Digital Methods and Tools to Support Healthy Ageing
2: WHO Collaborating Centre, UNSW Sydney, New South Wales, Australia
3: Department of Neuromedicine and Movement Science (INB), Faculty of Medicine and Health Sciences, NTNU/Norwegian University of Science and Technology, Norway
While digital transformations are happening in all walks of society and business, there is real potential for improving the quality of life of the elderly using digital methods and tools. This book evolved from a recent multi-country and multi-disciplinary initiative called Digital Health for the Ageing Population. This project (2019-2021) aimed to promote the general awareness of digital health for the ageing population with collaborative research across several countries including Australia, Bangladesh, China, India, Japan, Norway, The Netherlands, and USA.Digital health promises to deliver better healthcare quality cost-efficiently to more people, especially in the case of lifestyle diseases such as diabetes. It will achieve this by combining the benefits of telehealth, eHealth, data-driven personalised healthcare, and evidence-based care. This book presents a discussion of evolving digital technologies, such as smart phones and assisted living, and innovative digitally based services that are helping improve the quality and cost of healthcare for the elderly.With its international scope and detailed coverage of relevant digital methods and tools, this book will benefit healthcare technologists, ICT developers, managers of healthcare and mobile healthcare projects, and academic researchers working in related fields.
Inspec keywords: health care; medical computing; epidemics; geriatrics; mobile computing
Other keywords: medical computing; diseases; health care; epidemics; geriatrics; mobile computing; patient treatment; ageing; medical robotics; medical information systems
Subjects: Biology and medical computing; Mobile, ubiquitous and pervasive computing; General and management topics
- Book DOI: 10.1049/PBHE039E
- Chapter DOI: 10.1049/PBHE039E
- ISBN: 9781839534621
- e-ISBN: 9781839534638
- Page count: 360
- Format: PDF
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Front Matter
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1 Book overview: digital health for ageing population
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This book evolved from a new multi-country and multi-disciplinary initiative called Digital Health for the Ageing Population. This project (2019-2021) aims to promote the general awareness of digital health for the ageing population with collaborative research across several countries (developed and developing) including Australia, Bangladesh, China, India, Japan, Norway, the Netherlands and the USA. This project follows from the recently completed project mHealth for Belt and Road region (2018-2020) involving more than 50 investigators from 14 countries. The outcome of the project was published in the recent IET book Mobile Technologies for Delivering Healthcare in Remote, Rural or Developing Regions.
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Part I Underpinning principles of Digital Health
2 Digital health maturity – a foundational principle
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Digital health maturity is a foundational principle and a multidimensional construct comprising four essential digital health foundations and a cross-cutting quality improvement and evaluation foundation. Digital health maturity assessment is a quality improvement process from a personal, professional, organisational and system perspective, within the context of harnessing digital tools to achieve a country's strategic health priorities. The co-creation approach is an essential element with a capacity of development emphasis, beginning with the co-creation of the digital health profile and co-assessment of the maturity status, using a well-tested DHPMAT. This information from the DHPMAT is used to co-develop an achievable and sustainable digital health roadmap and operational plan with a realistic budget. The DHPMAT enables an overview and roadmap for the multisectoral co-implementation, co-monitoring and co-evaluation of digital health programmes and progress in achieving milestones in the roadmap.
3 Global demographic changes and ageing population: an overview
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Population ageing, or the increase in the relative number of older persons in a society, has been recognized as a major global issue for decades.The first item, different speed and extent of population ageing, certainly is a major factor that shapes the challenges to society. These are the main tasks of this chapter: providing an overview of the global population ageing by (i) describ-ing the speed and extent of population ageing in different parts of the world and (ii) providing a summary of the discussions concerning the challenges it brings to societies. Technologies can also encourage social engagements of the elderly by assisting with the mobility and making flexible arrangements of gatherings possible.
4 Digital health and elderly care in low- and middle-income countries: opportunities and challenges
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This chapter focuses on the use of digital tools in healthcare for elderly population in LMICs. Digital health presents a window of opportunities to provide health-related education, consultation, treatment, prevention services with the potential of improving the quality of life for elderlies. In this chapter, we provide a concise review of studies that employed digital tools for the management of diseases and disabilities of the elderly in developing countries. We also highlighted the role of family members or informal caregivers within the support system for elderlies. Furthermore, we adopted the SEM to introduce a conceptual framework through case studies that employed digital tools for elderly care in LMICs.
5 Health co-benefits in climate action policies for healthy ageing
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"Ageing is like climbing a mountain, you get out of breath but you have a magnificent view" (Ingmar Bergman). The world has seen a rapid rise in life expectancy and a reduction of morbidity, thanks to the advances in medical science. However, healthy life cannot be achieved only by taking medications and it depends on various factors in a person's life including economic condition, social and environmental factors, education, upbringing, etc. The WHO Report on Global Age-friendly Cities provides a holistic view involving six key determinants of Active Ageing (personal, physical environment, economic, social, behavioural and social and health services).
6 Health data privacy for aged population in Australia
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More than 15.9% of Australia's population is aged 65 years or above as of 2019 and this group is projected to increase more rapidly over the next decade. Over the last few years, there has been an active push by healthcare providers to have patient health data and records uploaded online for better and faster healthcare services. Due to Covid-19, many health service providers are taking their patients' records to online platforms. Even though accessing these online health records has become much easier and more cost-effective than working with physical documents, there has been increased awareness and concerns regarding health data privacy. In this chapter, we will look at the Australian health data privacy and how it is applicable to online health data of the aged population.
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Part II Digital Health Services for Healthy Ageing
7 Silvercare: a model for supporting healthy ageing services
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Ageing is a normal and inevitable physiological phenomenon. This is an age where people are urged to make this phase of life enjoyable and worth living. Silvercare models serve to provide assisted living services. The Silvercare model has been used in several countries, such as Japan and Singapore. Here we discuss the Silvercare model which is a win-win solution for two groups of people: elderly above 65 years (beneficiaries) and relatively young pensioners above 60 years (coordinators), retired from the workforce but willing to help older people in their neighbourhood. The silvercare application case studies were conducted as part of the project called 'Tablet-Based Well-Being Check' led by Pradeep Ray. In order to implement a practically feasible solution from the perspectives of all stakeholders (IT people, elderly, family members, healthcare providers and aged care providers).
8 Safeguarding the elderly in a pandemic: role of lockdown policies and digital health technologies
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Our systematic literature review has shown that the governments worldwide took several strategies to save the countries from pandemic using lockdown and partial lock-down policies. The study provided information about the severe impacts of the lock-down policies and their limitations in terms of the health of the elderly and found how these severely impacted their lives due to disruption in movement and social gatherings. If Covid-19 stays for long (and even for future pandemics), the policy-makers are required to come up with more innovative, granular approaches than complete lockdown to safeguard the older people. These measures could be different in different countries/communities based on their economic, social and cultural needs. Moreover, the use of digital services and technologies in contact tracing and health service delivery can be useful for maintaining social distancing and resuming economic activities. The challenge is to develop a unified, global high-level policy framework with an integrated digital approach, which would require substantial research in the foreseeable future.
9 Digital mental health in Bangladesh “MonerDaktar”: caring seniors during COVID-19
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Mental health matters and there is "No Health Without Mental Health." However, mental health care has long been neglected in health care policy, receives a tiny fraction of the health care budget, and is stigmatized. As a result, about 85% of people who are living in low- and middle-income countries (LMICs) received no treatment even for serious mental health disorders. However, this long-standing crisis in health care deepened during the recent coronavirus (COVID-19) pandemic due to bereavement, isolation, loss of income, fear of death, substance abuse, and/or exacerbating pre-existing mental illness, and all-round helplessness. Although the mental health crisis is accelerating, there are inadequate solutions to meet this crisis. The situation is more severe for seniors in LMICs as they have limited and in most cases no access to expert mental health professionals.
10 Digital health for aged care from a service perspective
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This chapter has provided an overview of the principles of digital methods and tools for enabling aged care services, as explained in the context of medication management (important aspect of aged care) from the perspective of supply chain management. The discussion has been organized at three major levels: service level, process level, and technology/tools level. The same methodology is applicable for other types of aged care services, such as admission, assessment, and care planning shown in Figure10.2 in the Section 10.2 "Aged Care Services and Providers".
11 Role of digital technology in aged care in China
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This chapter provides an overview of the role of digital technologies and services for aged care in China. Various data and existing technologies in aged care industry have been analyzed. A case study of Haiyang Group has shown how a pension company takes advantage of digital technologies. It will help readers to better understand the importance of digital health services for healthy ageing.
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Part III Digital Tools for Healthy Ageing
12 Using powered exoskeletons for rehabilitation in healthy ageing – a societal perspective
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This chapter explores how powered exoskeletons may be used in rehabilitation for older adults. It argues that combining characteristics of social robots with state-of-the-art exoskeletons, to create a social exoskeleton, will promote a disruptive innovation in the use of this technology for care. In order to implement technology into existing societal infrastructures, careful attention has to be given to the potential impacts. This chapter draws attention to these in the light of the concept of Responsible Research and Innovation (RRI). Seven specific sociotechnical considerations for technologists, regarding namely accessibility, economy, inclusivity, environment, culture, law, and ethics, are discussed.
13 SENSE-GARDEN – A concept and technology for care and well-being in dementia treatment
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This chapter describes the original SENSE-GARDEN concept and its supporting technology. In addition, it gives an updated reporting on the current implementations in real care settings. The chapter has a technical perspective but gives insights into both the clinical and the sociological perspectives. For the validation of the SENSE-GARDEN the test sites have conducted a clinical study designed as a multisite before-after controlled trial.
14 Challenges and opportunities in the adoption of IoT for the elderlys health and well-being: a systematic review
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With the advent of medical science and treatment, the aging population is increasing each year globally. Supporting regular care for the aging population at a large scale is a matter of great expense and labour-intensive. Without using new technologies, it might be a challenge for most countries, if not all, to support elderlies' needs with limited resources. To address this challenge, technologies like wearables and smart homes, powered by the Internet of Things (IoT), are now being employed to offer innovative ways to enable the elderly population to an independent living and improve health and well-being. While IoT is meant to ease the life and care of elderlies, the adoption of IoT-based devices is reported very low. Therefore, new studies should be conducted periodically to gain updated knowledge in terms of use cases and efficiency. Consequently, the authors have conducted an integrative review of the existing literature reviews on the use of IoT for older people. The authors conclude that a lack of formal clinical studies and contradictions in existing study findings are frequently reported. Hence, the authors suggest gathering more empirical evidence as a strong basis for a large-scale adoption of IoTs by the older population.
15 Designing mobile healthcare applications for elderly users
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Individuals over the age of 60, categorized as elderly, pose a unique challenge to mobile health application designers. Effective application design for this demographic recognizes and accounts for the average physical and mental obstacles that impair adoption and continued usage of healthcare applications for an older population. Application designers must also acknowledge the aesthetic and content preferences of the elderly and how they may differ from mobile phone users in other age groups. This chapter will present the challenges associated with designing mobile healthcare applications for the elderly followed by a series of recommendations for developers interested in designing an app for this demographic.
16 Telepresence robots for healthy ageing
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Researchers have been investigating the use of robots in the world for elderly in various types of applications, such as communication with relatives and friends at a distance, transportation of medical supplies and equipment across healthcare/aged care facilities, surgical procedures, etc. In China, ground zero of the COVID-19 outbreak, robots are being used in hospitals to deliver food and medication and take patients' temperatures. Drones are deployed to transport supplies, spray disinfectants, and do thermal imaging. This chapter will focus on telepresence robots that have become critically important to perform remote healthcare operations, complying with social distancing measures. The University of New South Wales (UNSW) and University of Sunshine Coast have been partners in the European Union VictoryaHome (VH) project (2014-2016) that involved Australia and EU countries Norway, Sweden, the Netherlands, and Portugal. The project was aimed at better emotional health of the elderly and their security at home. The project identified some major problems, such as the high cost of the robot and its high complexity, making its adoption difficult. This led to the project "Robots for Elderly", as part of the new "Robots for Elderly" project (involving Australia, China, Bangladesh, and EU) in mHealth for Belt and Road (mHBR) Initiative led by the UM-SJTU Joint Institute in China from 2018. The aim of this study is to design, implement, and test a low-cost telepresence robot for healthcare. The focus has been on implementing a low-cost telepresence robot for healthcare management for the elderly during pandemics like COVID-19.
17 Conclusion and future work
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This paper describes some underlying principles and examples of the use of digital methods and tools for healthy ageing. It brings together major international projects supported by the global bodies, such as the WHO, EU, and other international agencies from researchers in Australia, Bangladesh, China, Europe, Japan, and the USA. The chapter authors have discussed the challenges presented to those seeking to deploy digital technologies that have become so important for healthcare and aged care as evidenced during the COVID-19 pandemic. The book should be of interest to governments and industry, researchers, and academics working in aged care. As well as sections on the use of digital technologies (e.g., IOT, robots, mobile applications) the book has also included case studies related to the development of public-private partnerships and the cooperation required to facilitate the deployment of digital methods and tools to care for the vulnerable and aged population.
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Back Matter
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