Tag Archive for: eHealth

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Japan: Ageing society needs technology and community development

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The ageing of society is more advanced in Japan than in Switzerland. Japan has been under corresponding pressure to innovate for some time. A delegation from BFH travelled to Nara Prefectureto exchange views with local experts on how to deal with an ageing society and to discuss cooperation. In view of the severe shortage of skilled workers, which is not in itself a Japanese peculiarity, interest in research on robotics and smart systems is particularly high. Robots have been used in Japan for a long time and seem to be more accepted than in Switzerland. The Japanese use of smart technologies is therefore particularly interesting in relation to the question of the ageing of the population.

Smart solutions to relieve the burden on professionals

The Nara Institute of Science & Technology has a focus on information sciences with topics relevant to ageing. These are very similar to those in Switzerland, such as smart homes and robotic companions. The independent living of fragile elderly people at home is to be supported by sensor-based assistance systems so that one-to-one care becomes unnecessary. While such “smart devices” allow for safer and greater independence for older people, the human factor should not be underestimated: A device, no matter how intelligent, is not a substitute for people, but a support. Competences such as empathy and humour, but also flexibility and adaptability with regard to situations remain reserved for people. New smart technologies offer interesting solutions to support the meaningful relief and optimised use of resources of professionals in care and other sectors. However, community-based solutions should also be considered in order to promote the required human interactions between (older) people.

Community-based solution: the example of Nara

Senior women from Nara in rehabilitation. Photo: zvg)

Nara Prefecture is pursuing the goal of establishing a so-called “Community-Based Integrated Care System” by 2025. Within a certain perimeter, which is based on the school districts, elderly people living at home should be able to be provided with necessary services such as health care, nursing, prevention, etc. within half an hour. This requires that local pharmacies, hospitals, senior citizens’ clubs, community centres and care facilities work closely together. This form of integrated care should make it easier for older people to live and be cared for in their familiar surroundings until the end of their lives. The biggest challenge in Nara Prefecture is also to improve interprofessional cooperation between health and social care professionals. While some are strongly oriented towards the care mandate, others want above all to strengthen the resources of their clients. In addition, there are differences in training, values and terminology, which make the desired more intensive cooperation more difficult. Here, the prefecture focuses on promoting mutual understanding and cooperation. In interprofessional meetings, the professionals get to know each other better while working together on principles for coordinated care and practise working together.

Bridges between hospital and home environment

The Nursing Department of the General Medical Centre emphasises the importance of transitions between the hospital and the home environment, especially for older people. Therefore, a good cooperation between the General Medical Centre and the family doctors is strived for. A Regional Medical Liaison Office is located in the General Medical Centre, regulates the admission of outpatients and is also responsible for the coordination of discharge. For this purpose, all important information is exchanged with the local medical facilities. There is also the role of a care manager who mediates between patients and relatives on the one hand and the medical care system on the other. In Switzerland, too, the shortage of skilled workers in the health sector is becoming more acute, and the future provision of long-term care in particular poses a major challenge. For this reason, ways to relieve the professional nursing staff are also being considered in our country. For example, the term “caring community” is used to describe initiatives that view the care and support of older people as a task for society as a whole and emphasise the value of care networks that enable “ageing in place” locally through the interplay of a wide range of formal and informal services. The efforts of Nara Prefecture in the area of “Community-Based Integrated Care” are therefore also of great interest to Switzerland.

Opportunities for cooperation

Within the framework of a joint research project, a united laboratory “Innovation for the Ageing Society” is to be established. In this lab, practice-relevant topics from the fields of work with the elderly, business and administration in the Canton of Bern and the Nara Prefecture can be dealt with. The research should focus on community-based solutions and how they can be supported by smart technologies in order to optimally promote future technology-supported health care and the most independent life possible for older people.

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How a virtual platform promotes mental health – a project of BFH Gesundheit and Pro Mente Sana

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What expectations do people with mental illness, relatives and health professionals have of a digital platform to promote mental health? A project team from the Bern University of Applied Sciences for Health, the Pro Mente Sana Switzerland Foundation and a communication design studio (Giessform) explored this question together with potential users. Together they developed an interactive prototype of the inCLOUsiv platform, which will go into test operation in January 2020 Social inclusion, social participation and opportunities to have a say are important requirements when it comes to promoting and maintaining mental health (Richter et al., 2006, Pro Mente Sana, 2018). Health Promotion Switzerland lists 10 practical steps for this, including a) staying in touch with friends; b) getting involved and c) talking about it. Digitalisation offers new opportunities for this, on the one hand for the exchange of information between different stakeholders, but on the other hand also for social networking, regardless of time and place. International research describes great potentials of virtual communities in this context, especially when users with similar interests can exchange information on specific topics (Joinson, 2001; McKenna et al., 2002).

Lack of services in Switzerland

In Switzerland, for example, an above-average number of younger people (18 to 34 years) suffer from loneliness or depression symptoms, and this age group is also disproportionately represented when it comes to new retirements due to mental illness (Schuler & Burla, 2016). It is precisely this group of young, shy and socially isolated people who could benefit more from virtual contacts and offers. This is because people are generally more willing to share personal information in virtual interactions, which makes it easier to solve communicative problems and plans (Deterding, 2008). In Switzerland, there is currently a lack of virtual offers for the promotion of mental health with the possibility of interaction by users. With the planned encounter and exchange platform inCLOUsiv, we would like to close this gap and thus make a preventive contribution. With inCLOUsiv, people with mental health problems will have the opportunity to have a say and exchange on various topics related to the spectrum of “mental health” in a way that is appropriate to the target group and the digital age. The inCLOUsiv service is aimed at the following potential user groups:

  • People with mental health problems,
  • Relatives of people with mental health problems,
  • Health professionals,
  • Representatives of organisations and institutions in the field of mental health.

In order to be able to include the needs and requirements of potential users from the various stakeholder groups in the entire development process, we chose a user-centred project design. With this approach, representatives from the above-mentioned stakeholder groups were involved in the development and conception of the meeting and exchange platform from the very beginning. The continuous inclusion of potential users is the unifying core characteristic of the various existing models and procedures of this methodological approach and was continuously implemented in the course of the project by means of workshops and test runs (Abras, Maloney-Krichmar & Preece, 2004).

A platform for not being alone

During a first project phase for the conception of inCLOUsiv, the project team clarified their requirements for an exchange and encounter platform with a total of 30 potential users in two workshops between October 2017 and May 2018. It turned out that the potential users primarily wanted an interactive exchange with other actors. The platform should also convey feelings such as not being alone and becoming part of a community through its use. With regard to the structure and organisation of the platform, the interviewees wanted the platform to enable them to expand their own knowledge of mental health on the one hand and to exchange information on current topics with various people with diverse experience (experts with their own experience of the disease as well as health professionals with professional expertise) on the other. It should also be possible to visit the platform as a guest at any time without logging in. However, the publication of contributions and exchange with other members should be reserved for registered users.

Informative and interactive

In a second project phase between November 2018 and August 2019, a functional prototype of the virtual platform inCLOUsiv was developed according to these requirements and also tested by future users. It was decided to divide the structure of the platform into two main aspects, an editorial publication of contributions and an interactive exchange forum between the users of the platform on specific topics related to mental health. The topics should address the entire lifespan of adulthood and cover particularly vulnerable areas such as relationships, family, school and working life. The following chart 1 shows an overview of the planned topics:

Figure 1: Thematic areas in the exchange forum of the virtual platform inCLOUsiv

The virtual exchange and meeting space inCLOUsiv will in future be moderated and operated by employees of the Pro Mente Sana Foundation. After a further planned test phase with 50 users, the platform is expected to go online in summer 2020. We are curious to see how the interactions between the different user groups will turn out and which topics are particularly in demand.

Support organisation

In its social commitment, the Sanitas Health Insurance Foundation supports projects in the field of prevention and health promotion, especially for the benefit of young people in Switzerland.

References

  1. Abras, C., Maloney-Krichmar, D., & Preece, J. (2004). User-centred design. Bainbridge, W. Encyclopedia of Human-Computer Interaction. Thousand Oaks: Sage Publications, 37(4), 445-456.
  2. Deterding, S. (2008). Virtual Communities. In Post-traditional communities (pp. 115-131). VS Verlag für Sozialwissenschaften.
  3. Joinson, A. N. (2001). Self-disclosure in computer-mediated communication: The role of self-awareness and visual anonymity. European journal of social psychology, 31(2), 177-192.
  4. McKenna, K. Y., Green, A. S., & Gleason, M. E. (2002). Relationship formation on the Internet: What’s the big attraction?. Journal of social issues, 58(1), 9-31.
  5. Pro mente sana (2018). Manifesto. https://www.promentesana.ch/de/ueber-uns/portrait/manifest-2018.html. (Retrieved: 23.8.19)
  6. Richter, D., Eikelmann, B., & Reker, T. (2006). Work, income, partnership: The social exclusion of mentally ill people. The Health Service, 68(11), 704-707.
  7. Schuler, Daniela; Burla, Laila. Mental health in Switzerland. Monitoring 2016. Obsan Report 72. Swiss Health Observatory. Neuchâtel (2016: 7).
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Useful and secure digital identities for all areas of life and their properties

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Digital identities are with us every day. The technical possibilities are very diverse. How can digital identities enable secure identification for eGovernment and eHealth on the one hand and guarantee privacy protection on the other? Digital identities enable access to the digital society. They represent persons, organisations and objects in the digital world and are used in more and more areas of life. Each of us thus has – consciously or unconsciously – digital representations of our person for various purposes. Be it the Cumulus card from Migros, the SwissPass from the SBB or the SIM card in a mobile device, all these digital identities accompany us every day. Digital identities are very diverse. From a technical point of view, the spectrum ranges from user name/password combinations and smart cards to biometric means of identification and hardware-based certificates such as SuisseID. What characteristics should a digital identity have? A digital identity should be useful. It is a tool to be able to perform certain functionalities in the digital world. For example, with a digital identity you can prove who you are and thus use certain online services. You can digitally sign documents or data – analogous to a handwritten signature. With other, more passive identities, you can collect benefits from bonus programmes or use other real-world services, such as public transport. For some applications in the digital world, such as eGovernment, you have to be sure who is behind a digital identity. Identities, such as SuisseID, can be used as a digital ID. To do this, the identities used must be secure and trustworthy. With an identity based on a SuisseID, you can be 100% sure that you are dealing with the corresponding person. Trust in SuisseID is based on the one hand on a certified registration process, where you have to be present in person, and on the other hand on the security of the technologies used. For example, a hardware token, the SuisseID stick, prevents the SuisseID identity from being stolen. Only those who have the stick and the matching PIN can use the SuisseID. This is referred to as 2-factor authentication. A state-recognised electronic identity enjoys the highest level of trust. Here, the state assumes responsibility for registration, which is usually linked to the application for an identity document, for example an identity card or passport. But the high level of trust and security of a digital identity comes at a price: higher costs as well as complicated handling and an elaborate registration process. This usually results in poor user acceptance. Therefore, user-friendliness should always be weighed against security requirements when using digital identities. For example, a high level of security can be dispensed with for an online subscription to a daily newspaper, as the potential for damage is low. Privacy must be protected The data collection frenzy of some service providers on the Internet and various hacker attacks on customer data in recent months have strengthened the desire to protect privacy and anonymity. Particularly as it is now very difficult, and in some cases almost impossible, to remove data from the digital world once it has been disclosed. A good digital identity therefore also makes it possible to move anonymously or pseudonymously in the digital world. With these methods, the true identity of a person is hidden and only the characteristics that are essential for the use of a service, such as age, are revealed. This makes it possible to control access to inappropriate content for minors without knowing their name or gender. The disclosure of the identity (or parts of it) or the preservation of anonymity thus remains a decision of the person himself. A digital identity is not enough The various possible properties of digital identities make it clear that several identities are needed for the different areas of application. In eGovernment and also in eHealth, it is important to identify citizens and patients unambiguously in order to avoid confusion. Only a state-recognised digital identity or identities at a similarly high level of trust, such as SuisseID or the planned insurance card, which also has a unique identifier, make this possible. In other areas, where the potential for damage is lower, one can also use simpler electronic identities, such as those provided by Google or Facebook. These free identities are mostly based on self-registration with email or SMS confirmation. The personal attributes provided are mostly self-declared. Here, users and server providers alike should be aware of the dangers and risks.

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