Ageing and place

Considerations on the implementation of ICT for health and wellbeing in Ireland

Home Sweet Home Workshop Barcelona - 17th Jan 2013

Rodd Bond mriaiNetwell Centre, Dundalk Institute of Technology

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 community-

oriented services, more sustainable home and neighbourhood design, and more affective and age-friendly technologies.

Individual & family’sQuality of Life

(QOL)

Home, neighbourhood

& cityQuality of Environment

(QOE)

Public / private& voluntary

Quality of Service(QOS)

Netwell/Casala ……

The Issues – national cuts

Reducing costs

Improving outcomes

Demographic pressure

Staff reductions

The Issues – local cuts

Reduction in opening hours

70,000 Home help hours

Health spending cuts

36 Bed closures

National & EuropeanPolicy areas

National Agenda

• Health Strategy• Positive Ageing Strategy• Carers’ Strategy• Dementia Strategy• Public Sector Reform• Local Government

Reform• Industrial Development• R&D

EU Agenda

• Smart, Sustainable & Inclusive Growth

• Demographic change• EIP: AHA, Smart Cities• Regional development &

competitiveness – smart specialisation

• Horizon2020-R&D• Social innovation

Weak funding !Capacity !Austerity !

Addressing weak implementation!Fragmentation !

Greater dependency on collaboration with the community & voluntary sector

Person at the heart

Care & Cure

Act

ive

Age

ing

Private services

Family

1. Cross sectoral alignments

2. Pathway integration

Person

Public services

Community/Voluntary

Prevention &

intervention

Connect

1st Principle - Citizen centric

Touch pointsMovements

The Age-Friendly Cities Movement

Health Services ReformStakeholder collaboration

User/citizen engagement

Social innovation

Connectivity / ICT

Dissolving boundaries

Health Service ReformMovements

ResourceRe-

configuration

Clinical quality

Front-line Extend organisational edge for self-managementEquitable access Financial balance

• Model for age-friendly city development

• Driven at a local government/community integration level• Leadership of individual county managers• National oversight and commitments

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

Age-friendly cities / counties

(-)CVDRisk

(-)CVDRisk

(-)Blood

P.

(-)Blood

P.

(+)ThermalCom

f.

(+)ThermalCom

f.

(-)Stress

(-)Stress

EnergyEffic.

EnergyEffic.

FuelPov.

FuelPov.

Indoor Temp/

Indoor Temp/

Financial

security

Financial

security

HOUSING

Curriculum

Curriculum

Socialisati.

Socialisati.

SettingSetting

EDUCATION

(-)CVDRisk

(-)CVDRisk

(-)Obesity

(-)Obesity

(-)Chole

st.

(-)Chole

st.

(-)Blood

P.

(-)Blood

P.

(+)DietNutr.

(+)DietNutr.

Curriculum

Curriculum

Alcohol

Alcohol

Smoking

Smoking

Socialisati.

Socialisati.

SettingSetting

(+)Exercis

e

(+)Exercis

e

Socio-DemChar.

Socio-DemChar.

Neighbour.

Disadvant.

Neighbour.

Disadvant.

SECURITY

(-)CVD

Risk

(-)CVD

Risk

(-)Obesity

(-)Obesity

(-)Chole

st.

(-)Chole

st.

(-)Blood

P.

(-)Blood

P.

(+)Exercis

e

(+)Exercis

e

(-)Stres

s

(-)Stres

s

DisorderDisorder

Walking

Walking

FearFear

HealthyUrbanPlan

HealthyUrbanPlan

ENVIRONM.

(-)CVDRisk

(-)CVDRisk

(-)Obesity

(-)Obesity

(-)Cholest

.

(-)Cholest

.

(-)Blood

P.

(-)Blood

P.

(+)Social

(+)Social

(+)Exercise

(+)Exercise

(+)Air

Qual.

(+)Air

Qual.

(+)DietNutr.

(+)DietNutr.

NaturalEnvir.

NaturalEnvir.

WalkingWalking

BuiltEnvir.

BuiltEnvir.

Transportmobility

Transportmobility

Social Support

Social Support

Economic

Dev. Strategy

Economic

Dev. Strategy

MunicipalInvestment

MunicipalInvestment

Economic

Growth

Economic

Growth

Employment

Employment

Sociio Ec.

Equlity

Sociio Ec.

Equlity

Area basedInit.

Area basedInit.

Income

Income

ECONOMIC

WorkingCondit.

WorkingCondit.

(-)CVDRisk

(-)CVDRisk

(-)Blood

P.

(-)Blood

P.

(+)ThermalComf.

(+)ThermalComf.

(-)Stress

(-)Stress

EnergyEffic.

EnergyEffic.

FuelPov.

FuelPov.

Indoor Temp/

Indoor Temp/

Financial

security

Financial

security

HOUSING

CurriculumCurriculum

Socialisati.Socialisati.

SettingSetting

EDUCATION

(-)CVDRisk

(-)CVDRisk

(-)Obesity

(-)Obesity

(-)Cholest

.

(-)Cholest

.

(-)Blood

P.

(-)Blood

P.

(+)DietNutr.

(+)DietNutr.

CurriculumCurriculum

AlcoholAlcohol

SmokingSmoking

Socialisati.Socialisati.

SettingSetting

(+)Exercise

(+)Exercise

Socio-DemChar.

Socio-DemChar.

Neighbour.Disadvant.

Neighbour.Disadvant.

SECURITY

(-)CVDRisk

(-)CVDRisk

(-)Obesity

(-)Obesity

(-)Cholest

.

(-)Cholest

.

(-)Blood

P.

(-)Blood

P.

(+)Exercise

(+)Exercise

(-)Stress

(-)Stress

DisorderDisorder

WalkingWalking

FearFear

HealthyUrbanPlan

HealthyUrbanPlan

ENVIRONM.

(-)CVDRisk

(-)CVDRisk

(-)Obesity

(-)Obesity

(-)Cholest

.

(-)Cholest

.

(-)Blood

P.

(-)Blood

P.

(+)Social

(+)Social

(+)Exercise

(+)Exercise

(+)Air

Qual.

(+)Air

Qual.

(+)DietNutr.

(+)DietNutr.

NaturalEnvir.

NaturalEnvir.

WalkingWalking

BuiltEnvir.

BuiltEnvir.

Transportmobility

Transportmobility

Social Support

Social Support

EconomicDev.

Strategy

EconomicDev.

Strategy

MunicipalInvestment

MunicipalInvestment

EconomicGrowth

EconomicGrowth

EmploymentEmployment

Sociio Ec.Equlity

Sociio Ec.Equlity

Area basedInit.

Area basedInit.

IncomeIncome

ECONOMIC

WorkingCondit.

WorkingCondit.

Connecting the dots, managing the flows

CommunityCare pathsCommunityCare paths

Home Self-managementHome Self-

management

Hospital clinical

Pathways

Hospital clinical

Pathways

REQUIREMENT TO:•Improve connections and flows between care delivery locations.•Provide better intelligence to support better decision-making 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.

Care delivery locations

Service quality/risk zones

Entry/exit points

Transfers/visits/calls

Assistance/info access

Referral points

Poorly organised inter-site services coordination, compounded by under-developed community/home

capacity, and information access/exchange.

Service Innovation Needs

Connecting the dots, managing the flows

CommunityCare pathsCommunityCare paths

Home Self-managemen

t

Home Self-managemen

t

Hospital clinical

Pathways

Hospital clinical

Pathways

Care delivery locations

Manage services interaction zone

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

Services Navigation Hub

ConnectedCare infrastructure, with core clinical and triage capability provides distributed platform to support pathway

integration for falls, chronic diseases, dementia.

Service Navigation Hub

Connecting the dots, for health AND well-being

CommunityCare pathsCommunityCare paths

Home Self-managementHome Self-

management

Hospital clinical

Pathways

Hospital clinical

Pathways

Managed service interaction zone

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 ICT-based applications for Connected Care and Connected Community onto an integrated ‘cloud-based’ platform, maximising effectiveness and efficiencies.

Services Navigation Hub (ANP)

Age-Friendly community-based service network.

Safety/security. Transport.

Home repair.Isolation/social connection.

Service brokerCultáca

Extended Navigation Hub

A transformation architectureFor consideration

Empowerment:UsabilityUsefullnessChoice

Efficiency:System/service integrationClinical efficacyShifting silos and boundaries

Energy for change:MotivationAttractivenessSustainability

Standards Framework:What to fixWhat’s free to innovate

Procurement Framework:Freedom of the individualControlled by the tax-payer

Social organisation & innovation:MotivationTrust in collaborationSustainability

Implementation readiness