Home care and telemonitoring artur serrano nst 2012 01-16

Home care and telemonitoring- Redefining Participatory Design - Artur Serrano Leader Research Group HOPE - HOme care and PErsonalised health NST - Norwegian Centre for Integrated Care and Telemedicine © 2012 NST Artur Serrano

HOPEHOPE Norwegian UNN• HOme care & Centre for • University Hospital in PErsonalized health Integrated Care Tromsø• 15 members andTelemedicine • Regional (North• Social Science Norway) • 100+ people • 4 hospitals• Health Care • Research Dep. • Patients treated• IT • Consulting Dep . (total) 350K © 2012 NST Artur Serrano

1. Home care and telemonitoring• Elderly/chronic care – Ageing population, increased price of hospital treatment – chronic care and re-hospitalization• Home care – care at home and Care Homes• Telemonitoring and telemedicine• Social care• Primary care• IT for health care -> electronic health• ... © 2012 NST Artur Serrano

Care servicesIn the following are my graphical understanding of the concepts involved in CareServices, and also the Dep. of Healths definitions of the various terms used in this topicarea (RSM web site): Healthcare Social CareTelecare – service user to responder: environmental Telemedicine monitoring such as fire, flood, fit and falls in order to ensure appropriate responses TelehealthTelehealth – patient to clinician: vital signs and eHealth general condition monitoring such as blood pressure, weight, mental & physical state as an aid to treatment of Telecare Home Care congestive heart failureTelemedicine* – clinician to clinician: seeking expert advice such as a GP consulting a dermatologisteHealth – all the above* I include in this Telehealth as defined before © 2012 NST Artur Serrano

Before• Branko G Celler et al. (1999) – “Very few studies to evaluate the cost effectiveness of home telecare have been published” – “Large-scale trials to compare quality of life and healthcare outcomes of a matched cohort of elderly subjects … are required to provide evidence” – “Implementation of home telecare will require fundamental changes in every sector of the healthcare services” … “and driven by patient demands for a greater role in shared decision making”. © 2012 NST Artur Serrano

Today• Latest systematic literature reviews in telehealth: – “Although home telemonitoring appears to be a promising approach (…) future studies should consider ways to make this technology more effective” Paré et al. (2010) – “limited number of high quality studies with suitable reference standards” Martin-Khan et al. (2010) – “There is a need for more detailed, better-quality studies and for studies on the use of telerehabilitation in routine care” Hailey et al. (2011) – “All included studies suffered from methodological weaknesses” Anna Davies, Stanton Newman (2011) © 2012 NST Artur Serrano

Technology that works?• Technology that works – Video conference? Panic button?• Technology that does not (yet) work – Fall detection, speech recognition, Integrated Care Services Platforms• Users motivation – Are we forcing the elderly to cross the street? © 2012 NST Artur Serrano

Challenges• 6 important challenges in the research field of “home care for the frail elderly” – Who are the users? A complex triangulation between professional carers, informal carers and the care recipients – Tackling inherent complexity of the elderly health conditions (e.g. comorbidity ) – Inappropriateness of methods for controlled trials – Lack of immersion of IT specialists in the actual care settings – Incapacity of creating feasible business cases – Technology (solution or challenge ?) Addressing specific needs of the elderly target group relating to technology usability © 2012 NST Artur Serrano

Possibilities for cruising safely to a new Home care reality CRUISE• C aring scenario – Who are the users? A fuzzy triangulation of professional carers, informal carers and the care recipients• R elate – Complex health conditions of elderly - e.g. long term, comorbidity• U nique-User Trial – New methods for controlled trials• I mmersion – Lack of immersion of IT specialists in the actual care settings• S preading – Addressing the incapacity to create feasible business cases• E ndogenous – Addressing specific needs of the elderly relating to technology usability © 2012 NST Artur Serrano

R for Relate• Relate – ”To establish or demonstrate a connection between” – Long-term effects -> unfeasible trials due to high costs and difficult logistics – Co-morbidity -> confounding variables – additional outcome parameters -> functional dependency scales (SF-36, International Classification of Functioning Disability and Health ICF, Short Functional Dependence Scale SFDS, PADL-H, Functional Independence Measure FIM) © 2012 NST Artur Serrano

U for Unique-User Trial • Instead of small or large pilots… • create real services’ trials with ANY number of users - Yes, 1 user is enough!!! Pilots and more pilots...© 2011 NST © 2012 NST Artur Serrano

I for Immersion• How many researchers in this field have been in touch with the real care environments?• E.g. GITWiC [Get In Touch With Care] give care hours in elderly care instead of money for CO2 compensationUnderstand and try to feel!What do they feel? © 2012 NST Artur Serrano

E for Endogenous• Endogenous – ”growing from within”• NO ”adapt technology to the user”• YES ”the user is the reason for creating the technology”• Universal Design• The user leads – When? The start! – How? Listen – How often? When decisions must be made – When stopping? Never © 2012 NST Artur Serrano

3. Where are we going?How to shape the future bynovel design of IT in anevolving world? or "How tobe futuristic when all ischanging so fast"? Elderly in a research trial The Giraff robot © 2012 NST Artur Serrano

Home care and telemonitoring artur serrano nst 2012 01-16

by Art Serrano on Jan 17, 2012

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Home care and telemonitoring artur serrano nst 2012 01-16 — Presentation Transcript