Cuddly toy with a heartbeat: five avoidable obstacles

Some barriers to the use of healthcare technology are preventable but are simply overlooked. Researcher Sima Ipakchian Askari (Vilans) identifies five such barriers, based on a test involving a cuddly toy with a heartbeat.

People with dementia also need affection and closeness. But carers cannot always provide this. Care technology can offer a solution, such as a cuddly toy with a heartbeat that was developed in the UK, in collaboration with people with dementia. British research shows that this enhances the wellbeing of people with dementia and reduces agitation. Researcher Sima Ipakchian Askari (Vilans) therefore wanted to trial this cuddly toy in the Netherlands, in collaboration with care organisations Zorg in Oktober and Surplus. They carried out a pilot study in two care homes. An evaluation was published in early 2025 (see linkedin.com).

Ipakchian Askari shares here five obstacles she encountered during this and other implementation projects, all of which are easily avoidable. “It surprises me how many innovations fail due to issues such as a poor internet connection. But there are other avoidable obstacles.”

1. Users don’t see the benefit

The tool or technology is ready and sitting on the shelf, but is rarely used because users do not see the point of it or are unwilling to use the innovation for other reasons. This is a common obstacle to implementation.

The solution: involve both those who are supposed to use your healthcare technology (people with dementia) and those who are supposed to provide it (caregivers). Work with them to check whether your healthcare technology actually offers a solution to an existing problem in that specific situation or department.

And yes, it’s fine if it’s ‘quick and dirty’ – by scientific standards. Ipakchian Askari: “Just half an hour’s chat with one or two people can be a huge help and provide concrete insights.”

2. Er… how does this work?

This may seem obvious, but it’s often overlooked: practical information on use and maintenance, tailored to vocational level (most care workers have vocational qualifications). Who is your healthcare tech intended for, and what problem does it address? Are there any contraindications? Does your technology run on mains power or batteries? Does it have Wi-Fi or Bluetooth? How do you clean the healthcare tech?

“There was already a simple English manual for the cuddly toy with a heartbeat,” explains Ipakchian Askari. “We were able to translate that.” For longer manuals, a video is better, or explanatory images. And consider multilingual manuals if your healthcare technology is intended for a multicultural environment.

3. Over-emphasising coordination and co-creation

It’s best to check your user information for usefulness and clarity together with the user. In other words, co-creation. Does that make you think of validated surveys, organising focus groups and… pffff…? You’re not the only one. But it doesn’t have to be so scientifically rigid.

Put your healthcare tech in the hands of a few users. Let them try it out for themselves. Set them a few tasks as well. See what happens. Where do they get stuck? What questions do they ask? Ipakchian Askari: “With the cuddly toy that has a heartbeat, carers wanted to know if it could go in the washing machine.”

4. Incorrect implementation method

In the past, the wrong methods were often used for implementation. For example, a method designed to scale up implementation was used, whilst small-scale implementation still needed to be carried out. “Starting with ‘Exploration’ and then moving on to ‘Meaningful Testing’ gives you the chance to identify and tackle practical obstacles.” During the ‘Exploration’ phase, you assess whether your healthcare technology actually meets the wishes and needs; during ‘Meaningful Testing’, you test on a small scale whether it can be put into practice. Exploration, Meaningful Testing and Scaling Up are part of Vilans’ so-called Honeycomb Model: a methodology for effective implementation (see Vilans.nl).

5. Evaluation: too scientific

Naturally, you want to know afterwards what the impact is and what you can still improve about the healthcare technology you’ve put into practice. But getting responses to evaluations proves to be a challenge. This is partly because healthcare professionals work rotating shifts and have very little time. The solution: an accessible evaluation.

• Allow sufficient time for trialling the technology, for example six weeks.
• Keep your evaluation questionnaire short.
• Ask simple questions.
• Allow plenty of time – several weeks – for questionnaires to be completed.
• Be flexible.

A UK study into the cuddly toy with a heartbeat used scientifically validated questionnaires. In the Netherlands, healthcare providers indicated that they found these unclear and difficult to complete. “That’s why we adapted them into a short, simplified version. This was well received but also had a low response rate,” explains Ipakchian Askari. “We therefore supplemented the data with a few interviews. This meant we still gained enough insight for further development.”

UKON researchers also struggled with a lack of response; read in Zorgprogramma vertaald how they resolved this.