A New View on the European Knowledge Society

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ICTs for Health Independent Living Services C.
Centeno, R. Ozcivelek, N. Malanowski, M.
Cabrera Institute of Prospective Technological
Studies (IPTS) DG JRC, European
Commission http//fiste.jrc.es
ICEG EC Growth and Jobs ConferenceBudapest,
6-7th April 2006
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Institute of Prospective Technological Studies
(IPTS)
Part of the DG Joint Research Centre of the EC -
7 Institutes across Europe
IPTS mission to provide customer driven support
to the EU policy-making process by researching
science-based responses to policy challenges that
have both a socio-economic as well as a
scientific/technological dimension
IPTS tools for research Participation in FP
projects Open Calls, Experts workshops, networking

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Relevance of Health Sector

• Health Sector in EU 15 (2000) (1)
• Expenditure equivalent to 8 of GDP
• 684 billion total annual health expenditure
  , 1800 per capita
• 15 million employees (9.2 of total EU), more
  important than retail (13m) and business services
  (13.3m)
• Consensus on Health as a key priority area (2)
• (1)eBusiness W_at_tch, 2004
• (2)FISTERA project http//fistera.jrc.es,
  National Foresight exercises, 500 experts Delphi

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Experts consensus on some key priority areas
National FS 2001 to 2005 Delphi
Source FISTERA project
Conclusion
Actors
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Challenges Rising Health Care Costs Across EU gt
5 annual increase per year
Source OECD, 2005
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Challenges ageing
Share and number of population 65 years
increasing
In 2050 28 of population will be 65 Almost
double todays
Source Population Division, UNDESA

• Expected to put pressure on health care and
  long-term care costs,
• but which are also influenced by
• health status of elderly (healthy life
  expectancy)
• unit costs (wages, pharmaceutical)
• income elasticity of demand
• technology management and
• health policies (access, quality, prevention,
  support for informal care)

Source EPC and ECFIN report on The impact of
Ageing on public expenditure, March 2006
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Other challenges

• Increased share of women at work
• Changing family patterns
• Greater family mobility and migration
• Challenging family care
  options (80)
• Increasing demand for institutional care,
• or reducing quality of life of those in need

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Challenges and opportunities are high in the
political agendas

• Health
• WHO, Active Ageing, a Policy Framework
• Economy
• Active Ageing included in the European Employment
  Strategy
• Importance of Active Ageing re-emphasized in the
  mid-term review of Lisbon Strategy
• Technology
• i2010 policy includes Technologies for an ageing
  society as a flagship initiative
• Ambient Assisted Living Technologies initiative

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• Turning the big challenges into an opportunity
• Active Ageing and Independent Living

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Maximising Independent Living of the ageing

• Widely accepted that active life styles are
  determinants for good health and quality of life
• The ability to perform the activities of
  daily life with no or little help from others.
  But also the ability to control ones life,
  remain integrated within a community and the
  ability to participate to the social, cultural,
  political, economic life
• Health care Medical treatment
• Dimensions of life Housekeeping Se
  curity
• Participation Social Networking
• Learning Entertainment
• Independent Living also valid for disabled,
  temporary or chronic ill and wider population

SourceIPTS, Future of Independent Living
Services Project
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Olders preferences with regards to technology
Household
Health Care
Learning / Entertainment
Smart Home
Security Secure door Self-deactivating
cooker Personal emergency call Comfort
Automated light in entrance Noise adjusting
door-bell Automated heating
Tumbledryer Dishwasher Microwave
Hand holds in bathroom Blood pressure / Pulse
meter Massage device
Cordless phone Answering machine Cellular
phone
German Center for Research on Ageing, Database
sentha survey 1999 N1, 417 weighted data.
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Barriers to seniors independence

• Physical health
• Mental health
• But also
• Housing
• Transportation
• Mass market products and services
• Income

• Mobility impairment
• Pain
• Sensory loss
• Fall-related injuries
• Chronic illness
• Adverse drug reactions
• Loneliness
• Dementia and cognitive impairment
• National Advisory Council on Ageing, 1988
  (Canada)

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Examples of ICT based services The Tele-alarm
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Tele-care
Carers Station
Patients Station
ISDN
Office
128 kbit/s
Hospital
ViSaDom Network
Home
Département de Médecine Communautaire du C.H.U.
de Grenoble1 Pr Alain FRANCO
france telecom R D
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Smart Homes

• Many examples
• Europe AID House, Gloucester Smart House for
  people with dementia and Dementia Friendly
  House (UK), Smart model house (NL), comHOME
  (Sweden) , PROSAFE, Gardien, Grenoble HSH,
  Smardep (France)
• North America Rochesters Smart Medical Home,
  Georgia Techs Aware Home (USA), MITs House of
  the future, Sherbrookes smart home (Canada)
• Asia 'Smart House in Tokushima' (Japan).
  Australia Functional health status of the
  elderly people at home.

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Potential technologies for Independent Living
Services
Design for all and Inclusive Technologies
Mainstream, everyday
products, services and
Technology-
applications
Assistive
supported
Technologies
care services
Consumer electronics (Mobile)
Mobility
Smart homes
eServices Health Information Video Service
eLearning e-communication Networking
Telecare Home care
Vision
Telemedicine Telemonitoring Emergency systems
Hearing
Security Emergency
Workplace
Cognitive
technologies and
Healthcare
Tools E-work
Technologies Prevention services
Ambient intelligence
Robotics
Biosensors
Materials
Emerging technologies

• Source David Cullen, wrt Dublin 2005, adapted

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ICTs potential in Independent Living Services

• Enabling services in all dimensions of life
• Health care Medical treatment
• Housekeeping Security
• Participation Social Networking
• Learning Entertainment

Time and Complexity

• Participation, social networking, learning,
  entertainment
• Security, monitoring, comfort, housekeeping
  services
• Can introduce paradigm shifts in interface,
  procedural and organizational dimensions of
  medical care providing opportunities for new
  models of care
• Tele care, home care, seamless care
• Future applications

ICT based services ICTs combined with Ambient
Intelligence technologies ICTs combined with
Medical services ICTs integrated with other
technologies (bio, nano, cogno)
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Present barriers for realizing the potential of
ICT-based ILSLow IT expenditure
Source Eito 2005
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Low ICT infrastructure by the sector
ICT Infrastructure Index 2003/04
ICT use in health sector lags behind, Least
connected sector Great disparities across
countries and firm sizes etc.
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Low ICT use by patients
Source eUser, 2005
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Low ICT use for patients - doctors interaction
Source eUser, 2005
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In particular, low ICT use by ageing

• 50 have difficulties in using a PC and a
  mobile phone
• People in poor health use mobile phones and
  Internet less than people in good health
• and as technology evolves, a persistent risk of
  technology exclusion of older
• physical and mental impairments need to be
  accounted for in design

German Center for Research on Ageing, Database
sentha survey 1999 N1, 417 weighted data.
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Other barriers for ILS Miss-match between
supply and demand
Demand
Supply
Technological options
Use/ Acceptance of products/ services
Materials, Micro and embedded systems,
telemedicine, smart objects ,HMI, ubiquitous
Communication and Computing, context aware
services, Robotics, Security, ..
e.g. adequate design usability usefulness
privacy functionality personal control
affordable risk-free
Matchingdemand and supply
Industry/ Providers
Elderly people, caretakers

Service providers, ICT products, white goods,
smart homes, social care, insurances, health
care
Needs in Health/Activity Monitoring,Safety/
Security, Assistance,Independence,
Mobility, Social Contacts,
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Ethical challenges

• Who takes decision? (allow opt-out, decreasing
  human ability)
• Privacy and access rule to Eletronic Health
  record data
• Intrusiveness of technology (Videocameras,
  teleconsultation)
• Risks associated to technologies supporting
  critical-life functions (reliability, maintenance
  and responsibility in case of failure)
• Perceptions of lost decision-making ability or of
  potential erosion of social interactions
• Potential harm to self-image and self-confidence
  of the user

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Conclusions

• Health sector a key challenge for Europe
• ILS has huge potential for addressing the
  challenges
• For realising this potential
• ILS has to be embedded in ICTs for Health
  policies
• Innovative RD needed

Source Experts workshop, Nov 2005
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• Thank you !
• Contact clara.centeno_at_cec.eu.int
• http//fiste.jrc.es

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Most difficult activities for elderly
German Center for Research on Ageing, Database
sentha survey 1999 N1, 417 weighted data.
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How 65 citizens perceive the impact of health in
their daily activities limitations?
of people limited
Source The Survey of Health, Ageing and
Retirement in Europe (SHARE) www.share-project.org