Designing and Implementing for Stay Left, Shift Left-10X in the Construction Industry using an advanced site Screening Process and PEHR

Stay Left, Shift Left-10X (SL2-10X) is a new paradigm which seeks to revolutionize health by applying a proactive health mindset and methodology empowered by digital technologies to both population and personal health. The SL2-10X paradigm is underpinned by 10 Copernican Shifts including a shift from illness to wellness, analogue to digital and envisioning a health system that revolves around people and their mobiles phones rather than the hospital. Construction workers are not known to be particularly health conscious and this paper describes a unique collaboration between the Construction Workers Health Trust (CWHT), HeartPath Ltd and the Innovation Value Institute at Maynooth University to design, procure and implement on an onsite advanced digital supported screening process where construction workers could be screened and provided with a personal electronic health record (PEHR) on their phone and receive health education. Prior to this initiative CWHT had over a two decade long track record in screening construction workers and this provided confidence that the opportunity to take this process to a new level.

An extensive search of potential PEHR suppliers was performed and a rapid procurement process was executed using ten criteria to select a PEHR vendor. In parallel extensive research and work was done to create the process and standard operating procedures to allow nurse to perform on site screening with more advanced point of care diagnostics with construction workers. A call for proposals was issued in April 2024 and seven companies were selected and evaluated before Cushla Ltd were selected in May 2024 as the PEHR vendor. A process of co-design of the screening process commenced with Cushla Ltd and onsite screenings started in July 2024 in a year over 10,000 construction workers were screened and provided with a PEHR. Over 50% of the construction workers use their PEHRs on a regular basis indicating a strong desire for workers to have a participatory role in co-producing their health. A concierge system was also established with Centric Health to offer GP access to construction workers who did not have a GP. This project and solution can provide both the evidence and blueprint for the broader adoption of this advanced and proactive health screening process across other industries and across broader society. The paper will also include feedback and testimonials of the lived experience of construction workers who have been part of the living Lab.

Finally the paper comments on the use of the Open Innovation 2.0 Living Labs Methodology as a successful Innovation Science approach.