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How can you make people living in the latter stages of their lives as comfortable as possible and how can you facilitate the healthcare professionals who need to make this possible? Sevagram, an elderly care organization in The Netherlands, is working with Ascom to find the answer. “Through the right mix of technological and social innovation, we can tackle the demographic challenge,” says Tim van de Geijn, Program Manager Innovation at Sevagram.
More and more elderly people are reaching an advanced age with more complex care needs. Government policy is focused on shifting from outpatient care to home care for as long as possible. The staff shortage in healthcare is commonplace across the globe and is placing further pressure on the sector.
“We want to provide a sustainable answer to these questions,” says Van de Geijn. "Technology plays an important role in the possible solution, such as smart sensors in residents’ rooms. Caregivers are the crucial factor: their willingness to change and their ability to adopt new ways of working are decisive for the success of the innovations."
Van de Geijn worked as an occupational therapist in healthcare for many years. "I soon knew that I wanted to contribute to the design of sustainable and future-oriented elderly care. Together with professionals, we try to tackle complex problems from a user perspective."
Sevagram is a major player in elderly care in the Heerlen, Maastricht and Heuvelland regions. The organization has 23 care centers, a geriatric rehabilitation center, two hospices, and home care. There are 2,750 employees and 1,200 volunteers. Sevagram operates based on the Planetree care vision, which aims to ensure that clients experience good care and employees enjoy providing excellent care. The Heerlen and Heuvelland locations and support services have now achieved the Planetree Certification.
Sevagram also wants to make a difference by adopting innovative technology. "We want to be at the forefront of innovation. Two of our themes are technology that contributes to personalized elderly care and sustainable employability of employees, so that we can offer the same quality of care with fewer people," says Van de Geijn.
Personalized elderly care is possible thanks to the revolution in Big Data & AI, combined with the rapid development of biomedical science and adjacent disciplines. It provides insight into the underlying causes of disease at an individual level, and helps to translate this knowledge into treatments at an individual level.
Van de Geijn: "It’s all about precision and customization. Medications and treatments are therefore much more effective than they are now. The care plan is based on the unique characteristics of the individual. In the future, technology will determine which medications are suitable for whom, in which dosages, and what freedom they can cope with. How often does someone get up at night, and is there a discernible pattern? Can we let someone walk around without a wrist transmitter, so that they can live their own life as much as possible?"
We first want to have a good overview of the issue, then come up with possible solutions, and only then does technology come into play. This approach is in line with how Ascom works."
Sevagram is already familiar with healthcare technology such as sensors, life circles and cameras. These can be adjusted proportionally to the individual resident. However, it is not about the application of technology, but about the problems faced by caregivers and residents. "We want to have a good overview of the issue first, then come up with possible solutions, and only then does technology come into play. This approach is in line with how Ascom works."
The applications that Sevagram has set up with Ascom are building-specific, i.e. each location has its own server and network. In most locations the Ascom Nurse call system operates in conjunction with the Ascom communications software. The Activity Monitoring solution with SmartSense software is used for lifestyle monitoring and fall detection. The next step is organization-based working, with centralized facilities for all locations. Van de Geijn calls this a radical renewal.
In the Sevagram roadmap, all sites will be equipped with the same base as soon as possible. The Ascom Healthcare Platform provides the foundation, with proprietary software for distributing alarms to caregivers’ mobile devices.
So, there’s enough work in the store for Bryan Lemeer. He is the ICT & Healthcare Technology Project Manager at Sevagram. "In my job, I am involved in integrating healthcare technology into primary processes, from new building projects to setting up the digital architecture. To shape this digital transformation, I work with all stakeholders. We see healthcare professionals as our customers. A top-down methodology for creating a functional design does not work for this group. We can push technology, but that is not a guarantee of proper use."
Lemeer wants to develop the design together with the Sevagram employees. That means speaking two kinds of languages. Lemeer said: "Only then can you set the functional needs of professionals against technical developments. We will also go with our employees to look at Ascom on site in a mock-up room. Technology can look very attractive, but if it’s not developed for care staff, everything falls apart. We hear the same thing again and again: It has to be simple. Our colleagues in care have to want to work with it spontaneously, otherwise the system has already failed before it has been implemented."
There is a special customer-supplier relationship, notes Rob Hoogland, Solution Consultant at Ascom. "We are involved in thinking about the development agenda: what are our first priorities, what will we work on later? The decisive factor is healthcare property. This usually comes under the facility business, whereas we only dealt with ICT. We are seeing a shift: care staff, facilities and ICT are all around the table when we present a proposal. This is not always easy due to different concerns and interests. But the end result is better: support for the innovation is part of the process."
Van de Geijn sees another shift. "Previously, a system was dumped on the work floor and the supplier said: good luck, this is what you'll be working with for the next ten years. That’s no longer possible, we need to deal with new technology faster. This requires digital architecture that matches users' needs. Only then can innovation be achieved."
One of Sevagram’s ambitions is to have early detection up and running. This is how to make the step from fall detection to fall prevention: no longer signaling that a resident has fallen, but preventing someone from falling by monitoring and analyzing behavior. This means a huge health benefit and better quality of life. It also provides data that can be used in choices for care and well-being. Van de Geijn: "This can help the family and treatment team: what form of fall prevention is appropriate, what space is possible for this individual resident?"
Together with COMPO Software, Sevagram realized an innovation project focused on facial recognition. The idea behind it was that a camera could detect a resident and process biometric data into signals. The resident could then walk around without a wristband, which is less stigmatizing and provides more freedom. It was also possible to track who else came into a resident’s room: a staff member coming in to provide care according to plan, or another resident wandering around?
From a legal point of view, the project has been thoroughly examined, explains Van de Geijn. "But GDPR is not written for this type of situation, where a balance must be found between collective safety and individual freedom. The project is now part of the Ministry of Health, Welfare and Sport's Digital Care Sandbox." The purpose of this 'sandbox' is to overcome barriers encountered by care staff in innovation and transformation. This involves difficult issues relating to quality, funding, accessibility or lawfulness.
Hoogland concludes: "Co-creation is important for Ascom. We find it valuable to spar with customers like Sevagram about future-proof elderly care. They consequently have an influence on our development portfolio. We have this kind of collaboration with a number of customers who have a clear vision of innovation and a development strategy."
