Digitalisation enhancing voice of elderly

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1 Digitalisation enhancing voice of elderly PIRKKO KOURI PhD, PHN, RN Principal Lecturer in Healthcare Technology Coordinator for the Master programme development group in Savonia UAS China collaboration coordinator in Social and Health care field Vice-President of International Society of Telemedicine and ehealth Member of IMIA-NI Nursing Informatics Education Working Group Secretary of Finnish Society of Telemedicine and ehealth Board Chair of Regional Cancer Association

2 Official view of the European Union Digital, Healthy, Happy: ehealth

3 USING INTERNET, age group -> Male Female sending / receiving (%) Banking Search for things and services New, tv-programmes Info-search: illness, nutrition or health Instant messaging service use Listening music Following sosial media like FB Travel and hotel search Blog reading Doctor s appointment Games playing, loading games Internet-call and videocalls Buying old staff Selling own goods, services Writing dating pages Writing own blog Source: Finland s official Statistics (SVT): Väestön tieto- ja viestintätekniikan käyttö [verkkojulkaisu]. ISSN= , Liitetaulukko 19. Use of intenet in 2017, %-share of population 1). Helsinki: Tilastokeskus [viitattu: ]. Saantitapa:

4 A day in the life of a smartphone

5 Nordic countries strategies ehealth communication

Overview of e-health Communication in Sweden National Patient Overview All care providers publish patient Information. Healthcare staff can access if the patient consent.

6 Overview of e-health Communication in Sweden National Patient Overview All care providers publish patient Information. Healthcare staff can access if the patient consent. Not so much used shared EMR systems in the counties/regions reduces the need My Healthcare Contacts e.g My Care (secure login) lets citizens request, cancel, or reschedule healthcare appointments, renew prescriptions, and request contact with a specific clinician or hospital se The Care Guide, national phone number and website for questions and guidance about symptoms, diseases, and healthcare. Decision support for nurses giving advice on the phone. (Available in different languages) Read more: 6

7 Overview of e-health Communication in Norway 7

Overview of e-health Communication in Denmark Citizens (Orange), GP/Specialists (Green), Hospitals (Blue) and Health Authorities (Purple) can see different information through the

8 Overview of e-health Communication in Denmark Citizens (Orange), GP/Specialists (Green), Hospitals (Blue) and Health Authorities (Purple) can see different information through the portals. Two access portal: Sundhed.dk (Red), which is for citizens and professionals, and the Health Data Net (Cloud) which gives access to a variety of systems for professionals. 8

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11 PERSONAL HEALTH RECORD (PHR) is an integral part of personalised health Data can be entered through web applications, online services and mobile apps. Kela builds the PHR data management platform and some essential web user interfaces as part of My Kanta Pages (Finnish national patient portal). Third parties will develop services which produce, store and analyze the data. Nationally and regionally coordinated projects are developing self care solutions a general trend and hot topic at the moment. Two big national projects are involved: ODA (for primary healthcare) and Virtual Hospital (for specialized healthcare) Healthcare professionals will be able to access the data with patient s consent, and put parts of it on the official patient health record. 11

12 Analysis of Nordic National ehealth Strategies Strong adherence to standards, public funding and centralized governance. The emphasis is on improving information security and patient privacy Policy documents contain affirmations about increasing the quality, statements of empowerment and activation of patients/citizens to access information, and effectiveness of healthcare services through the use of IT within healthcare, especially in Denmark ICT as a tool and support for the healthcare organisations change processes was important in Sweden and in Denmark The make better processes with ICT was important too to Sweden and Denmark. (ehealth tools to doctors in Sweden and in Norway, and ehealth tools for the patients in Sweden & Finland) The infrastructure of well functioning ICT was emphasized in Finland Plans for standardization were in Finland, Sweden and in Norway. To make better access health information and importance of using health IT to improve access to relevant health information to promote continuity of care and increase patient safety was mentioned mainly in Icelandic, Swedish and in Norwegian strategic plans. References: Nordic ehealth Benchmarking. Status TemaNord 2015:

13 Features - ehealth in Nordic Countries All the Nordic countries have implemented or are in a process of implementing a National Health Information System (NHIS), and Finland and Sweden also have regional repositories. Patient Portal functionalities are either local or national e.g. mediating prescriptions electronically to be dispensed from any pharmacy and viewing list of patient s prescriptions were available in 100% of public organisations in all the Nordic countries. The proportion of eprescriptions of all prescriptions made in 2014 exceed 60% in all the Nordic countries In Finland prescription data and in Iceland immunization data were also viewed relatively frequently References: Nordic ehealth Benchmarking. Status TemaNord 2015:

14 Nurses technology - elderly

15 Henderson defined the essence of nursing as follows (in 1979) To help persons, sick or well, from birth to death, with those activities of daily living that they would perform unaided if they had the strength, the will and the knowledge to do so. (Henderson, 1979, p. 246) The challenges relate to the conflict between the humane (the art of nursing) and the technological aspects of nursing practice (the science). Henderson s goal: basic nursing care is essential to human welfare, while achieving technological competence to enhance clinical practice.

ehealth supporting nurse and patient towards multiprofessional collaboration Figure. Ahonen O., Kouri P., Kinnunen U-M., Suutarla A. 2017.

16 ehealth supporting nurse and patient towards multiprofessional collaboration Figure. Ahonen O., Kouri P., Kinnunen U-M., Suutarla A Nordic ehealth Strategies Supporting Nurses at the Forefront. Poster at ICN Conference: Nurses at the forefront transforming care. Barcelona, Spain, 27 May - 01 June

17 Ongoing change is happening

18 Transformation Landscape Integrated assistive systems to support health self-management Technology enhanced care delivery systems for care providers Maeder 2018

19 Motivation Caring for elders in our ageing society requires transformation of care models and delivery Information technology and digital health can assist transformation by providing new tools Knowledgeable citizens

20 Ageing in Place Achieving Personal Health and Wellness Healthy Ageing Personal Assistive Systems Maintaining Community Connections Ageing-friendly Connected Communities Reducing Adverse Events Health-Smart-Homes for Ageing

21 Ageing with Care Personal Health Trajectories Ageing Health Care Ecosystems Chronic Disease Management Health Condition Management Systems MyCare Consumer Portal and MyKanta examples Ageing Health Information Environments In all cases: Quality of Aged Care and Compliance should be monitored

22 How to enhance technology use of elderly

23 Education increases voice of elderly Setting a clear vision Establishing goals and measurements Providing a plan and a roadmap to success Creating a good and effective work environment Managing implementation and communication Minimizing disruption Providing training and effective support Providing good management, assistance and leadership Staying focused Selling your program to others Publishing your results and accepting both outside criticism and recognition

25 My AgeCare -Service to stay at home Help at home personal care like help getting dressed transport modifications to your home like hand rails or ramps nursing, physiotherapy and other care meals household jobs like cleaning or gardening equipment like walking frames social activities Short-term help when you have had a setback and want to get your independence back recovery from an accident or illness, including after a hospital stay when you or your carer needs a break (respite care).

26 e-health solution for the aged and community care and disability sectors - includes a self-service portal and telehealth monitoring platform for clients

27 Real patients in a virtual hospital (Virtual Hospital Project) Finnish university hospitals are building a joint national virtual hospital, a digital service hub for specialist health care The Terveyskylä ( Health Village ) portal, intended for the patients, their families and health care professionals, is part of the Virtual Hospital Project

28 A citizen chooses houses focusing on mental health, weight management, pain management, women, rehabilitation and rare diseases by the end of this year there are 20 houses serving citizens

Choose your own house And step in You find services: Guides to use Feedback Qualified Information, advice, information search helpers Self- tests, quiz, sympton navigator Support,

29 Choose your own house And step in You find services: Guides to use Feedback Qualified Information, advice, information search helpers Self- tests, quiz, sympton navigator Support, peer experiences, patient associations, III sector Self-care guides Self-care programmes/digital treatment pathways, and guidance Care paths, and other services, follow-up, rehabilitation

Services My own Health and welfare Digital Services Estimation client s life situation Planning of care and services Realising care & services My condition My health

30 Services My own Health and welfare Digital Services Estimation client s life situation Planning of care and services Realising care & services My condition My health observations My health plan My health coaching Self-evaluation Benefits: Flexibility, no time or place depency + continuing follow-up, more choices, easiness, transparency, my voice 30

31 Services My health coaching My condition My health plan (in collaboration with social and health care staff Self-evaluation My health observations 31

32 Technologies give people the opportunity to take greater control of their own health. Take elderly with all phases from planning to realisation,

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34 Conclusion How patients in EU act and reflect elderly

39 Elderly people want to be active and let their voice hear Thank you

Current reality and trends of ehealth in Finland

Current reality and trends of ehealth in Finland PIRKKO KOURI PhD, PHN, RN Principal Lecturer in Healthcare Technology, Savonia University of Applied Sciences Coordinator for the all Savonia s Master programme