Transcript Document

Ageing and place
Considerations on the implementation of ICT for health and wellbeing in Ireland
Rodd Bond mriai
Netwell Centre, Dundalk Institute of Technology
Home Sweet Home Workshop
Barcelona - 17th Jan 2013
Netwell/Casala ……
The Netwell Centre and CASALA collaborate
with governmental agencies, academic
institutes and industry to:
• develop new ideas that enhance the
quality of life and well-being of older
people and those who care for them
• Through more integrated communityoriented services, more sustainable
home and neighbourhood design, and
more affective and age-friendly
technologies.
Individual & family’s
Quality of Life
(QOL)
Home,
Public / private
neighbourhood
& voluntary
& city
Quality of Service
Quality of Environment
(QOS)
(QOE)
The Issues – national cuts
Demographic pressure
Staff reductions
Reducing costs
Improving outcomes
The Issues – local cuts
Health spending cuts
36 Bed closures
Reduction in opening hours
70,000 Home help hours
Policy areas
National Agenda
• Health Strategy
• Positive Ageing Strategy
• Carers’ Strategy
• Dementia Strategy
• Public Sector Reform
• Local Government
funding !
Reform Weak
Capacity !
!
• IndustrialAusterity
Development
• R&D
National & European
EU Agenda
• Smart, Sustainable &
Inclusive Growth
• Demographic change
• EIP: AHA, Smart Cities
• Regional development &
competitiveness – smart
specialisation
Addressing weak
implementation!
• Horizon2020-R&D
Fragmentation !
• Social innovation
Greater dependency on collaboration with the
community & voluntary sector
1st Principle - Citizen centric
Person at the heart
Person
Family
Community/Voluntary
Public services
Private services
Connect
Care & Cure
1. Cross sectoral alignments
2. Pathway integration
Movements
Touch points
The AgeFriendly Cities
Movement Stakeholder collaboration
User/citizen engagement
Social innovation
Connectivity / ICT
Dissolving boundaries
Health
Services
Reform
Movements
Health Service Reform
Clinical quality
Resource
Reconfiguration
Front-line
Equitable access
Financial balance
Extend
organisational
edge for selfmanagement
Age-friendly cities / counties
•
Model for age-friendly city development
Buildings and outdoor spaces
Housing
Transport
Respect and inclusion
Social participation
Civic participation/employment
Information and communication
Community and health services
•
•
•
Connection:
Rural transport & urban mobility
Confidence:
Sense of safety & security
Empowerment:
Better access to better information
Alignment & Convergence:
Health, housing and care
Shareable places for all:
recognise frailty
Lifecourse:
Inter-generational solidarity
Energy for change:
Older people as a resource
Driven at a local government/community integration level
Leadership of individual county managers
National oversight and commitments
HOUSING
Energy
Effic.
Indoor
Temp/
(+)
Therm
alCom
f.
(-)
CVD
Risk
(-)
Blood
P.
Financi
al
securit
y
Fuel
Pov.
(-)
Stress
EDUCATION
Curriculu
m
Alcoh
ol
(+)
Diet
Nutr.
(-)
Obesity
Setting
(-)
CVD
Risk
(-)
Chole
st.
(+)
Exercis
e
(-)
Blood
P.
Socialisati
.
Smokin
g
SECURITY
Disorder
SocioDem
Char.
(-)
Obesity
Neighbo
ur.
Disadva
nt.
(-)
CV
D
Risk
(-)
Chole
st.
Walkin
g
(+)
Exercis
e
(-)
Blood
P.
Fear
(-)
Stres
s
ENVIRONM.
(+)
Diet
Nutr.
Transport
mobility
(-)
Obesity
Built
Envir.
Healthy
Urban
Plan
(+)
Social
(-)
CVD
Risk
(-)
Cholest
.
Walking
(+)
Exercise
(-)
Blood
P.
Natural
Envir.
(+)
Air
Qual.
ECONOMIC
Sociio
Ec.
Equlity
Social
Support
Area
based
Init.
Economi
c
Dev.
Strategy
Working
Condit.
Economi
c
Growth
Municipal
Investment
Incom
e
Employme
nt
HOUSING
EDUCATION
SECURITY
ENVIRONM.
ECONOMIC
Energy
Effic.
Curriculum
Sociio Ec.
Equlity
Social
Support
Socio-Dem
Char.
Area
based
Init.
Economic
Dev.
Strategy
Indoor
Temp/
Disorder
(+)
Thermal
lComf.
Comf.
Alcohol
(+)
Diet
Nutr.
Transport
mobility
(-)
Obesity
Built
Envir.
Healthy
Urban
Plan
(+)
Social
Working
Condit.
Setting
(-)
CVD
Risk
(-)
Cholest
.
Walking
Economic
Growth
Neighbour.
Disadvant.
Municipal
Investment
(+)
Exercise
Income
(-)
Blood
P.
Natural
Envir.
(+)
Air
Qual.
Fear
Socialisati.
Financia
l
security
Employment
Fuel
Pov.
Smoking
(-)
Stress
Service Innovation Needs
Connecting the dots,
managing the flows
Care delivery locations
Service quality/risk zones
Hospital
clinical
Pathways
Entry/exit points
Transfers/visits/calls
Assistance/info access
Referral points
Community
Care paths
Home Selfmanagement
Poorly organised inter-site services coordination,
compounded by under-developed community/home capacity,
and information access/exchange.
REQUIREMENT TO:
• Improve connections and
flows between care delivery
locations.
• Provide better intelligence
to support better decisionmaking across settings.
• Increase patient / family
home-based management
capacity.
• Improve mobilisation and
allocation of community
resources.
• Provide visibility of patient
status 24/7 in home and
community.
• Extend reach of clinical
excellence through
community to home.
Connecting the dots,
managing the flows
Service Navigation Hub
Care delivery locations
Manage services interaction
zone
Hospital
clinical
Pathways
Services Navigation Hub
Community
Care paths
Home Selfmanagemen
t
ConnectedCare infrastructure, with core clinical and triage
capability provides distributed platform to support pathway
integration for falls, chronic diseases, dementia.
OPPORTUNITIES TO:
•Locate clinically led advanced
nurse practice (ANP) at heart of
connection.
•Coordinate / improve
pathways/protocols between
services.
•Develop ICT-based ‘community
intelligence’ information resource.
•Provide clinical ‘triage’ as
screening service (24/7)
•Implement ICT-based
‘connectedCare’ between home,
community and
hospital/outpatients.
•Strengthen community care and
‘service-to-home’ quality and
capacity
Extended Navigation Hub
Connecting the dots,
for health AND well-being
Hospital
clinical
Pathways
Managed service interaction
zone
Services Navigation Hub
(ANP)
Community
Care paths
Home Selfmanagement
Service broker
Cultáca
Safety/
security.
Transport.
Home repair.
Isolation/
social connection.
Age-Friendly community-based service network.
OPPORTUNITIES:
•Services Navigation Hub
provides rich and coherent
connection to community services
and resources out-side of the
health service domain.
•Link with age-friendly services
broker, or similar (concept in trial
in North Louth) can align
resources to promote well-being
and maintain quality of life.
•Opportunity to connect ICTbased applications for Connected
Care and Connected Community
onto an integrated ‘cloud-based’
platform, maximising
effectiveness and efficiencies.
For consideration
A transformation architecture
Empowerment:
Efficiency:
Energy for change:
Usability
Usefullness
Choice
System/service integration
Clinical efficacy
Shifting silos and boundaries
Motivation
Attractiveness
Sustainability
Implementation readiness
Standards
Framework:
Procurement
Framework:
Social organisation
& innovation:
What to fix
What’s free to innovate
Freedom of the individual
Controlled by the tax-payer
Motivation
Trust in collaboration
Sustainability