JMIR Publications

ABSTRACT

Background:

Labor shortages in healthcare pose significant challenges to sustaining high-quality care for people with intellectual disabilities (PwID). Social robots show promise in supporting both PwID and their healthcare professionals, yet few are fully developed and embedded in productive care environments. Implementation of such technologies is inherently complex, requiring careful examination of facilitators and barriers influencing sustained use.

Objective:

This research aims to evaluate the value creation and implementation of social robot Ivy for PwID and healthcare professionals, examining facilitators and barriers to sustained use across six care organizations.

Methods:

A qualitative field study was conducted involving 19 cases of robot implementation across six care organizations in the Netherlands; each case consisted of PwID (client) and the involved healthcare professionals. The study examined actual robot deployment in daily care practice between April-October 2023. Semi-structured interviews were conducted with healthcare professionals after two months of implementation. Analysis followed a thematic approach guided by the NASSS framework and a model for tracing facilitators of and barriers to the adaptive implementation of the robot. Facilitators were classified as key drivers (complex), enablers (complicated), minor benefits (simple), while barriers were categorized as deal-breakers (complex), obstacles (complicated), or minor hurdles (simple). Robot’s sustained use (i.e., robot use continuance at two months post-implementation) served as a key indicator of success.

Results:

After two months, robot use was sustained in 12 of 19 cases (63%). For successful cases, key value emerged for both clients (enhanced daily structure, improved emotional well-being through non-judgmental interactions, increased independence) and healthcare professionals (reduced workload through automation, improved quality of client interactions, reduced emotional burden). Sustained use was determined by client characteristics (cognitive capabilities, care predictability), healthcare professional factors (available time, digital competency), contextual conditions (timing, connectivity), and organizational support (training, resources). Main implementation barriers included complex/unpredictable care needs, insufficient programming time, and contextual factors influencing care environments.

Conclusions:

The findings inform long-term care organizations on the implementation and value of sustained use of social robot Ivy for both PwID and their caregivers. Social robot Ivy demonstrates potential for supporting care delivery to PwID when implemented under appropriate conditions. Success requires careful matching of robot capabilities with client needs, sufficient time and support for healthcare professionals, and stable care environments. Future research should examine longer-term sustainability and integrate direct client feedback.