Karunanithi Mohanraj, Zhang Qing
Australian eHealth Research Centre, Health & Biosecurity, CSIRO, Queensland, Australia.
Stud Health Technol Inform. 2018;246:102-110.
Australian population aged over 65 years is 14% (3.3 million) and this expected to increase to 21% by 2053 (8.3 million), of which 1.9% to 4.2% is attributed to Australians over 85 years. With increase in ageing, there is high prevalence in long-term health conditions and more likely multiple visits to the doctors or the hospitals, particularly when one's functional condition declines. This adds burden to the already stretched health system such as the overcrowding of emergency departments in hospitals. This is partly due to many ageing patients with high care needs occupying significant number of hospital beds because they are waiting for entry to the limited placements in residential care. To address this increase in ageing population and its impact in the society, the Australian government has funded aged care reforms for initiatives for older community stay at home longer. Recently, this was implemented through consumer directed age care reform. Advances in information and communication technologies, particularly in the advancement of lifestyle technologies and its increased use, show promise in the uptake of telehealth approach to support older people to live longer in their homes. In 2011, CSIRO took the initiative to a develop consumer designed innovative platform that would assist and support the older community in their functional ability and health for day to day living in their home environment. This platform was called the Smarter Safer Homes technology. The Smarter Safer Homes platform infers the Activities of Daily Living information from a passive sensor-enabled environment and correlates the information with home-based health monitoring measurements. The use of sensors enables the information to be captured in an unobtrusive manner. This information is then provided to the individual in the household through an iPad application while information can also be shared with formal and informal carers. The platform has undergone a few pilot studies to explore an objective and individualised approach to Activities of daily living based on an individual's profile and its applicability in multi-resident home setting in individual's in regional Queensland. Furthermore, the platform is being validated in a clinical study for its application in the aged care service in various geographical settings such as in urban and remote communities. This paper describes the platform, outcomes of pilot studies, and its future application.
澳大利亚65岁以上的人口占14%(330万),预计到2053年这一比例将增至21%(830万),其中85岁以上的澳大利亚人占1.9%至4.2%。随着老龄化加剧,长期健康问题的患病率很高,人们更有可能多次就医或住院,尤其是当一个人的功能状况下降时。这给本已不堪重负的医疗系统增加了负担,比如医院急诊科人满为患。部分原因是许多有高护理需求的老年患者占用了大量病床,因为他们在等待进入有限的居家护理床位。为应对人口老龄化加剧及其对社会的影响,澳大利亚政府为老年人社区居家养老时间更长的倡议提供资金进行老年护理改革。最近,这是通过以消费者为导向的老年护理改革来实施的。信息和通信技术的进步,特别是生活方式技术的进步及其使用的增加,显示出采用远程医疗方法支持老年人在家中更长久生活的前景。2011年,澳大利亚联邦科学与工业研究组织主动开发了一个由消费者设计的创新平台,该平台将在老年人的家庭环境中协助并支持他们的日常生活功能和健康。这个平台被称为“更智能更安全的家”技术。“更智能更安全的家”平台从一个启用了无源传感器的环境中推断日常生活活动信息,并将这些信息与家庭健康监测测量结果相关联。传感器的使用使得信息能够以不引人注意的方式被获取。然后,这些信息通过iPad应用程序提供给家庭中的个人,同时信息也可以与正式和非正式护理人员共享。该平台已经进行了一些试点研究,以探索基于个人资料的客观、个性化的日常生活活动方法及其在昆士兰地区多住户家庭环境中的适用性。此外,该平台正在一项临床研究中得到验证,以确定其在城市和偏远社区等不同地理环境中的老年护理服务中的应用情况。本文介绍了该平台、试点研究的结果及其未来应用。