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AAL FOR ALLM U LT I S TA K E H O L D E R C O - C R E AT I O N S E S S I O N
2 7 S E PT E M B E R 2 0 1 6
A A L FO R U M ST.G A L L E N
C H A I R : D R . R E N S B R A N K A ERT
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Programme•Setting the scene:
• Introduction to the ENSAFE project• Gociety technology • Technological sensor opportunities for elderly (HELICOPTER)• Integration into a cloud platform• User involvement in ENSAFE
•Interactive Co-creation session:• Multi-stakeholder perspective on innovation• Impact of innovation in a wellbeing context
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Part 1: Setting the scene
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Aim of the project•ENSAFE stands for:
Elderly-oriented Network-based Services Aimed at independent life.
•Supporting more effective prevention and self-care strategies bycreating a smarter, more accessible and versatile link among elderly, their living environment and support network around them.
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Target group•Elderly people:
• Support their lives, enabling them tolive longer independently at home.
•Informal caregivers:• Monitor and receive signals during
abnormal situations which need their attention.
•Formal caregivers:• Access to full set of data, suitable for being
linked to clinical data management tools andpolicies.
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Product portfolio
•Sum of products is stronger then the individual parts
•Challenge is fitting these together into a single business case
•… the ENSAFE solution
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Continuum of Care
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Business Case
ConsumerMarket
MixedPayment
model
MixedPayment
model
InstitutionalPayment
model
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Business Case
ConsumerMarket
MixedPayment
model
MixedPayment
model
InstitutionalPayment
model
200 euro
10 euro
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Project details•Duration: July 2015 – June 2018
•Total Budget: €2.1 million
•Made possible by the AAL programme
•Four countries in Europe• United Kingdom• Netherlands• Sweden • Italy
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Participating organisations
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AAL for all, multi stakeholder co-creation
27 September 2016
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Loneliness:
30%feels
lonely
Security:
5%not coming
outside
1
Falls 1% of total health care expenditure2030
6%sometimes
unsafe
1Active:
Aging challenges:
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Efficient Peace of mind
Lower costsActive
Mobile
Relevant
Not stigmatizing
Easy
User centric for all relevant stakeholders:
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Smartphone more importantfor seniors than young generation:
The smartphone will become a
smart-companion
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What we offer:
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Health analytics:
“ Trend and abnormality indication ”
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Prevention:
“ Catch your clients before they fall..! ”
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Quality of life:
“ besides objective, also subjective data “
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Mobility & safety:
“ Polygonal safe zones “
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GoLiveAssist dashboard:
“ continues remote care ”
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GoLiveAssist dashboard:
“ continues track & trace ”
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Longterm road map:Tricorder for older adults
“ every six month new functionalities ”
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User
Caregivers NetworkClinical & Home
Mobile & Wearable
Cloud Infrastructure ServicesSensors
ENSAFE architecture
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Why “home” sensors ?
Data accuracy Data dimensionality Expressiveness Monitoring continuity Intrusivity
• Support indirect, behavioral monitoring• Integrate/complement clinical monitoring
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Which sensors ?Motion (PIR)
Bed occupancy
Door/window
Toilet
Chair occupancy
Appliance power
Bodyweight scale
Blood glucose
Blood pressure
Blood oxygen
CLINICAL HOME
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Sensors outputFood drawer
Fridge
Chair
Toilet
Bed
Wearable
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Home sensors: data processing
• Raw sensor data not suitable for direct inspection • Need interpretation, fusion, visualization• Large variability of human behaviors• No absolute reference • Relative changes are significant• Anomaly detection• Trend analysis
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Looking for shifts in the average behaviour:Each point in the solid curve represents the expected (i.e. mean) active time of the sensorwithin the time slice (30 min. in this case).Shaded areas represent the confidence interval of the estimateTwo different months are compared (red vs. blue: no significant deviations is shown).
Bed occupancy
Time of the day
Models
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PROBLEM: How to automatically recognize meaningful behavioral changes (different fromnormal statistical fluctuations) ?
Time of the day
ModelsChair
occupancyChair
occupancy
Differences in averaged behaviors exceeding confidence intervals
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• Trend analysis• Anomaly detection
Toilet usage
Days count
Models
• Bayesian Poisson regression of daily toilet visits• Solid black line: predicted average toilet visits (trend)• Shaded blue areas: plausible prediction intervals (toilet visits)
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ENSAFE platform - Design goals•ScalabilityThe platform should be able to scale to support the different flavours and actors of elderly healthcare in the EU
•Technical opennessThe platform should be able to integrate with different technical environments
•Commercial opennessThe platform should support, welcome and embrace third party suppliers and consumers and their business models
•Respect for the individual’s wish and integrity
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Mini PC
Gateway
Sensors
ENSAFE platform
Ingestion and distribution
Services
Applications / PresentationsDevice backend
system
ServicesServices
Individual’s Private storage
Mobile devices
Gateways
ENSAFELegend
Hardware component
Software component
External to ENSAFE
DisplayApplications / Presentations
Applications / Presentations
ENSAFE platform – Ecosystem
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Hardware
PartnerGateway
Devices
Ensafe Platform
3rd party Service
3rd party app
ScalabilityTechnical opennessCommercial openness
Platform open to 3rd parties
3rd partyGateway
Devices
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Co-creation with users•Joint methodology for case finding at beginning of the project..
•… resulted in a large scale survey among senior users…
•… which results were validated by Focus Groups in the different countries…
•… and will now be followed up with Co-creation sessions!
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Survey– set up •Joint methodology for case finding set up by partners.
•Resulted in a survey including questions about the following topics:• demographic measures• technology use• daily activities• mobility • health conditions.
•418 surveys from SE, IT, UK and NL (368 active responses).
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Survey - results•No be major differences between the countries concerning type of technology used by target group.
•Most of them perceive themselves as medium-level users (48%), followed by low level (25%)
•Technology used the most for contact with family and friends (71%), followed by email (57%) and browsing on internet (48%).
•Almost 50% of the participants indicate to experiences barriers whenusing technology.
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Focus Groups•Set up of Focus groups in different countries
• What was their purpose?
Engage With Stakeholders
End-UserFormal Care
Provider
Friends/Family to the End-
UserHealth Care
Professionals
Voluntary Sector
Service Commissioners
• All stakeholders in the sameconversation to share their thoughts
• To validate our findings from the surveys
• To gain an understanding of whatperceptions stakeholders held over technology, health and care in generaland what they valued the most. How they deliver and receive care services.
• Both current and future states
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Focus GroupsHow?Clean Language Techniques – Not Influencing AnswersLaddering – Making sure we get to the root cause/ideaWe used ICE’s Creative Graphic Scribes to capture a visual story
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Focus Groups•Results
• How did we analyse the conversations?• The responses of participants who took part in the focus group were transcribed and analysed
using an iterative and well-documented thematic analysis approach.• From this a 31 page report was created
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Focus Groups•Results
• A common understanding of ‘Care’• It is personal and human• It is putting somebody else’s needs ahead of your own• The importance of having face-to-face contact
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Focus Groups•Results
• The benefits of introducing technology
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Focus Groups•Results
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Focus Groups
Results of first focus groups
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Part 2: Co-creation session
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Different roles in innovation•Different stakeholder have a different role in innovation
•In the context of healthcare this stakeholder network is complex and we need strategies to align these
•By looking through the eyes of someone else you might get new ideas and perspectives on your own idea
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Different roles in innovation•Divide into five groups based on your role:
•Industry/Companies
•Knowledge institutes
•Family members/users
•Government/Municipality
•Care organisations
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Round 1: The platformThe ENSAFE offers services and products that should grow with the individual situations of users. To achieve this the solutions should be usable, affordable, and fitting with current practises.
Discuss:◦ Introduce yourself to each other◦ Share your first view on the stakeholder role◦ What would your stakeholder need or want this solution to
be and why?
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From the other stakeholders you probably heard a very different view on the ENSAFE system and service.
Discuss:What where the conflicts with other stakeholder groups and how can we resolve them?
Round 2: The perspectives