Assistive Technologies and Rehabilitation                - Challenges and Solutions -Jan Alberssenior consultant EPRAEGIS ...
Structure   Background   Major developments and challenges   Possible approaches and solutionsAEGIS – Brussels, 30 Nove...
Background   Dutch   Study University Heidelberg   Director Communication SRH   Director VT Centre Hoensbroek   CEO H...
AT and Rehabilitation   Long common history   Focus on individual AEGIS – Brussels, 30 November 2011   4
AT not new … but new is ….• Speed of technological developments and theirpossible applications• Context of disability worl...
The message           DC + DC                   DOAEGIS – Brussels, 30 November 2011        6
Environment/context    Social economic                                   Adapt      Challenges                            ...
Context          Paradigm shift in health and social services   From public programming to more market-based regulationPos...
AT - not a ‘normal’ product          An assistive product           A need unexpected and not           createdAEGIS – Br...
AT - not a ‘normal’ product      An assistive product                 A product that nobody wantsAEGIS – Brussels, 30 Nov...
AT - from individual to environment   Independent living   AT not uncontroversial   Critics about technology driven nat...
AT - Definition           Any item, piece of equipment or product system,            whether acquired commercially, modif...
AT and Telecare           AT&T = the delivery of health and social care to            individuals within the home or wide...
AT and AAL (housing / environment)• (Semi)independent living elderly and pwd• Security• Communication• Comfort / convenien...
AT – universal design   Universal design strives to be a broad-spectrum    solution that helps everyone, not just people ...
Experience of rehabilitation    professionals   75% of AT professionals believe that    persons with disability do not re...
Critical Success Factors (CSF)   Knowledge   Assessment   Expectations / stigma / acceptance   Ongoing process   Sust...
 Different         skills needed (not only technical) Profound           knowledge of market (many and complex   product...
 Multidisciplinary                  team - flexible and continuous Person-centered                    approach Task    ...
     High or low expectations     Trial and error process     AT                        he / she has a disability     ...
   AT is more than a product   “after sale’ is crucial   Time lapse between need and provision   (re)assessment as con...
75% of AT devices abandoned within 3 yearsReasons: too complex no acceptance by users no acceptance by environment not...
     is like a positive catalyst - it participates in the chemical reaction,      speeds it up, but is not consumed by th...
Ethical Issues   Universal application / access for all   Privacy   Data protection   Delegation of responsibility to ...
Ethical guideliness   Privacy: access / protection   Autonomy: decision about use of AT   Integrity and dignity: respec...
Core drivers AT / ICT developmentKnowledge disabled end-userKnowledge diagnostician, (para)medical/technical professiona...
Barriers AT / ICT developmentLack of knowledge marketDifferent interpretations national/regional levelsLack of coordina...
Industry key player AT / ICT   Fragmented interest   Mainly restricted to specialised niches   Not recognizing market p...
Purchase of AT / ICT by end userMedical model   Disability / physicianSocial model   National legislation / systems / ag...
Future role of Rehab SP in AT/ICT (1)     Participation in R&D     Alliances with universities, research centers     Co...
Future role of Rehab SP in AT/ICT (2)    Cooperation with mainstream organizations    Empowerment of service users    T...
The message         DC + DC                      DO AEGIS – Brussels, 30 November 2011                                    ...
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Day 2 jan albers presentation aegis (final)

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Day 2 jan albers presentation aegis (final)

  1. 1. Assistive Technologies and Rehabilitation - Challenges and Solutions -Jan Alberssenior consultant EPRAEGIS conference 30 November 2011 / Brussels 1
  2. 2. Structure Background Major developments and challenges Possible approaches and solutionsAEGIS – Brussels, 30 November 2011 2
  3. 3. Background Dutch Study University Heidelberg Director Communication SRH Director VT Centre Hoensbroek CEO Hoensbroek (SRL / now Adelante) Co-founder EPR International activities (EU / RI a.o.)AEGIS – Brussels, 30 November 2011 3
  4. 4. AT and Rehabilitation Long common history Focus on individual AEGIS – Brussels, 30 November 2011 4
  5. 5. AT not new … but new is ….• Speed of technological developments and theirpossible applications• Context of disability world / rehabilitationKey: changeAEGIS – Brussels, 30 November 2011 5
  6. 6. The message DC + DC DOAEGIS – Brussels, 30 November 2011 6
  7. 7. Environment/context Social economic Adapt Challenges to changing needs• Finances Modernisation• Globalisation • Understand needs• Labour market flexibility • Flexible responses• Individualisation • New target groups • New services• Ageing • New ways service provision• Inclusion Sophisticated and complexIncreasing and diversifying services demand 7
  8. 8. Context Paradigm shift in health and social services From public programming to more market-based regulationPositive & proactive High level expertise approach Modernisation / Change• Mainstreaming/partnership • Demonstrate added value• Inclusion / maximise potential • Quality assurance• Empowerment • Competition: tendering• Decentralization • Market analysis and orientation Paradigm shift in disability field 8 From medical model to social / consumer model
  9. 9. AT - not a ‘normal’ product  An assistive product A need unexpected and not createdAEGIS – Brussels, 30 November 2011 9
  10. 10. AT - not a ‘normal’ product  An assistive product A product that nobody wantsAEGIS – Brussels, 30 November 2011 10
  11. 11. AT - from individual to environment Independent living AT not uncontroversial Critics about technology driven nature Stigmatizing character No replacement of communication 11AEGIS – Brussels, 30 November 2011
  12. 12. AT - Definition  Any item, piece of equipment or product system, whether acquired commercially, modified or customized, that is used to increase, maintain or improve functional capabilities of individuals with disabilities. (The US Assistive Technology Act of 1998, Section 3)  AT has the potential to help people with disabilities to live in the least restrictive environments and attain their personal and vocational aspirations. (Peterson DB, Murray GC. Ethics and assistive technology service provision. Disability and Rehabilitation: Assistive Technology 2006;1:59–67) AEGIS – Brussels, 30 November 2011 12
  13. 13. AT and Telecare  AT&T = the delivery of health and social care to individuals within the home or wider community outside formal institutional settings, with the support of devices enabled by information and communication technologies (Tang P, Curry R, Gann D. Telecare: new ideas for care and support @ home. Bristol: The Policy Press, 2000.) AEGIS – Brussels, 30 November 2011 13
  14. 14. AT and AAL (housing / environment)• (Semi)independent living elderly and pwd• Security• Communication• Comfort / convenience• Support Avoid institutionalizingAEGIS – Brussels, 30 November 2011 14
  15. 15. AT – universal design Universal design strives to be a broad-spectrum solution that helps everyone, not just people with disabilities and it recognises the importance of how things look. Assistive technology which is not guided by the universal design concept may benefit people with disabilities but result in separate and stigmatising solutions, for example, a ramp that leads to a separate entry to a building from the main stairway.. (Perry J, Beyer S, Holm S. Assistive technology, telecare and people with intellectial disabilities: ethical considerations. J Med Ethics 2009;35:81-86.)AEGIS – Brussels, 30 November 2011 15
  16. 16. Experience of rehabilitation professionals 75% of AT professionals believe that persons with disability do not receive the AT that they need Assistive product as a successful solution is very knowledge demanding and needs professional expertise of various domainsAEGIS – Brussels, 30 November 2011 16
  17. 17. Critical Success Factors (CSF) Knowledge Assessment Expectations / stigma / acceptance Ongoing process Sustainability / durability 17AEGIS – Brussels, 30 November 2011
  18. 18.  Different skills needed (not only technical) Profound knowledge of market (many and complex products) National and international networking Involvement and training of clientsNOTE: lack of sufficient evidence based practiceAEGIS – Brussels, 30 November 2011 18
  19. 19.  Multidisciplinary team - flexible and continuous Person-centered approach Task analysis (real-life scenarios) and site trials documentation the assessment Education/ training of the team, including the client Wide scope of knowledge is required to service delivery of ATAEGIS – Brussels, 30 November 2011 19
  20. 20.  High or low expectations Trial and error process AT he / she has a disability Involvement of users from the very beginning Creating informed choices Involvement of environment / family AEGIS – Brussels, 30 November 2011 20
  21. 21.  AT is more than a product “after sale’ is crucial Time lapse between need and provision (re)assessment as continuous process AT service includes training and ongoing trainingAEGIS – Brussels, 30 November 2011 21
  22. 22. 75% of AT devices abandoned within 3 yearsReasons: too complex no acceptance by users no acceptance by environment not enough training provided bad qualityTo do: better follow-up awareness raising and information (re)assessment as ongoing process AEGIS – Brussels, 30 November 2011 22
  23. 23.  is like a positive catalyst - it participates in the chemical reaction, speeds it up, but is not consumed by the reaction itself – it must be there but forgotten! Client skill and competency development Maximum independence Full participation in society / Inclusion AEGIS – Brussels, 30 November 2011 23
  24. 24. Ethical Issues Universal application / access for all Privacy Data protection Delegation of responsibility to machines ‘personal’ care vs. technology Relation provider / user 24AEGIS – Brussels, 30 November 2011
  25. 25. Ethical guideliness Privacy: access / protection Autonomy: decision about use of AT Integrity and dignity: respecting individuals as human beings Reliability: reliable AT solutions . No threat physical / mental health E-inclusion: accessible for all user groups Benefit for society: use of AT increase quality of life 25AEGIS – Brussels, 30 November 2011
  26. 26. Core drivers AT / ICT developmentKnowledge disabled end-userKnowledge diagnostician, (para)medical/technical professionals (eastin)Knowledge rules and procedures of service provider systems and reimbursement schemes in EuropeFlexibility in product design (different geographical markets)AEGIS – Brussels, 30 November 2011 26
  27. 27. Barriers AT / ICT developmentLack of knowledge marketDifferent interpretations national/regional levelsLack of coordination involved stakeholders Different national SP systemsHigh prices AT / ICT devicesAEGIS - Brussels, 30 November 2011 27
  28. 28. Industry key player AT / ICT Fragmented interest Mainly restricted to specialised niches Not recognizing market potential Major international industries developed only for US market European signal (Inclusion driven calls within FP6 and FP7-first step) Appropriate EC legislative frameworkAEGIS – Brussels, 30 November 2011 28
  29. 29. Purchase of AT / ICT by end userMedical model Disability / physicianSocial model National legislation / systems / agencies / fundingConsumer model Direct contact user - supplier AEGIS – Brussels, 30 November 2011 29
  30. 30. Future role of Rehab SP in AT/ICT (1)  Participation in R&D  Alliances with universities, research centers  Cooperation with industry  Involvement of own professionals in AT developmentAEGIS – Brussels, 30 November 2011 30
  31. 31. Future role of Rehab SP in AT/ICT (2) Cooperation with mainstream organizations Empowerment of service users Training of service users AT is a challenge but even more an opportunityAEGIS – Brussels, 30 November 2011 31
  32. 32. The message DC + DC DO AEGIS – Brussels, 30 November 2011 32

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