1. "What matters when you try to replace the warm hands with technology?” steinar.pedersen@telemed.no Centre for research-based innovation in telemedicine and eHealth systems for chronic, age, and lifestyle related diseases, 2006 – 2014Centre for research-based innovation in telemedicine and eHealth systems for chronic, age, and lifestyle related diseases, 2006 – 2014

2. What matters is To keep all persons, the elderly included, out of the health care system as long as possible And, if so needed, even with the help of technology

3. Some characteristics of the future ICT solutions Cordless and invisible sensors ”everywhere” –IP –Broadband –Open source –CAD –EWS The services will be delivered at new places –From the hospitals to the primary health care institutions –From the hospitals and the primary health care institutions directly into the patients home New, private institutions will surface Requirements for competence about own health will increase

4. Services within the hospitals

5. Tele-Dialysis TMS Tromsø Vefsn Sandnessjøen Rana Harstad Hammerfest Narvik Lofoten Bodø Kirkenes Alta Control and follow-up of Remote visit, guiding and education

6. UNN St Olav Haukeland DNR/Ullevål NSS GFS VAS SiR Canser treatment Doseplan Samarbeid med satelittsykehus ved simulering og doseplanlegging. Lineærakselrator

7. Spesialist Pasient and assistent Screening diabetics

8. Telestroke – trombolysis 15 000 patents a year Must intervene with in 3 hours Time is brain!

9. Some services between the hospitals and the nursing homes and/or the homes

10. Arterial ulcers

11. Photography

13. Outpatient department at UNN

14. Some services directly into the patients homes

15. Healthcare at home

16. Automatic control of patients compliance for medicine admission

17. Automatically transferee blood sugar measurement

18. SMS to parents

19. Heart patients

20. The Journal of the Norwegian Medical Association Results from a 14 articles meta- analysis show that the death rate is reduced with 30 %

21. BodyMedias SenseWear Armband (www.bodymedia.com) Sensors: - 2-axis accelerometer - heat flux - skin temperature - near body ambient temperature - galvanic skin response - heart rate receiver

22. Telecare of the future Lötsjögården (Stockholm) Body watch: Temperature Motion Pulse A lot of services in the flats in can be remotely controlled by the residents

23. GPS Universial Locator GPS Offender Locator Exampels on telecare Position monitoring

24. ... the system enables a doctor to observe remotely up to four different medical signals from a freely moving patient. Signals that can be transmitted include the ECG, blood pressure, oxygen saturation and blood glucose level.

25. Liquid cooling garment (overlay) Skin Temperature sensor Pulse oximetry sensor Galvanic Skin Resistance Bio Sensor Network Physiological sensor network in direct contact with skin Integrate sensor signals into a single feed to computer with VPack All wires from sensors embedded inside sock to prevent tear in suit bladder http://www.flcmidatlantic.org/power_point/2006/Wednesday/merrell.ppt#324,7,Slide 7

26. Given Imaging M 2 A Camera Pill Ingestible pill containing camera, semiconductor, and radio transmitter Flashes 4 pictures per second for 24 hours Provides unparalleled medical imaging capabilities for endoscopy, proctology, and colonoscopy SOURCE: National Semiconductor

27. Senior citizens’ home of tomorrow

28. Will all this make us healthier? A patient who have the feeling of being healthy, is a patient that has not been examined good enough Will all this sensors make us feel secured? Or will all this sensors make us feel unsecured?

29. The burden on health care sector today

30. The requirement of health care wokers Figur Sysselsettingsbehovet 2000–2050 målt i årsverk ved utsatt sykelighet og konstant familieomsorg, målt i antall årsverk (Kilde SSB 2006).

32. About robots and warm hands

36. Why do we demand all kind of high-tech medicine to older and older persons/patients, but when it comes to ICT it is looked upon as we patronize the elderly? Centre for research-based innovation in telemedicine and eHealth systems for chronic, age, and lifestyle related diseases, 2006 – 2014Centre for research-based innovation in telemedicine and eHealth systems for chronic, age, and lifestyle related diseases, 2006 – 2014

39. Do ”we” very strongly want to place the elderly under legal guardianship ?

40. The use of Internet for health purposes?

41. What does Google tells us about technology and care of the elderly? Care of the elderly + challenges gave 69.800 hits Technology for care gave 800 hits (mostly focused on protection of privacy) Care of the elderly + technology gave 0 hits

42. A ethical dilemma? To me there is a border between those mentally present (adequate) and those who are not Dementia

43. An old lady I once knew

44. Patients and level of care Persons per month Care level 2 (1) University hospital 13 (9) Local hospital 150 General practitioners 500 Self-care 85 Symptoms, no treatment 250 No symptoms 1000 Risk population Source: Anders Grimsmo

45. The aim has to be To keep all persons, the elderly included, out of the health care system as long as possible And, if so needed, even with the help of technology

46. Thank You !