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Introduction to DREAMING and current status

El D e R ly-fri E ndly A larm handling and M onitor ING. Introduction to DREAMING and current status. Table of contents. DREAMING in a nutshell The DREAMING Consortium DREAMING is … Project objectives Indicators Technical and functional architecture Current status (30/6/2010)

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Introduction to DREAMING and current status

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  1. ElDeRly-friEndly Alarm handling and MonitorING Introduction to DREAMING and current status

  2. Table of contents • DREAMING in a nutshell • The DREAMING Consortium • DREAMING is … • Project objectives • Indicators • Technical and functional architecture • Current status (30/6/2010) • Interim conclusions

  3. DREAMING in a nutshell • DREAMING is a Pilot Type B project funded under the new European Union CIP-PSP (Competitiveness and Innovation Programme – Policy Support Programme) • Project start date: 1st of May 2008 • Project duration: 36 (48) months • Total budget: 5.540.000 Euros • EU contribution: 2.770.000 Euros • 6 real life trials in Denmark, Estonia, Germany, Italy, Spain and Sweden

  4. 4

  5. The DREAMING Consortium

  6. DREAMING is … • about demonstrating that technology, when it is properly selected and integrated: • allows to provide elderly people wishing to continue living independently a sufficient level of safety and reduce their loneliness; • can follow elderly people wherever they go, for a short walk or for their summer holidays; • is usable by elderly people who have never been previously exposed to technology and have some physical impairments; • is cheap and robust enough to be deployed on a large scale (hundreds of thousand or million of individuals); • provides a documented ROI by reducing costs in other areas of the health and social care provision.

  7. DREAMING is … • more ambitious than most of the other eHealth and eInclusion projects that have been carried out so far in a number of respects: • it borrows the rigorousness of the method from multicentre randomised trials (candidate participants will be randomly allocated to a Test Group - those who receive the DREAMING goodies – or to a Control Group - the others). This will enable to depurate the results from factors other than the access of the DREAMING • anonymised results from the various trial sites will be centralised, in compliance with national rules on personal data protection and aggregated. In this way, DREAMING results will become publishable in respected scientific journals

  8. DREAMING is … • more ambitious than most of the other eHealth and eInclusion projects that have been carried out so far in a number of respects (cont.) • the resulting business case will be based on hard evidence and will be “sellable” to health and social care buyers and providers for them to act • should open the door to the mass deployment of a technology-based solutions which can alleviate one of the biggest societal problems our countries are facing today

  9. Project objectives • Improving the quality of life of elderly people by extending their independent life (if they wish so) even if they live alone while providing a level of safety equivalent or better than that enjoyed in elderly homes • Allow elderly people to be in touch with the Contact Centre, where this exists, with their carers and their loved ones even when they live far away through an intuitive videoconferencing system which is based on the familiar combination of a TV set and of an infrared remote control

  10. Project objectives • Reducing the cost of social and health care to elderly people through better targeting of interventions and early detection of situation of risk and deterioration of health conditions; • Compensating through the deployment of affordable, reliable and user-friendly technology the ever growing shortage of formal caregivers and homecare personnel in general.

  11. Indicators • Primary outcomes • Health-related quality of life as assessed by the SF-36 questionnaire, at the beginning, ad midterm and at the end of the trial period • Number of hospitalisation episodes

  12. Indicators • Secondary outcomes • Time to permanent transfer to elderly homes • Total and average length of stay in hospital • Number of consultations with GPs • Number of consultations with specialists • Number of home visits by nurses • Number of home visits by social operators • Number of ambulance transports

  13. Indicators • Secondary outcomes • Number of accesses to emergency rooms • Number of falls • Number of bone fractures • Depression as measured by HADS • HbA1c change over time (participants with diabetes only) • Survival

  14. Indicators • User satisfaction indicators • Satisfaction with the use of the service for all the other categories of users will be assessed using questionnaires specifically designed for each category of users because of the different interests that these categories have

  15. Key Components HIS Central Unit Mambo 2 HIS Portal Video Conference Vital Monitors Environmental and Bi-directional Monitors

  16. Measurements / Alert Trigger HIS Portal Sensors HIS Central Unit Measurement Mambo 2 SMS/E-Mail Call Monitoring Center, Doctor, Nurse etc.

  17. Alert-Trigger by Mambo 2 Scenarios ALARM Nomanualreset! Fall Daily Announce Mambo 2 Noconfirmation! Repeat MedicationReminder Noconfirmation! Emergency Button Nomanualreset! KeyFob Nomanualreset! Call Monitoring Center

  18. “No-Movement-Alert”/ Movement Alert Senior is not home but a movement is detected Senior is at home but there is no movement in a predefined time frame „No-Movement“ Detector Movement Detector Movement detected Nomovementdetected detects Can not detectthe Butler Mmabo 2 Central Unit Central Unit Mambo 2 ? rules/timeframe rules/timeframe Call Monitoring Center Monitoring Center SMS/E-Mail SMS/E-Mail

  19. Videoconferencing System Monitoring Center Contact Center Add contacts My Community

  20. N = 44 N = 60 N = 60 % % M M M F F F Mean age: 75.5 (67-88) Mean age: 75 (68-93) Mean age: 81 (59-94) %

  21. N = 60 N = 37 N = 80 % % M M M F F F Mean age: 75.5 (65-85) Mean age: 78 (68-93) Mean age: 81 (59-94) % 21

  22. Statistical power at the DREAMING trial sites (Trial start, 5.2009) 0.98 0.92 0.87 0.80 0.78

  23. Statistical power at the DREAMING trial sites (6.2010)

  24. Interim conclusions • Recruitment difficulties • High number of drop-outs • Technologies needed time to stabilise • Unforeseen technical problems (e.g. ADSL is not available all over Europe) • Equipment should not be deployed in one go • New workflow need time to be assimilated (need to keep old and new workflows both alives)

  25. Interim conclusions • User acceptance • Elderly people • fear of the new technology (e.g. in Spain 20% did not want to participate for this reason) • fear of not seeing faces anymore (loss of human contact) • HC professionals • Some people felt threatened by technology (e.g. nurses in Germany) • human resistance to change (we address people who are already under high workload)

  26. Interim conclusions • Further deployment has already started (e.g. integration of DREAMING into mainstream Health Information Systems and new projects in Aragon and Trieste) • Cultural and organisational differences • Contact Centre yes/no • Acceptance of forced videoconferencing calls • Involvement of relatives

  27. Thank you for your attention ElDeRly-friEndly Alarm handling and MonitorING

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