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
This event is kindly supported by the New Dynamics of Ageing
#tech4care
Alan WalkerDirector
The New Dynamics of Ageing Research Programme
The New Dynamics of Ageing Research Programme
This event is kindly supported by the New Dynamics of Ageing
#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
THE NEW DYNAMICS OF AGEING RESEARCH PROGRAMME
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
THE NEW DYNAMICS OF AGEING RESEARCH PROGRAMME
PROGRAMME OBJECTIVES
www.newdynamics.group.shef.ac.uk
THE NEW DYNAMICS OF AGEING RESEARCH PROGRAMME
Mark HawleyProfessor of Health Services Research
University of Sheffield
Is technology for older people cost effective? Do we know and does it
matter?
This event is kindly supported by the New Dynamics of Ageing
#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
12/04/2023© The University of Sheffield
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’
12/04/2023© The University of Sheffield
Smart home technologyMartin et al Cochrane review 2009
• ‘dearth of well-designed studies’• ‘does not provide significant
evidence’
12/04/2023© The University of Sheffield
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’
12/04/2023© The University of Sheffield
TelerehabilitationKairy et al Disability and Rehabilitation 2009
• ‘some preliminary evidence of potential cost savings for the healthcare facility’
12/04/2023© The University of Sheffield
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
12/04/2023© The University of Sheffield
12/04/2023© The University of Sheffield
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)
12/04/2023© The University of Sheffield
£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’
12/04/2023© The University of Sheffield
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
12/04/2023© The University of Sheffield
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
12/04/2023© The University of Sheffield
http://malt.group.shef.ac.uk/
Is technology for older people cost-effective?
• Do we know?
• Does it matter?
12/04/2023© The University of Sheffield
Dr Nick GoodwinSenior Fellow, Health Policy
The King’s Fund
What impact does telehealth have on long-term conditions
management?
This event is kindly supported by the New Dynamics of Ageing
#tech4care
Leela DamodaranProfessor of Participative Design and
Change Management Loughborough University
The role of ICTs in ageing well
This event is kindly supported by the New Dynamics of Ageing
#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?
This event is kindly supported by the New Dynamics of Ageing
#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 International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevity, ageing and population change.
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
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevity, ageing and population change.
Google knows! Location Based Services
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevity, ageing and population change.
My Society/Fixmystreet.com
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevity, ageing and population change.
Tripadvisor for Care Homes
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevity, ageing and population change.
Ocado for care
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevity, ageing and population change.
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/
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevity, ageing and population change.
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)
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevity, ageing and population change.
Challenge 1: Usability
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevity, ageing and population change.
Usability
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevity, ageing and population change.
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/
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevity, ageing and population change.
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
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevity, ageing and population change.
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!)
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevity, ageing and population change.
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
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevity, ageing and population change.
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/
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevity, ageing and population change.
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
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevity, ageing and population change.
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.
The International Longevity Centre-UK is an independent, non-partisan think-tank
dedicated to addressing issues of longevity, ageing and population change.
Contact
David Sinclair
Head of Policy and Research
International Longevity Centre – UK
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
This event is kindly supported by the New Dynamics of Ageing
#tech4care