Accelerating the uptake of assistive health technologies requires new strategies and will rely on multidisciplinary networking, writes Dr Erol Harvey and Professor Greg Tegart.
Australia needs to actively drive the uptake of assistive healthcare technologies to allow people to stay at home longer and live more independently. This was the major finding of the report Assistive Health Technologies for Independent Living.
Assistive technologies are any devices or systems that can provide assistance with everyday living and range from simple devices such as motion sensors to interactive devices developed using sophisticated technologies such as nanotechnology, biotechnology, information and communications technologies and advanced manufacturing.
Tackling the grand challenges of society and addressing complex problems requires an approach that extends beyond the traditional discipline-based academic model. Assistive Health Technologies for Independent Living sought to explore the potential, by bringing together a range of disciplines in a user-centred network, for improvement in the uptake of innovative technologies for independent living in Australia.
The report represents the final phase of a long running study by the Australian Council of Learned Academies (ACOLA) that set out to develop a set of evaluation guidelines for interdisciplinary research.
The report made a number of key findings:
A market focus is critical: There is no competitive market in Australia to bring assistive technologies into the mainstream and to make them a preferred option in healthcare delivery. A new approach through a user-centred network is needed to create an environment in which new and old players can seek to change policies in order to better service the needs of individuals and isolated customers, improve delivery efficiencies and promote opportunities for technology improvement.
Expert ‘champions’ are required: The participation of enthusiastic and knowledgeable promoters who want to assist in improving the current status of healthcare delivery is critical. There is a need for the leadership of well-respected champions who have skills in planning for sustainability and who are able to bring together clinicians, funders, policy makers and enterprises to promote this agenda.
A long-term business model is crucial: Achieving success calls for business models that focus on the needs of the individual, the value the technology can bring and the ability to deliver improved health and wellness outcomes. Innovation is required to build sustainable businesses that are not dependent upon ongoing government financial support to achieve this end.
New interdisciplinary players will be involved: The healthcare market is changing as people take more control of their health through personalised medicine and new players will take the opportunity to break into the industry. The new players such as IT and electronics companies, telecommunications providers, large retail companies and insurance companies are interdisciplinary and will contribute by broadening the business base, leveraging market diversification, expanding expertise and augmenting scale by providing necessary capital.
Impact on health outcomes
Chronic illness and aged care accounted for 70 per cent of Australia’s $140 billion expenditure on healthcare in 2011-12. The report found that the application of smart technologies enables people to live at home longer, better identify symptoms, control medication, and live more safely and independently, thereby having a positive impact on healthcare outcomes.
Despite the demonstrated benefits of new technologies, deployment and use in Australia is limited and Australians are missing out on improvements in healthcare. At the same time, a larger number of new, non-traditional, players is moving into the health sector with the potential for major disruption of established systems.
Much has been written about the large electronics companies such as Apple and Samsung moving into the health and wellness market. They and many other companies, small and large, are developing innovative business models for delivery of assistive technologies to seniors and people with disability.
Barriers to adoption
Across Australia there have been numerous pilot programs and demonstrations of telehealth and various technologies to enable independent living. Many of these innovations demonstrated considerable efficacy but failed to gain traction beyond the pilot studies.
Barriers to sustained adoption include lack of commercial incentives, poor dissemination of the beneficial outcomes and limited data on cost effectiveness. Generally speaking, most pilot studies are not designed with commercial sustainability as an objective. However, one of the major barriers in Australia has been scale. Initiatives and trials have focused solely on demonstrating that a product works and therefore have lacked the scale required to capitalise on the benefits from such complex projects.
Technological innovation alone is not adequate. Many technologies fail due to a lack of user uptake for a variety of reasons including difficulty to use or integrate into daily life, or simply that the technology does not meet the needs of the user. Devices that operate seamlessly in the background and integrate with existing technologies will have a better chance of adoption. CSIRO’s ongoing Smarter, Safer Homes trial is a case study putting the end-user in the centre of technology development in order to enable the elderly to live at home longer (see Case study below).
Accelerating the uptake of assistive health technologies requires new strategies and will rely on multidisciplinary networking, which brings together researchers, service providers, carers, housing providers and end-users in a continuous improvement framework.
An assistive technologies network, underpinned by a strategic plan, could positively impact on the large proportion of Australia’s healthcare expenditure currently focused on treating chronic illness and providing aged care. It could also enable the development of new sustainable business models and, by linking user experience with product developers, could provide valuable input to new product development. (See illustration for examples of sectors that could be linked in a multidisciplinary network.)
As a result of the study, an independent steering group has been formed to establish the basis for such a network. Comprising volunteers from a range of disciplines, including health care providers, technology developers and researchers, the steering group aims to start a network that will provide a focal point for community discussion, promotion of business opportunities in assistive technologies and influence policy that underpins this emerging market.
Dr Erol Harvey and Professor Greg Tegart are co-chairs of the expert working group, Assistive Health Technologies for Independent Living. The report is available here
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Case study: CSIRO Smarter, Safer Homes trial
Currently being trialled in regional NSW, CSIRO’s Smarter, Safer Homes is the use of sensors, such as motion detectors and energy sensors to monitor an elderly person as they go about their day and report the data back to family members or carers.
The sensors have been placed in the homes of up to 20 participants where they can be used to detect a variety of health information and activities such as getting out of bed, putting the kettle on, cooking and even if the oven has been left on.
The data is reported to a tablet device owned by the user, who retains full control over what data gets reported to others and what stays private.
To enhance the chances of a successful outcome, the CSIRO trial is putting the end-user at the centre of the trial rather than the researcher. In effect this means that users are providing feedback around what technology is acceptable and helping design a service that serves the needs of older residents, their families and healthcare staff.
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This report first appeared in the January 2015 Technology Review