored, and shared—particularly in AI-powered tools.", "instances": [ { "id": "T114", "quote": "What's The security of your data?" }, { "id": "T118", "quote": "he asked for my consent to record our consult using AI..." }, { "id": "T135", "quote": "people agree to things. They don't realise what they're agreeing to." } ] }, { "label": "Importance of Accountability", "definition": "The role of reminders and human interaction in helping people stay on track.", "instances": [ { "id": "T076", "quote": "feedback... helps with The accountability..." }, { "id": "T077", "quote": "you've got that accountability as well..." } ] }, { "label": "Barriers to Implementation", "definition": "Concerns about real-world deployment, including NHS adoption and technological gaps.", "instances": [ { "id": "T069", "quote": "problem might be The integration" }, { "id": "T071", "quote": "getting all the departments... on board..." } ] } ], "themes": [ { "label": "Navigating Complexity in Healthcare Advice", "definition": "Participants highlight confusion and frustration caused by conflicting or oversimplified health guidance.", "codes": [ "Complexity of Nutritional Advice", "Mistrust in Professional Guidance", "Concerns Over Medical Expertise" ], "evidence": [ { "id": "T006", "quote": "completely the wrong thing for me. So I had progression, nearly died" }, { "id": "T028", "quote": "wrong advice... osteopenic..." }, { "id": "T029", "quote": "nutrition thing... based on old information" } ] }, { "label": "Individual Responsibility and Empowerment", "definition": "A strong emphasis on personal knowledge, choice, and accountability in managing health.", "codes": [ "Self-Education and Advocacy", "Digital Tools as Empowerment", "Importance of Accountability" ], "evidence": [ { "id": "T037", "quote": "we are responsible and... the central member of that team." }, { "id": "T074", "quote": "log everything... calculates all my protein" }, { "id": "T076", "quote": "feedback... helps with accountability..." } ] }, { "label": "Desire for Personalised and Flexible Support", "definition": "Calls for treatment plans and apps to reflect individual needs, fluctuations, and preferences.", "codes": [ "Individualised Treatment Needs", "Variability in Health Conditions", "Desire for Hybrid Support Models" ], "evidence": [ { "id": "T010", "quote": "treatment... regardless of what the body's doing" }, { "id": "T047", "quote": "point I am in The month... affects my ability to exercise." }, { "id": "T055", "quote": "not just... here's an app off you go." } ] }, { "label": "Barriers to Access and Consistency", "definition": "Structural and logistical hurdles that limit effective and equitable care.", "codes": [ "Need for Consistent Support Personnel", "GP and System Barriers", "Barriers to Implementation" ], "evidence": [ { "id": "T018", "quote": "trainees... go A/E... can't cope with it" }, { "id": "T021", "quote": "different advice every time..." }, { "id": "T069", "quote": "problem might be The integration" } ] }, { "label": "Ethics and Trust in Digital Health", "definition": "The role of transparency, security, and communication in building confidence in AI tools.", "codes": [ "AI Transparency and Ethics", "Ethical Concerns Around Data and Consent", "Trust in Digital Tools" ], "evidence": [ { "id": "T114", "quote": "What's The security of your data?" }, { "id": "T117", "quote": "once it's in... can't get it back out..." }, { "id": "T121", "quote": "definition of AI... it continues to learn." } ] }, { "label": "Digital Divide and Inclusion", "definition": "Concerns about equitable access to tech tools for people with varying digital confidence.", "codes": [ "Digital Literacy and Accessibility Concerns", "Critique of Blanket NHS Approaches" ], "evidence": [ { "id": "T100", "quote": "doesn't have a special expensive phone... how would they access it?" }, { "id": "T126", "quote": "they would use that as a communication to physically go and see..." }, { "id": "T024", "quote": "They don't fund it... these sort of things." } ] } ] } ]