Monday, August 28, 2006

MIE2006 – medical informatics in an ageing society

Sabine Koch, Centre for eHealth, Uppsala University, Sweden ( gave the day's first keynote lecture, titled 'Meeting the challenges: the role of medical informatics in an ageing society'.

She began by talking about the demographic changes in the elderly population varying between different European and other countries, although most figures seem to suggest that the elderly will make up between 25 – 40% of the total population by 2050. Spain seems like it might be worst affected in terms of the fewest working age people to support the economically inactive and dependent elderly population.

There is increasing mobility in the population, increases in chronic diseases and patient demands, at the same time as changes in the distribution of healthcare, with more and more home-based healthcare.

Sabine's recent literature review of home telehealth states that there is still little scientific evidence on the effects of home telehealth; most literature seems to be on measurement of parameters and on information systems and decision support; there are few evaluation studies (Int J Med Inf (2006), 565-576). There are various projects developing smart home applications, and increasing interest in robotics (especially in Japan).

What are user needs in the ageing society? - are they the same for all, or are there different needs? There are, Sabine, says, that there is not a 'one size fits all' for 'the elderly, but there is an interaction between the elderly, care providers (professional), differing health and social care needs, the role of relatives, and the role of policy developers. There are different roles, with different needs; independent living with mininal support needs; moving through increasing support needs to various degrees of assisted living, to full support being needed in nursing homes, etc. Systems need to be developed that compensate for age-related declines, but also support independence and help the elderly keep control over their own lives. Access to information is often a key need for relatives of the elderly, to provide feelings of security about the level of support and care received.

The role of medical informatics in the future will/should be about the information about the patient being at the centre of care (which is slightly different from the rhetoric in much policy of the patient being at the centre of care). Work will be needed in the areas of standards, interoperability, knowledge management and ubiquitous computing, human-computer interaction, modelling and simulation – but the ethical aspects also need to be strongly borne in mind.

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