In the Dutch elderly care sector, we are facing an increasing and more complex demand for care, an aging population, staff shortages, rising care costs, high administrative burdens and a shift of care tasks to district nursing and informal caregivers. Now, one in six employees in the Netherlands works in the care sector. To meet the increasing demand for care, one in four employees would have to work in care in 2040. This is not realistic, feasible or desirable. Fortunately, technological capabilities that can help meet these challenges are growing by the day. What major technological developments are we seeing at the moment?
More and more objects in our daily lives are equipped with sensors and connected online via applications. Think of your smart watch that tracks in real time how well you sleep, how much you move and how stressed you are, or apps that allow you to remotely adjust your thermostat and see who is at your door or where your electric bike is. These smart systems are increasingly being used in healthcare as well. Caregivers can see how often the refrigerator door has been opened, to get an impression of whether their loved one is thinking about eating. Or care workers can be alerted if an elderly person's diaper is too full or if someone has fallen. You can read more about lifestyle monitoring and smart incontinence care, among other things, on Vilans' Digital Care Knowledge Bank.
Where healthcare technology used to be offered from the healthcare organization, you now also see a shift to consumer electronics. For example, there is a huge range of self-measuring devices for sports activities and exercise or eating patterns. So you can keep a good eye on your heart rate or blood pressure yourself. And if you are forgetful, there are plenty of apps that can alert you when you need to take medicine, water the plants or have a doctor's appointment. It's not just about healthcare technologies, but also technologies that extend your independence and allow you to live independently for longer. Consider also the electric bicycle that keeps you more mobile, curtains that close electronically or a robotic lawn mower or vacuum cleaner.
Big data is about turning large amounts of data into useful information in a relatively short period of time. Smart software is able to recognize patterns in a large pile of unstructured data. By collecting, combining and analyzing data, you gain more insight into the current situation and can also predict future trends and/or behavior. Information that is very useful for future-oriented thinking about care tasks: what can be done better, differently and what will save costs? Movement sensors, for example, can provide signaling trend data. If a trend line indicates that Mrs. is sitting alone in her chair for longer and longer, this provides a signal about her mobility. Information about "decline" that without data you often don't notice until much later.
It is also very valuable when you get information that allows you to prevent something - for example, a fall - from happening: take a bed sensor that indicates when someone sits on the edge of the bed. With someone with unsteady balance, you then know that you need to go help quickly. The possibilities seem endless, but there are just as many dilemmas. To what extent is privacy compromised? How reliable are the predictions? And how do we ensure that we use all that information in the right way? Only if data are carefully collected, analyzed and used in making decisions, will data-driven work contribute to reducing the workload and increasing the quality of care.
Developments in AI are accelerating. AI has been driving social media, online search engines, virtual assistants such as Siri, route planners and translation software for years. Since the launch in late 2022 of ChatGPT - a generative chatbot - a shift seems to be taking place. AI systems like ChatGPT can not only answer questions and summarize and translate text, but also write creatively, create research plans, analyze data and generate new ideas. Developments go beyond ChatGPT, and AI's capabilities are expanding rapidly. In healthcare, for example, AI also offers many opportunities in diagnostics and determining treatment paths. AI can sometimes support radiologists in detecting rare cancers, and in some hospitals AI advises physicians on the discharge timing of patients for intensive care. AI is also finding its way into elderly care. Well-known examples include AI-driven monitoring, care robots, voice-based reporting and smarter scheduling (Vilans, 2023). These AI systems have already proven themselves to such an extent that they are gradually being deployed on a larger scale.
With the rise of big data and AI, security and privacy are increasingly important and sensitive topics. After all, if something is connected to the Internet, there is a chance it could be hacked. What do you do if a hacker takes over your thermostat, lock or pacemaker externally? All that personal data in many piles and clouds makes privacy (which some already claim is dead) a very important issue. If all those smart devices track our data, what happens to it? Who can access it? And when? You may think you have nothing to hide now, but look at it very differently in 10 years.
A lot is happening around robotics. In the automotive industry, robots are unimaginable, and in healthcare, too, there are many opportunities for the use of robots. For example, a robot can support healthcare professionals in their work and encourage clients to exercise, keep them company or give reminders for medication use. Moreover, we can make robots ever smarter and more effective by incorporating AI. Then the robot can come back to previously discussed issues, for example. But there are also questions about the use of robotics. How does the robot relate to the work of the healthcare professional and what about personal contact and safety?
A cyborg is part human and part machine. In the medical world, we are increasingly equipping people with techniques that remove some disability or make our bodies stronger. In principle, this is now done only for medical purposes, for example, if your heart no longer works properly or if you are disabled. You then get a pacemaker or prosthesis. Some prostheses can even be controlled by the brain of the wearer. There are even already sounds that our brain can be connected to the cloud in the future. Either way, we will have more and more opportunities to tinker with the body and the senses. So in the near future, we will simply encounter cyborgs on the streets or maybe you will become one yourself. Maybe it's even already here? It's just how you look at it. After all, we carry more and more digital applications with us that we can hardly do without and are almost inseparable from us as human beings.
Augmented reality (AR), virtual reality (VR) and mixed reality (MR) are different forms of reality technology that have the ability to partially or fully immerse the user in a simulated environment. AR is best known in the Netherlands for Albert Heijn's dino campaign and the Pokémon-GO app. Here you still see the people and objects around you, but additional information is added. VR creates a new, virtual reality. By wearing special glasses, it seems as if you are in another world in which you can also look around. There is also mixed reality (MR), which is somewhere in between AR and VR. In this, you don't get a full VR environment, but an interplay between digital objects and physical ones. These technologies have great potential for healthcare. For example, it can help surgeons remotely control surgical robots, it can help in education and training to get more life-like, hands-on experience, and it helps patients treat physical complaints.
In mental health, VR has already been used to help patients overcome their worst fears through exposure therapy. Beyond this, holograms also exist. Doctors, for example, can project holographic projections, or 3-D images of body parts in front of them to give explanations to patients. And surgery can even be performed virtually on the hologram, after which a robot performs the actual operation. In this way, a home care worker can also provide home care while not physically present with the client. Screen care new style!
3D printing eliminates steps between production and end user. 3D printing is driving a future where everything is personalized for the end user. With the cost-effectiveness offered by 3D printing, companies are better able to customize products to their customers. Customization is a piece of cake. That applies to artwork, toys, building materials, tools and weapons, as well as food, medicine, bones and joints, prosthetics and even organs based on one's own DNA. Who knows what we will soon print out for ourselves to stay healthy or get better.
In the coming decades, we can also expect much from biotechnology research in solving pressing health problems. Biotechnology uses animals, plants, bacteria or other living things to develop drugs, food or new substances. This ranges from making cheese to growing bacteria to produce vaccines. Biotechnology research may lead to preventing Alzheimer's disease and curing various forms of cancer and heart disease. In fact, there are already breakthroughs that just might help combat aging. This could significantly change our lives and the demand for care and support.
Meaningful trial of technology
Although these developments are sometimes already quite visible in healthcare and society, they are often still in their infancy. At the same time, the speed at which technology is developing is almost paralyzing. Because if you don't know what will be different ten or twenty years from now, how can you prepare for it? Yet continuing to wait with your arms crossed is not an option either. It is important to be open to innovation, to create space for experiments and to translate that into vision and policy. An experiment does not have to be an extensive pilot, a small test of a few weeks can provide a lot of insight. The distance from these developments to "trying things out for yourself" often seems unbridgeable. It is almost impossible to respond to all developments, but that is also not necessary. Instead, it is important to discover which developments and technology or eHealth applications fit the organization and care needs. You can find this out, for example, by meaningfully trying out technology. You can also learn a lot from healthcare organizations that have gone before you with certain healthcare technologies. Vilans shares this information via webinars, learning courses and learning units.