Katarzyna BAŁUCKA-DĘBSKA from DG for Information Society and Media of the European Commission announced the fourth workshop of the EU Conference on Innovation for Digital Inclusion at Gdansk, Poland as a workshop that will present a range of ICT services that want to be useful and helpful in a time of crisis when everything, also health services, are being cut.
Wojciech DZIWORSKI, DG for Health and Consumers, European Commission introduced the workshop under the title The challenge of ageing well and healthy. He explained that ageing is the major challenge of tomorrow, as we are all facing the same: the group of +65 is growing, but also the group +80 is growing quickly. This entails a pressure on health issues, as the sector is already the biggest sector of the GDP in our economy, with the prediction that by 2060 the % of age-related spendings of the GDP will raise by 4,75 points.
According to Mr. Dziworski, we should start to look for new solutions now, to contain the costs and to avoid the welfare going down. This should be done in the same way as many solutions to diseases that were covered by innovative & IT solutions, also because innovation can be a trigger to move on through a difficult period.
A good way to overcome the barriers that exist in today's system is the concept of a European Innovation Partnership: a venture that combines the political debate while focusing on the results, bringing together actors at all levels and sector to build synergies. For example: building a system where the end users of eHealth services can help patients.
The goal of this partnership is to increase the number of healthy life years on average by two in the EU by 2020, and let people lead a healthy, active and independent life until old age, improving the sustainability and efficiency to keep the cost of social and health care systems under control. This certainly offers opportunities for the market, as the EU and Japan are the big players in this field.
The partnership will also bring benefits, by scaling up already existing solutions, bridging gaps & breaking the silence that now exist between the health community: doctors blaming nurses, nurses blaming doctors, and doctors blaming the funders. The partnership essentially exists in bringing all these people together, and would wish to see the doctors collaborating with industries and thus bringing the benefits to the end user, as the feeling is that certain programs with a lot of money involved do not connect between each other and do not bring the benefits they could bring.
The partnership will act on 3 broad fields:
A lot of ICT based innovation has already been done, and lots of applications have already been developed, but the political debate always focuses on the barriers & bottlenecks. 5 actions to overcome these have been prioritized and can be implemented quickly:
After 4 years, some lessons are already learned:
Niamh SCANNELL, from TRIL - Technology Research for Independent Living in Ireland explained why chip companies like Intel invest in programs that deal with the aging process. Just like everybody, she said, at Intel they also face the challenges of today's demographics and rapid increase of the global aging process, while confronted with a shortage of qualified healthcare professionals and healthcare costs rising to unsustainable levels. So they want to contribute to find a solution and have chosen for a holistic approach: while the focus is on technology they also work with anthropologists, psychologists, philosophers,… not only to have a holistic picture of the ageing process and to understand the leading causes of why elderly people go to the hospital, but also to understand how people use technology in real life, and if technology really works once it is out of the labs.
According to the TRIL consortium between the government and Intel, the solution lies in fostering more care in communities and at home through technology, through what they call "connected community care". This shift from the more expensive systems of "acute care" (hospitals, specialty clinic, intensive care) and "residential care" (assisted living through a skilled nursing facility) is also what people want, as most of them prefer to stay at home.
The “Building Bridges” project is an example of such a "community care", it's a communication tool that was not designed as a PC but as a touchscreen, it very much looks like a phone and immediately gives elderly people the feeling they can use such a thing. The holistic research also resulted in a new function of the avatar: as older people are usually more polite, they wanted an avatar that can ask permission to speak in the chat-like online room the tool provides. Also, when they "dragged and dropped" an icon, they wanted to know where the icon went, and also asked for a more protected chat room, which they called their “tea room”. These rooms were also used by older people taking care of other older people, who often felt isolated when they were "off duty" and used the tool at 3 o’clock in the morning when they felt like talking to someone.
Also resulting from this holistic approach is a "self alert" sensor that measures one's alertness through neuro activity and because of the old people's feedback developed from a laptop towards a sensor built into a cushion. Another example was a "falls risk" sensor that detects when your physical health is at a point where you risk to fall. Falling is a symptom of bad health and most elderly people get into the hospital after several falls, mostly when bad health has evolved in such a way that it is very difficult and costly to help the elderly. With the "falls prediction test", a family doctor can now predict the possibility of falling with an accuracy level of 80%, thus preventing people to getting into the hospital.
All these examples show how important it is to co-design with and for older people and their carers, but also how important it is to use imagination for solving problems at a time when there simply is not enough money to maintain the mainframe caring model.
Marco D'ANGELANTONIO, from Health Information Management SA, Belgium presented the ICT based elderly care project DREAMING, that focuses mainly on alarm handling and monitoring. He first explained the context in which the project was born: given the aging population in Europe and the headaches the costly elderly care was giving to the EU finance ministers, there seems to be no alternative for technology based solutions, simply because there are not enough of qualified (and even unqualified) hands in elderly care personnel to meet the demands. Moreover, no big player seemed to be dominating the market here.
The ingredients of such a platform were multiple, as it should:
As technology is developing, the platform will also need to mature continuously: from wearable sensors to implantable sensors, using today's touch screens, introducing remote controlled domotics, using behaviour analysis to detect for example if a decrease in activity points to depression, etc.
The DREAMING project has already evolved into senior.comfort@home, a project designed together with the city of Antwerp (Belgium), that includes a door opening system through a badge that can be programmed and blocked. The next phase is the evolution towards the "Home Sweet Home" project, that on top of the existing DREAMING ingredients adds domotics, a daily scheduler, a navigator, behaviour analysis and exercise for maintaining and measuring mental faculties.
The senior.comfort@home project is for the moment offered free of charge by the city of Antwerp to the users, but in the future the cost of the initial capital investment of 5500€ will be included in the rental price of the service flat, so the user will not consider it as an extra cost.
After this first implementation, some lessons have already been learned:
Though there is not a real business plan developed, the benefits of the outcomes are objectively clear and there is a return on investment coming out already.
Morten LEMBKE, from The Association of Senior Citizens in Denmark tackled the issue of digital literacy training for the elderly. In Denmark, 23% of the population is over 60 and this is the section of the population with the fewest computer skills: between 65-69 30% has no access to a computer at home, 50% between 40-74, 60% between 75-79 and 80% between 80-89. Also: the greater the age, the lower become their computer skills.
The digital inclusion of the elderly is a big problem in a 'fully digitalized' country like Denmark, where not only the banking system has gone digital, but also lots of public authorities such as the inland revenue system, the medical service system and all municipalities, all of them reachable through the link www.borger.dk. The situation is driven by Danish law, that for example says that by 2012 all communication between public authorities and private companies must be digital. The law also says that by 2015 all Danish citizens must have an electronic mailbox. Meanwhile, all Danes have already been issued with a digital signature to access all public communication through an individual log-on.
The Danish Association of Senior Citizens quickly understood that computer literacy is as essential as reading, writing and arithmetics and already 13 years ago has set up its first ICT centre for elderly. To raise awareness about computer technology and its benefits among the elderly, the projected evolved into a mobile ICT centre converted into a bus that visited 150 towns, where soon an ICT centre for elderly was established, all following the same philosophy:
To overcome the barrier of unpleasant experiences many elderly have from their school days, as much as "the old school" is taken out: there is one-to-one tuition with many coffee breaks, chatter and networking in between and the student's experience of success is a very important element of the tuition.
Today, the Association of Senior Citizens operates more than 150 ICT centers for elderly in Denmark, where about 1000 over-60 volunteer instructors give tuition to about 7000 over-60 students providing 60.000 lessons annually.
Gitte OLSEN, Director of the Danish Association of Senior Citizens also presented "Life Guard" a safety line through internet for active elderly who live alone and can use the free internet service to make family or friends aware if they have a problem: if they don't log in at the internet, the system sends out an sms and if they don't reply, a group of online "life guard" volunteers makes sure someone will respond in case an accident should have happened.
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