Bin Noon Gaya, Hanjahanja-Phiri Thokozani, Dave Harishree, Fadrique Laura, Teague Jennifer, Morita Plinio P
School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada.
Communitech, Waterloo, ON, Canada.
JMIR Aging. 2023 May 22;6:e40606. doi: 10.2196/40606.
Active assisted living (AAL) refers to systems designed to improve the quality of life, aid in independence, and create healthier lifestyles for those who need assistance at any stage of their lives. As the population of older adults in Canada grows, there is a pressing need for nonintrusive, continuous, adaptable, and reliable health monitoring tools to support aging in place and reduce health care costs. AAL has great potential to support these efforts with the wide variety of solutions currently available; however, additional work is required to address the concerns of care recipients and their care providers with regard to the integration of AAL into care.
This study aims to work closely with stakeholders to ensure that the recommendations for system-service integrations for AAL aligned with the needs and capacity of health care and allied health systems. To this end, an exploratory study was conducted to understand the perceptions of, and concerns with, AAL technology use.
A total of 18 semistructured group interviews were conducted with stakeholders, with each group comprising several participants from the same organization. These participant groups were categorized into care organizations, technology development organizations, technology integration organizations, and potential care recipient or patient advocacy groups. The results of the interviews were coded using a thematic analysis to identify future steps and opportunities regarding AAL.
The participants discussed how the use of AAL systems may lead to improved support for care recipients through more comprehensive monitoring and alerting, greater confidence in aging in place, and increased care recipient empowerment and access to care. However, they also raised concerns regarding the management and monetization of data emerging from AAL systems as well as general accountability and liability. Finally, the participants discussed potential barriers to the use and implementation of AAL systems, especially addressing the question of whether AAL systems are even worth it considering the investment required and encroachment on privacy. Other barriers raised included issues with the institutional decision-making process and equity.
Better definition of roles is needed in terms of who can access the data and who is responsible for acting on the gathered data. It is important for stakeholders to understand the trade-off between using AAL technologies in care settings and the costs of AAL technologies, including the loss of patient privacy and control. Finally, further work is needed to address the gaps, explore the equity in AAL access, and develop a data governance framework for AAL in the continuum of care.
主动式辅助生活(AAL)指的是旨在提高生活质量、帮助实现独立并为在人生任何阶段需要帮助的人创造更健康生活方式的系统。随着加拿大老年人口的增长,迫切需要非侵入性、持续、适应性强且可靠的健康监测工具,以支持就地养老并降低医疗成本。AAL凭借目前可用的各种解决方案,在支持这些努力方面具有巨大潜力;然而,还需要开展更多工作来解决受照护者及其照护提供者对将AAL整合到照护中的担忧。
本研究旨在与利益相关者密切合作,以确保AAL系统 - 服务整合的建议符合医疗保健及相关卫生系统的需求和能力。为此,开展了一项探索性研究,以了解对AAL技术使用的看法和担忧。
与利益相关者进行了总共18次半结构化小组访谈,每个小组由来自同一组织的几名参与者组成。这些参与者群体分为照护组织、技术开发组织、技术整合组织以及潜在受照护者或患者权益倡导团体。访谈结果采用主题分析进行编码,以确定AAL的未来步骤和机会。
参与者讨论了使用AAL系统如何通过更全面的监测和警报、对就地养老更有信心以及增强受照护者的权能和获得照护的机会,从而为受照护者带来更好的支持。然而,他们也对AAL系统产生的数据的管理和货币化以及一般问责制和责任提出了担忧。最后,参与者讨论了AAL系统使用和实施的潜在障碍,特别是考虑到所需投资和对隐私的侵犯,AAL系统是否值得的问题。提出的其他障碍包括机构决策过程和公平性问题。
在谁可以访问数据以及谁负责根据收集到的数据采取行动方面,需要更好地界定角色。利益相关者了解在照护环境中使用AAL技术与AAL技术成本之间的权衡很重要,包括患者隐私和控制权的丧失。最后,需要进一步开展工作来填补差距、探索AAL获取方面的公平性,并为连续照护中的AAL制定数据治理框架。