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
Official view of the European Union Digital, Healthy, Happy: ehealth https://www.youtube.com/watch?v=whwwknmu43o&feature=youtu.be
USING INTERNET, age group -> 16-25- 35-45- 55-65- 75-24 34 44 54 64 74 89 Male Female Email sending / receiving (%) 98 99 98 95 84 62 28 84 83 Banking 79 97 98 96 86 66 30 82 81 Search for things and services 91 97 91 91 82 60 25 80 78 New, tv-programmes 89 96 93 90 79 59 28 80 78 Info-search: illness, nutrition or health 75 80 78 71 61 46 21 56 72 Instant messaging service use 97 95 86 69 54 25 5 62 65 Listening music 99 94 79 67 47 24 9 64 59 Following sosial media like FB 96 92 81 64 44 26 12 59 62 Travel and hotel search 56 70 73 71 55 38 14 56 57 Blog reading 50 66 57 46 37 20 10 36 49 Doctor s appointment 28 44 45 47 38 26 9 30 41 Games playing, loading games 63 46 42 28 21 19 8 37 29 Internet-call and videocalls 57 47 43 28 23 15 8 33 31 Buying old staff 23 42 36 32 21 11 3 27 24 Selling own goods, services 20 38 33 23 17 11 2 19 24 Writing dating pages 12 13 12 9 5 3 1 11 5 Writing own blog 2 5 3 2 1 1 0 2 3 Source: Finland s official Statistics (SVT): Väestön tieto- ja viestintätekniikan käyttö [verkkojulkaisu]. ISSN=2341-8699. 13 2017, Liitetaulukko 19. Use of intenet in 2017, %-share of population 1). Helsinki: Tilastokeskus [viitattu: 11.3.2018]. Saantitapa: http://www.stat.fi/til/sutivi/2017/13/sutivi_2017_13_2017-11-22_tau_019_fi.html
A day in the life of a smartphone
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. 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. 1177.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: http://www.nationellehalsa.com/national-ehealth 6
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 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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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
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 2014. TemaNord 2015:539. http://dx.doi.org/10.6027/tn2015-539 12
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 2014. TemaNord 2015:539. http://dx.doi.org/10.6027/tn2015-539 13
Nurses technology - elderly
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. Nordic ehealth Strategies Supporting Nurses at the Forefront. Poster at ICN Conference: Nurses at the forefront transforming care. Barcelona, Spain, 27 May - 01 June 2017 16
Ongoing change is happening
Transformation Landscape Integrated assistive systems to support health self-management Technology enhanced care delivery systems for care providers Maeder 2018
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
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
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
How to enhance technology use of elderly
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
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).
e-health solution for the aged and community care and disability sectors - includes a self-service portal and telehealth monitoring platform for clients
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
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, 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 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
Services My health coaching My condition My health plan (in collaboration with social and health care staff Self-evaluation My health observations 31
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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Conclusion How patients in EU act and reflect elderly
www.eu-patient.eu
Elderly people want to be active and let their voice hear Thank you