ILC-UK, New Dynamics of Ageing and the Actuarial Profession debate: Improving care, tackling...

Improving care, tackling isolation and reducing costs? Can new

technology live up to its promise?

16 May 2012

This event is kindly supported by the New Dynamics of Ageing

#tech4care

Welcome

Baroness Sally Greengross

Chief ExecutiveILC-UK


#tech4care

Alan WalkerDirector

The New Dynamics of Ageing Research Programme

The New Dynamics of Ageing Research Programme


#tech4care

ALAN WALKERDIRECTOR OF THE NDA PROGRAMME

THE NEW DYNAMICS OF AGEING RESEARCH PROGRAMME

2005-13

The NDA is a multidisciplinary research collaboration to both investigate the new dynamics of ageing and the various influences shaping them; and to show how their consequences can be managed to achieve the maximum benefits for older people and society

ESRC, EPSRC, BBSRC, MRC, AHRC Budget = £22 million 2005 – 2013 35 projects, 136 senior researchers, 29 post docs, 22

PhDs, 128 others


Generate new knowledge: life course influences, changes and increasing diversity in meaning and experience of ageing

To encourage and support the development of new multi- and interdisciplinary perspectives on ageing

To encourage comparative research and provide new opportunities for UK science to link with other countries

To support a new generation of multidisciplinary researchers To provide a sound evidence base for policy, practice and

product development so that research contributes to well-being and quality of life


PROGRAMME OBJECTIVES

www.newdynamics.group.shef.ac.uk


http://www.newdynamics.group.shef.ac.uk/

Mark HawleyProfessor of Health Services Research

University of Sheffield

Is technology for older people cost effective? Do we know and does it

matter?


#tech4care

Is technology for older people cost-effective?

Do we know and does it matter?

Mark HawleyUniversity of Sheffield

12/04/2023 © The University of Sheffield

Cost-effectiveness

12/04/2023© The University of Sheffield

Cost

Health gain

Technology for Older People

• Assistive Technology• Information and Communication

Technology• Smart homes• Telecare• Telerehabilitation• Telehealth


Ageing and TechnologyBlaschke et al, Br J Social Work 2009

• Assistive Technology• Behaviour monitoring, telehealth, smart homes• ‘no clear evidence at present that any one

technology will be both efficient and cost-effective’

• ICTs• Email, internet, chat rooms, on-line support,

videoconferencing• ‘ little evidence to date to address the cost-

benefit analysis in this area’


Smart home technologyMartin et al Cochrane review 2009

• ‘dearth of well-designed studies’• ‘does not provide significant

evidence’


TelecareBarlow et al J Telemed Telecare 2007

• ‘insufficient rigorous evidence about the effects of alert systems such as fall detectors and community alarms on either individual or system outcomes’


TelerehabilitationKairy et al Disability and Rehabilitation 2009

• ‘some preliminary evidence of potential cost savings for the healthcare facility’


TelehealthCanadian Agency for Drugs and Technology in Health 2008

• Most studies found that telehealth was cost saving from the healthcare system perspective

• Studies of poor quality therefore evidence not strong



Does it matter?

• Ageing population & increasing prevalence of long-term conditions

• Increased emphasis on self-care but reduction in family care

• Static or reducing public sector budgets

Ageing population

65+ years80+ years

0.00%

5.00%

10.00%

15.00%

20.00%

25.00%

1970

2000

2050

197020002050

‘support ratio' = working age population divided by pensionable age population

• 2002 – 3.35• 2011 - 3.10 • 2021 - 3.09• 2031 - 2.53• 2050s - < 2.2 in the 2050s

Long-term conditions

• Over 15 million people in England have a Long-Term Condition (LTC)

• The treatment and care of those with LTCs accounts for around 70% of total health and social care spend

Heart Failure

Chronic Obstructive Pulmonary Disease

Diabetes

Stroke

Chronic Pain

etc.....Department of Health: Raising the Profile of Long Term Conditions Care A Compendium of Information

NICE (National Institute for Health and Clinical Excellence)

• Cost per QALY (Quality-adjusted life year)


£20,000 - £30,000

Telecare

• ‘insufficient rigorous evidence about the effects of alert systems such as fall detectors and community alarms on either individual or system outcomes’


1.6 million people in UK with telecare

Telehealth

• Most studies found that telehealth was cost saving from the healthcare system perspective

• BUT studies of poor quality therefore evidence not strong


5000 current telehealth users in England

Some factors

• Traditions of health vs social care• Government policy and investment• Scale of investment required vs

uncertainty of cost savings• Lack of proven service and business

models for large-scale deployment• Staff and user acceptance


http://malt.group.shef.ac.uk/

Is technology for older people cost-effective?

• Do we know?

• Does it matter?


Dr Nick GoodwinSenior Fellow, Health Policy

The King’s Fund

What impact does telehealth have on long-term conditions

management?


#tech4care

Leela DamodaranProfessor of Participative Design and

Change Management Loughborough University

The role of ICTs in ageing well


#tech4care

ILC-UK, NDA and the Actuarial Profession debate “Improving care, tackling isolation and reducing costs? Can new technology live up to its promise?”

Staple Inn Hall, High Holborn, London. 16th May 2012.

Leela Damodaran and Wendy OlphertDepartment of Information Science, Loughborough University

The role of ICTs in ageing well

Can new technology live up to its promise?

2005 NDA First Call for proposals: (only 2 projects were funded in the first round of NDA ).

Nov 2007 Submission of outline bids for Collaborative Research Projects (CRP)

Dec 2007 Invitation to submit a full proposals for CRP

Mar 2008 Submission of full proposals for a CRP

Oct 2008 Funding awarded for CRPs

Jan 2009 CRP project work began!

Feb/Mar 2012 Pulling it all together.....

Apr/June 2012 Dissemination and Exploitation

Apr 1st 2012 - ImpactMar 31st 2013

48

NDA Project gestation

49

Contents• Defining features of the NDA programme

• Overview of NDA technology projects

- Components in common- Outputs/outcomes of investments in technology

projects- Policy implications

• Forward strategies to promote implementation of NDA outcomes and recommendations.

.

50

Defining Features of the NDA• Recognition that complex multi-faceted issues of ageing

demand a multi disciplinary approach.

• Innovation of the preparatory network grant - (adopted in the form of a catalyst grant on LLWB programme).

• Central role of older people as research participants.

• Research user engagement from early stages in the research process.

• Policy formulation as an integral component of the project work.

51

NDA Technology Projects 1. Mappmal, hospitalfoodie: Multidisciplinary Approaches to a Prototype for Prevention of Malnutrition

in Older People: Products, Places, People and Procedures.

2. SomnIA: Optimising Quality of Sleep Among Older People

3. Design for Ageing Well: Improving the Quality of Life for the Ageing Population Using a Technology Enabled Garment System

4. TACT3 – Tackling Ageing Continence through Theory, Tools and Technology

5. Envision – envision to envision: Innovation in Envisioning Dynamic Biomechanical Data to Inform Healthcare and Design Practice

6. Making the Kitchen Easier: Transitions in Kitchen Living

7. NANA: Novel Assessment of Nutrition and Ageing

8. Sus-IT: Sustaining IT Use by Older People to Promote Autonomy and Independence

9. Safety on Stair: Biomechanical and Sensory Constraints of Step and Stair Negotiation in Old Age

• End user engagement• Collaborative exploration of issues and

potential solutions• Co-design of prototypes and demonstrators• Early engagement of users of research • Motivating/facilitating adoption of solutions

through demonstrators and prototypes• Sharing emerging findings with policy-makers

52

Components in Common

• Prototypes e.g.– Hospitalfoodie – a food and nutrition management system – Musical pillow and background lighting unit to promote quality of sleep– Wearable technologies in activewear to encourage healthy exercise and social engagement

• Demonstrators e.g. – Adaptivity framework – identifying appropriate accessibility options for computer users – Software tool to support envisioning of biomechanical/movement data

• Training aids e.g. – An on-line resource where the voices, experiences and actions of older people enhance existing

guidance on kitchen design across the life course – Tailor made exercise training – to enhance the competence and confidence of older people to

mitigate both the reality and fear of falls.

• Design tools and toolkits e.g.– Measurement toolkit for capture of data on nutrition, cognition, physical and mental health.– Inclusive design guide to publicly accessible toilets – Design concept catalogue

• Engaged research users (including older people, service providers, designers, developers etc.)

• Policy recommendations

53

Outputs/Outcomes of Investments

54

Benefits from the Investment

£7 millionresearch

investment

• Individuals:– More autonomy/independence– Better health, safety and wellbeing– Improved quality of life

• Providers and developers of services and equipment:– Better match to needs of older people– Greater uptake of technology– Fewer ‘failures’

• Society:– Improved social inclusion– Economic benefits– Sustainability

55

• Application of technology needs to meet the expressed needs of older people.

• Ensuring older people stay engaged in design and planning.

• Encouraging attention to research findings and their implications.

• Eliciting solutions from business, government and third sector.

• Changing hearts and minds of many stakeholders.

• Promoting investment.

Policy Implications

56

So, can new technology live up to its promise?

Yes............

the NDA research evidence shows that it has the potential to do so

but......

only as part of an integrated sociotechnical strategy

57

Forward Strategies to Exploit NDA Research

• Promote awareness of needs

• Whose responsibility?

Needs include:• Informed decision making and control • Affordability (actual or perceived)• Social inclusion• Addressing concerns about

- privacy

- security of data

- stigmatization (being seen to need support - relates to appearance of devices)

• Adequate support in the community • ICT skills/confidence and access

(Damodaran & Olphert 2010)

Meeting Needs of Older People

59

Whose Responsibility?

Individual citizens?

Private sector?

Agencies/Third sector?

Government (central and

local)?

60

Todays debate: • Develop a compelling vision of Ageing Well;

• A widely shared vision;

• Robust and well-found policies (to support and promote

implementation of the vision);

• Strategic alliances, partnerships and collaborations

• Leadership!

How do we Move Forward

61

• Policy makers• BBC• Business sector• Third Sector• Education and Healthcare• Professional bodies

– all have an important part to play in achieving a ‘joined-up’ strategy for Ageing Well

Strategic Alliances and Partnerships

62

Strategy planning and preparation

or

Crisis-driven decisions?

The Big Choice:

63

We have the technology, the research know-how, the expertise – and the precedent of bringing together relevant parties to achieve societal

change e.g. the Digital Switchover support for older people – lets get off the starting blocks

64

Ready to go...

65

AcknowledgementsFunding from the ESRC’s New Dynamics of Ageing Programme

(Grant Number RES-353-25-0008)

Thank Youfor listening!

David SinclairAssistant Director, Policy and Communications

ILC-UK

Can technology improve care?


#tech4care

The International Longevity Centre-UK is an independent, non-partisan think-tank

dedicated to addressing issues of longevity, ageing and population change.

Can technology improve care?

David Sinclair, International Longevity Centre -

UK



The role for new technologies

134 years ago– first two way

phone call made

In 2000 – ½ world had never

owned a phone

By 2007 ½ the world had a

mobile phone

It took 75 years for telephones

to reach 50 million users

It took 4 years for the internet to

reach 50 million



Google knows! Location Based Services



My Society/Fixmystreet.com



Tripadvisor for Care Homes



Ocado for care



Technology to facilitate active ageing

Volunteering

Gradual Retirement

(slithers of time)

Opportunities for fun

Opportunities to

participate in societyhttp://www.flickr.com/photos/richardstubbs/5933679919/sizes/m/in/photostream/



Web facilitating access to Information and Advice

• More confident consumers of care with raising

expectations rather than patients

• More tests available online/instant response

(telehealth/care/monitoring)

• Greater access to information about conditions

(accuracy?)

• Expectations to become more focused on “fix it”,

prevent it, cure it?

• Growth in health tourism. What about care tourism?

(Travelodge/recuperation in Spain)



Challenge 1: Usability



Usability



Challenge 2: Motivating and inspiring the older population

“But how much smaller do

we want a phone?”

Some/many do want new

technology but: “I don’t

want to live in a smart-

home – I’d rather be dead”http://www.flickr.com/photos/un_photo/5832685007/sizes/z/in/photostream/



Challenge 3: Can’t continue to ignore the ethical issues

Moral and ethical debates – cant afford to ignore them

Must help older people choose technology when it is right for them (tagging/urine tests)

Privacy



Challenge 4: Technology wont tackle the fundamental problems

The first rule of any technology used in a business is that automation applied to an efficient operation will magnify the efficiency. The second is that automation applied to an inefficient operation will magnify the inefficiency.

Bill Gates

(Let’s get the basics right first!)



Challenge 5: Digital Exclusion

Q 4 2011: 8.2 million n

Proportion of age cohorts ever having used the internet (Source: ONS)

Quarter 4: 2011:

8.2 million never

used the internet



Challenge 6: No culture of private purchase of health/care technologies

Personalisation?

Access to

information and

advice?

But Health Apps are

biggest growth area

for Iphone.http://www.flickr.com/photos/thousandshipz/4679235/sizes/m/in/photostream/



Policy implications

Usability: Perhaps we need a legislative approach?

Or would this constrain innovation?

Inspiring and engaging the older consumer: How

can we tackle “its not for me”

Addressing ethics: Need to be more up front with

consumers about the use of technology



Complacency about technology: Technology is a

tool. But not a magic bullet.

Digital Exclusion: Do we need compulsion? Can we

nudge?

Creating a culture of private purchase: Need

healthcare technology on the BBC breakfast sofa.



Contact

David Sinclair

Head of Policy and Research

International Longevity Centre – UK

[email protected]

Twitter.com/ilcuk

Twitter.com/sinclairda

Panel Debate and Q&A• Is technology a red herring. Will it really save money and

improve costs?• Why has healthcare technology not reached the consumer at

the same speed as other consumer technologies?• What can we learn from the NDA and other research

presented today to improve access to technology?• How can we create a market for new products and convince

people to buy them?• Will personalisation drive greater demand for new products

and new technology?• How can we deal with some older people’s hesitation to use

technology (and should we?)

Improving care, tackling isolation and reducing costs? Can new

technology live up to its promise?

16 May 2012


#tech4care

ILC-UK, New Dynamics of Ageing and the Actuarial Profession debate: Improving care, tackling...

Technology

Transcript of ILC-UK, New Dynamics of Ageing and the Actuarial Profession debate: Improving care, tackling...