CCTR's mission is to develop innovative end-to-end solutions that will enable extramural diagnosis, monitoring, coaching and treatment, to provide scientifically sound knowledge on how this technology can be safely and effectively used in new concepts of care and care relate prevention,  and as a  whole implemented  in daily life and  care practice, and  to  make  a significant  contribution  to  economic  activity  in  this field.

For now, promise offered by technology in care at home remains unfulfilled

Many promising technological innovations have been tested for care at home, with varying degrees of success. Although expectations are high, these experiments have often been too fragmented and on a scale that is too small to demonstrate their effectiveness. This has emerged from the Netherlands Institute for Health Services Research (NIVEL) survey study on technology in care at home. NIVEL is one of the partners in the Centre for Care Technology Research (CCTR). This study is one of the activities of the CCTR.

An elderly person using an iPad to contact home health care services. Or people with arthritis doing exercises at home via the internet. In health care as well, technology holds out promise for the future. Technology would provide the answer to the growing demand for health care, and as a result, we would need fewer health care professionals. In both hospitals and in the home setting, extensive experiments have been carried out in recent years with technology that assumes care tasks or makes them easier. Nonetheless, it is not yet possible to fulfil the promise offered by technology: that it will enable people to live independently for longer. There is also not enough evidence of savings in terms of health care professionals and costs.

The time is ripe

People are, however, increasingly familiar with technology such as the internet, tablet computers, and smartphones, and innovators in home health care have lots of experience with this. While it is usual to go online to make an appointment for the fitness centre, making an appointment online with the dentist or general practitioner is far less so. Alarm buttons for the elderly have become commonplace, there are now possibilities for making remote diagnoses in patients with abnormal heart rhythms, “intelligent sensors” are being used in the home setting, along with GPS, lifestyle apps, and more. But not enough well-designed, large-scale, long-term research has been done till now into the usability and effectiveness of all of the different technological applications in care in the home setting. Research that is in line with the actual situation in the home and patient perceptions.

Development

Although many health care organisations plan to use technology in care at home, almost all of them find it difficult to organise its implementation. And the response of many staff members has been lukewarm till now. To resolve this, knowledge about successful implementations of such initiatives has to be made more readily available, and staff members must be better prepared. Professor Roland Friele, deputy director of NIVEL: “If technology is to live up to these high expectations and contribute to self-sufficiency among older people and patients, a great deal of development work remains to be done. Although there are many promising initiatives, as of yet there are no ready-to-use technologies. Now that the government has handed over more control to insurance companies and municipalities, they will have to take on this role themselves, and also come up with new initiatives.”

Survey study

This survey study is part of a series of survey studies, research initiatives, and knowledge syntheses in which NIVEL brings together existing knowledge, tailored to a specific policy issue and on topics of current importance, the opportunities they offer, and the possible risks. The research is based on a literature review, a survey among members of the public and health care organisations, and case studies, among others.

Peeters, J., Wiegers, T., Bie, J. de, Friele, R. NIVEL Overzichtstudies: technologie in de zorg thuis. Nog een wereld te winnen! Utrecht, NIVEL, 2013 Fulltext PDF