Ageing (年老化), New Technology (新高科技), and Future Innovations (未來的創新)
in Chronic Disease Management (慢病管理)
and Home-Care (家庭護理)
Steven Yeo
25th November 2017
新
Where we were (之前)
2002Over Age 60, WW Average is 10%
0-9 %10-19 %20-24 %25-29 %30+ %
% of Populationover age 60
Where we will be (将来)
0-9 %10-19 %20-24 %25-29 %30+ %
Source: United Nations “Population Aging 2002”
2050Over Age 60, WW Average is 21%
% of Populationover age 60
Shift in demography correlate to:
• Increase in medical/health expenditure
• Social issues
• Disruptive Economy: Smaller workforce
The Foreseeable Horizon
Trend 1
• Independent Living of Seniors: Life of Active Retirement, especially when viewed as an opportunity for travel, further education etc. This is imminent.
Trend 2
• Disrupt Ageing with New Technologies and Care Models: Characterized by a fusion of technologies that is blurring the lines between physical, digital and biological spheres. This is at our doorstep
Trend 3
• Senior Living: From building institutions to ageing in place
Changing Lens on who is in “Independent Living”
Very independent- Self travel- Self feed- Self toileting
Able to contribute economic valueTotally need help
(A) Likely to be acute
condition, stay alone, with someone or has a helper/
caregiver
(B) Likely to be relatively
independent in a familiar
setting. May have a
caregiver
(C) Very independent.
Active lifestyle. caregiver is an
option
End Goal
It is possible to move each group up a notch with technology
Modern Aging Program in SingaporeSilver is the New “Gold”
Trend 1: Celebrate Ageing-Opportunities
Governments and development partners Philanthropists and impact investors
“ Action Plan for Successful Aging ”
“Hong Kong 2030+”
“ 9073” “Healthy China 2030”
“ Senior Citizen Welfare Fund”
“National Plans of Action on Aging”
“Hong Kong Founders’ Network on AgeingWell”
Trend 1 : Continue
Industry and Investors Innovators and Entrepreneurs
Developers
Insurers and financial institutions
Pharmaceuticals and health providers
Technology Companies
Investors
Growing communities of innovators for Modern Aging: 1,500+ in Singapore; +2000+ China
Products and services that improve thequality of life for aging population
Community partners:
Trend 1 – Elderly Independent Living
Living independently – the key factors
Dressing Bathing
Using the
toilet
EatingWalking
Transferring
Shopping for
groceries
Using the
telephone
Preparing
meals
Personal
grooming
Doing light
housework
Washing
clothes
Managing
medications
Managing
finances
Getting beyond
walking distanceLeisure
SecurityNews and
information
Relationships
Safety
Giving care
ComfortEducation
Company
Entertainment Activities of
daily living
Instrumental activities of daily
livingQuality of life
Person-centred care
Abilities
Interests
FamilyValues
Goals
is not…
Practitioner-based
Problem-based
Deficit focus
Professional dominance
Acute treatment
Cure/improvement
Facility based
Dependence
Episodic
Reactive
is…
Person-centred
Strengths-based
Skill acquisition
Collaboration
Community integration
Quality of life
Community-based
Empowerment/choices
Least restrictive
Preventive
Care is
personalised
Care is
coordinated
Care is
enabling
Person is treated with … dignity, compassion and respect
Trend 2: Technology Enabled Care
medical monitoring
and alarms
activity and well-being
monitoring and alerts
wearables/
quantified-self
home
security
smart home
applications
personal and
activity alarmsreminders, prompts,
planning and scheduling
safety confirmation/
proactive calling
tele-coaching
information and
entertainment
communication
e-services
medication
dispensing
navigation
A spectrum of technology enabled care
Human Interactive Robots
Humanoid Robot
Pet Robot
コミュニケーション用
掃除ロボット
セキュリティ管理
Welfare Robot
Medical Robot
セラピーロボット
Home Robot
アニマルロボット
管理支援用
機器管理
多目的用
アクアロボット
観賞用
健康管理
二足歩行ロボット
介護/介助用
盲導犬ロボット
Assistive Technologies, Robotics, AI , Chatbots
• Helpful in physical tasks
• Communication• People consider them as social entities.
Assistive Robotics
Care-O-bot® by Fraunhofer IPA: grasping items and bringing them to resident PARO by U Penn, 2011RIBA , Japan: Transferring patients, 2009
18
• Reducing the need for movement
Example ADL Assistive Robots
Topio Dio by TosyCare-O-bot® by Fraunhofer IPA: grasping
items and bringing them to resident
Dusty II by GA Tech: Retrieving objects from floor
19
Example IADL Assistive Robots
PERMMA by U Penn, 2011uBot-5 by UMAss, 2011
Roomba by iRobot, 2011
20
Example EADL Assistive Robots
PARO, Japan, 1993 Pearl by CMU, 2002 iCat by Philips, 2006
21
Assistive technology (AT) groups
slow to provide
quick to provide
mainly mechanical
mainly electronic
Fixed AT Portable AT
Electronic AT Connected AT
ApplicationsCognitive Orthotics
• Reminders ● Navigation and stray prevention
• Planners
Health Monitoring
• Continuous Monitoring of Vital Signs ● Sleep Monitoring
• ADL
Therapy & Rehabilitation
• Tele-Health
Emergency Detection
• Fall Detection
• Medical emergency
Emotional Wellbeing
• Social Connectedness
• Facilitating Communication
23
Trend 3 : Senior LivingHome Care & Monitoring
Personal Health Eco-System
The Continuum of Care
AmateurAthlete
Diet/FitnessFocused
WorriedWell
Elderly LivingIndependently
ChronicPatient
AcuteRecovery
Infant
CONTINUUM of LIFE
CONTINUUM of CARE GIVERS
Doctor/NP/Nurse
HomeNursingProfessional
The Family
FitnessWellnessCoachNew Parents
Enable a personal health eco-system that empowers individuals & families
to better manage their own health and wellness across the continuum of life
and care methods.
Shift Left Strategy
$1 $10 $100 $1,000 $10,0000%
100% Healthy, Independent Living
Chronic Disease Management
Doctor’s Office
CommunityClinic
RESIDENTIAL CARE
ACUTE CARE
COST of CARE/DAY
QUALITY
of LIFE
Specialty Clinic
Community Hospital
ICU
Assisted Daily Living
Skilled Nursing Facility
HOME CARE
Trend 3 Senior living: from building institutions to enabling agingin place (China Case Study)
Aging Industry in China
Aging Population
Shift in the Concept of
Aging
4-2-1Increase elders to
young ratio
Societal Outlook Shift in Aging
Policy shift in Elder
care
Large Demand
and Supply Gap
• Huge population base
• Increased rate of aging population
• One Child policy and the ‘4-2-1’ family
structure
• Baby-boomer generation
Aging Population in China
The “9073” eldercare policy
3%:Institutional
care
90% Home care
7%: Community
care
Connecting the Homecare Ecosystems
PatientProfile
Diabetes Mellitus
Hypertension
Cardio Vascular Diseases
Chronic Obstructive Pulmonary Disease (COPD)
Post Cerebrovascular Accident/Diseases (CVA)
IoT Gateway
Tele-Monitoring
Tele-Alerts
Tele-Consultation
Integrated Tele-Health
Portal
Cloud Services
Physician / SpecialistHealthcare
Professional
Eldercare Monitoring Station
Next-of-Kin /Caregiver
Internet
VirtualHealthcare Provider
Disease Management860 million chronic disease patients world wide
TV
Internet
Familycaregivers
ElderlymonitoringService
Diseasemanagementservice, Clinic /PersonalHealth Record
Aging Independently
• An adult child helping their
elderly parents age gracefully
in their own home.
• Basic life monitoring as
appropriate (ADL):
• Motion sensors (Fall)
• Emergency sensor
• Vital sign monitoring (RPM)
• Hypertension
• Diabetic
• Cardiovascular
• Personal Health Record
• Medication reminders and
compliance
• Trend analysis and alerts
• Appointment scheduling
• Email, chat, video
• Independentliving
• Chronic disease
HomeAutomation& Control
Pedometer
Blood-
pressure
Cuff
Medication
Tracking
Pulse
Ox
Weight
Cell
Phone
Robot
Implant
Elderly Monitoring600 million elderly individuals world wide
Bed
Internet
Familycaregivers
Hospital CareTeam
Health Plan
• Post Ops Recovery
• Chronic disease
Pedometer
Blood-
pressure
Cuff
Medication
Tracking
Pulse
Ox
Weight
Cell
Phone
Robot
ElectronicHealthRecord
Post Ops Recovery &
Disease
Management
• Bed exit sensor
• Motion sensor
• Vital sign monitoring
(RPM)
• Medication reminders and
compliance
• Trend analysis and alerts
• Email, chat, video
• Tele-Rehabilitation
• Tele-Monitoring
• Tele-Consulting
Center of Excellence for Elderly Care
Living Room and Bedroom setup
Control Center demonstrating Care Models
Dashboard and Analytics
Integrated Sensors and Devices
Laptop
Objectives and Roles of COE
• Most of such technology solutions are innovative and designed for future care models.
• Challenges that COE will address:• Paradigm shift on care models.
• Generate awareness and incept the acceptance on the availability of such solutions.
• Bridging the social and knowledge gap between the tech sector and the clinical, medical and care industry.
• Standards and interoperability of Medical devices.
• Safety of wearables.
• Data Analytics and Security.
Participating Companies and Supporters
Key Takeaway
“Technology is at its best when it is invisible”*
Unobtrusive
Passive
Respects their privacy
Elderly prefers technology that is
Delivering holistic, elderly-centric personalized care…
Elderly
Technology providers
Healthcare professionals
Social workers &
Befrienders
VWOs & Private care
providers
Gov’t agencies
…
Critical Success Factors (for now)
• There is a need to contextualize the application of various technology solutions for:
• Policy makers
• Healthcare providers
• Caregivers
• End users
• There is a need to collect data through pilot and trials to care/usage usage for Hong Kong and Asia market
• Innovating Care• Care Models (Policy, Regulations, Insurance)
• Collaborate and drive for integrated solutions
• Ease of use and interoperable