How to implement welfare technology: barriers and facilitators

hi everybody welcome to this uh webinar my name is ben thunderchon and i work at the nordic welfare center as a senior advisor in the area of welfare technology and this is our first webinar from in our network nordic research network health and welfare technology how to implement welfare technology that's what we're going to talk about today and this is our program uh we will have now i'm [Music] saying welcome to you and then we go on me and helena melcas we talk a little about what we're doing in this network uh i will also introduce the launch of our new website and then 20 plus one will victoria sander the presentation of implementation of welfare technology systematic review of barriers and facilitators uh and after that we will have a discussions with lilac's nabari ganila rootwald and around half past two we will close uh the webinar but first of all a little bit about this network uh the aim of the resources is to consolidate knowledge research higher education and experiences in the field of health and welfare technology with the user perspective this initiative started in 2019 and it was christine gustafsson associate professor at the melody university that contacted us at the nordic welfare center to see if we could do something about it there are in fact a lot of publications and research going on in this area the welfare technology area so we started up to see if could we put put up a network and the goal of the network is to increase knowledge research higher education and practical financing health and welfare technology view globally the medical care and the social care sectors are both facing major changes and the utilization and technology play an even greater role in various types of welfare services at the same time it is important to develop patient and client focuses processes that enable people to live independently for for longer and health fair and welfare technology may also become significant significant the fields of disability and pedagogics so you can go in and read more about this this website uh this the network's public website on this website address as you see see here uh this this is the website uh that we have and where you can go in and read the read read off what we're we're aiming at the responsibility will be formalized this this network during 2020 and uh the responsibility of the network's ongoing work is yearly followed by the chairmanship of the nordic council of ministers and during 2021 it is finland that is uh has the chairmanship of the nordic council of ministers so therefore always also finland that are responsible responsible together with us at the nordic welfare center to organize their work and to do these different activities that we have planned for and go that's going on but one of the activities is this seminar webinar that we have today today and i would like to welcome in uh helena melkas professor at lachlan university of technology finland uh here and and say some somewhat please please helena uh i give the word to you uh you can present yourself and then go on with with with the activists yes thank you very much bent and uh hello everyone so i'm helena melkas from ruth university in finland i'm a professor of service innovations in the department of industrial engineering and management and i'm fortunate to have as my co-chair for this year uh anna forsman from auburn academy in barcelona um i have a long background in the research uh on the use of welfare technology about 20 years have passed in this field and i have done research on various solutions in various services and also at different levels of the society next slide please so i will tell you just very briefly about this research network's planned activities for this year um we bend is actually going to tell you more about this web page for the members very soon we will arrange other webinars this year too altogether four to now in the spring and then two in the autumn we will also prepare a research proposal together that's also uh something that we have been already doing and um that's obviously an important opportunity for a network to um to um create new partnerships and new combinations of research fields for instance we will also participate in various events arranged by the nordic council of ministers during this finnish presidency we are planning to have a network meeting at the end of this year and we will participate in various national and international conferences as well then i would like like to say just a few words more about this one project that is currently ongoing so um next slide please this is one example of the activities this year and also next year and so we have received funding from this joint committee for nordic research councils in the humanities and social sciences via academy of finland and we have funding to arrange a workshop series to synthesize and advance nordic research-based knowledge on proactive health and welfare technology we approach this topic at different levels so we focus on the nature and nature of the needs for a proactive health and welfare technology use from the point of view of older clients or patients people with disabilities and also their informal caregivers secondly we focus on the implementation from the perspective of professional caregivers and then finally in the third workshop we focus on the societal level in the expected future implementation of such proactive health and welfare technology and this word proactive is very important it's in the title of the project and we can see that in many cases health and welfare technologies is perhaps brought into use by the end users too late so this kind of proactive approach is what we wish to advance so again this is one example of our activities and we will be providing further information um as it proceeds welcome to this webinar once again and i will now hand over to bence thank you yes and uh i will now give the word to victoria sander who will start up her presentation there you are victoria yes here i am yeah and sharing your presentation very good then i will turn off my video and my microphone and i will give the word to you victoria the word is yours thank you very much paint so i will present to you the findings from research about barriers and fast facilitators that affect implementation of welfare technology and this work was done in collaboration between the melody university and the london university in sweden and it was founded by funded sorry by the swedish research council for health working life and welfare alpha technology is considered part of the solution to meet a double demographic challenge of an aging population and fewer people within working age and technology has the potential to increase quality of life of all the persons and persons with disabilities and their relatives but also to improve their working environment for health and care personnel and this past decade we have seen an increase in the interest to use welfare technology taking into consideration its purpose and it's also its broad user base welfare technology has been described as all technology that in one way or another improves the lives of those who needs it but the point of departure of this presentation is the somewhat narrower approach by the swedish national board of health and welfare that defines welfare technology as digital technology that is aimed at maintaining and increasing the safety activity participation or independence in a person who has or is at an increased risk of impairment and this includes for example smart homes technologies for self-care medication positioning telecare and m health but also surveillance systems and assistive computers for example the focus of this presentation is on implementation of digital technology for all the persons and persons with disabilities and their informed caregivers their relatives that is i will have a user perspective so this does not include research on technology development or validation of the technology itself so we have excluded technical reports on welfare technology and studies evaluating the features of the devices but despite the large potential large-scale implementation welfare technology has been slow and also narrow in scope there have been attempts to identify reasons for this slow adoption but they have been limited to individual studies or expert opinions there have been some suggestions of barriers such as high costs lack of competence lack of knowledge about available solutions different organizational issues resistance to change among personnel weak analysis of needs and technical problems as well as legal complications and all the studies addressing these barriers and facilitators of the implementation have been published we haven't been able to find any systematic reviews synthesizing this evidence this presentation is based on a systematic review of existing research on factors that influence the implementation of welfare technology and the findings have been categorized into these six themes there are capacity entities and values expectations health participation and identity and lifestyle this i will present to you now the first team capacity includes competence knowledge and ability among the individual users relatives caregivers and within health and welfare organizations knowledge is about awareness about the technology as well as knowledge and skills to be able to use it and this involves having opportunities to practice and to have adjusted information about the products the user's willingness to learn their their self-esteem and also their trust in their own abilities will of course affect the willingness to learn and adopt the use and use the technology sorry but this means a need for health and wealth organizations to ensure the possibilities for education and practice for the staff as well as the end users and their relatives and from the individual perspective it has been recognized that timing is very important that the technology should be introduced in early stage of illness for example in cognitive dysfunctions to be able for the individual to learn to use the product previous experience of technology use and previous ownership will also influence the will to adapt new technology and this may be both hindering and facilitating it is easier for those who have and who use technology within their homes to take on new products the experience of products that are familiar and that have worked positively will of course affect the abduction of new technology but if you have experienced malfunctioning devices or products that did not meet your needs then you won't you don't want any new products social economy is another influencing factor it was shown that being married or living with a spouse or partner and a higher income predict technology ownership implementation with the technology may not fit within an organization's existing systems and there may be a conflict with established routines and workflows while it's demanding an integration of technology in the care processes and also new ways of work in these cases leadership is a very important capacity for successful implementation together with clearly expressed roles and also responsibilities and implementation is always a time demanding process which also demands efficient resources and from a technology perspective implementation of products in the user's homes is dependent on infrastructure and interacting components as well as a stable electricity supply there are recurrent discussions about the safety of networks and the risk of access to data on unauthorized persons technology should also be usable for those it's meant for it should be practical easy to use and not demanding advanced knowledge it has been suggested that it is as important for all the persons to learn about technology what we call technology literacy as it is for the developers to learn about aging aging literacy and research has also discussed the cost of implementation of technology and who should pay for it there are several factors related to attitudes and values entities among individual users informal caregivers and personal effect implementation just as the level of trust in the technology attitudes are affected by external influences such as social networks but also meetings with care providers and home care staff especially the opinions from our family are one important influencing factor for adoption it may be perceived as either an encouragement to use new new technology or it could be perceived as a pressure and among personnel within care and social services there is a perceived pressure to adopt new technology which is sometimes associated with a with a sense of worry and also a sense of threats one recurrent discussion is about ethics and privacy this is related to who will be involved in the use of technology and who will access to the data that is gathered but also related to remote monitoring and the possible perception of surveillance is also worry that technology may be deceptive and this is related to human-like or pet-like technology that may deceive persons for example with dementia believing it's real from an organization perspective the climate within the organization together with a shared vision and shared goal setting is important for successful implementation and the resistance to change within organization will become a barrier in one of the articles the organizational climate was even perceived to punish creativity and the organizations are also influenced and dependent on existing laws and policies there are both expectations and concerns related to the implementation of welfare technology technology that is expected to be able to meet needs such as safety or contribute autonomy in everyday life and that this is expected to be useful and also contribute to social connectedness it's also easy to to assimilate there is on one hand expectation on technology to contribute to social connections but at the same time i worry that it instead will contribute to social isolation and loneliness and from a caregiver perspective informal and formal there is a concern for quality of care and the perception that technology will replace human delivered care which will have an impact on the user caregiver relationship and for personnel technology is also associated with new ways of work and a possible threat against the profession and the professional identity as they are expected to assume new rules health was discussed related to the individual users which in this case are the older persons and persons with disabilities within the included articles physical and mental health body function number of force and self-reported general health were factors that influence the perception of need for technology for example it was recognized that previous force increased the readiness among older persons to use technology within their homes the theme participation is about involvements of individuals informal caregivers and personnel in decisions and planning this involves consent and the possibility for individuals and their relatives to be able to choose between technology or human delivered care and services it is also about the possibility to participate in the planning of the care and for successful implementation the personnel should be involved in the process from decision goal setting and during the intervention and finally the identity and lifestyle is about acceptance and fit of technology in their everyday life acceptance is discussed in in relation to identity of being a technology user and the process towards acceptance among the individuals may be rather long and also associated with overcoming stigma related to being frail and dependent also adjustment of technology to everyday life is important for the individuals and placement of the equipment such as cameras or sensors within the home is important to consider because if they are visible they may contribute to sensor surveillance and also contribute to stigma and besides visibility appearance was discussed it was suggested that the devices should have an appealing design so when planning for implementation of welfare technology for all the persons and persons with disabilities it is important to consider capacity attitudes and values health expectations participation and identity and lifestyle the technology should be available it should be safe usable and fitted users daily lives an implementable world for technology should focus on needs but also consider design and possible experience stigma related to the identity of being a wi-fi technology user so according to these findings there are several dimensions to take into consideration when implementing welfare technology and they relate the changes in workflows and routines a relatively limited part of these factors that was found is about the technology itself the main part is very much similar to what has been recognized within implementation research and for example so-called determinant frameworks with factors that influence implementation of innovations but i also believe it points at the importance of not just focus on the technology itself but the change of workflows and routines that comes with implementation of technology welfare technology is one method to meet the needs and decrease independence safety activity and participation and quality of life for persons who has or are at risk of impairment the results from this review may be used as a support when planning an implementation interventions or welfare technology for all the persons and persons with disabilities and if you have any questions you are welcome to contact me thank you very much and i give the word to christine oh thank you yeah i could i could could i could you change back to the slide you had yes yeah could i could i put in another question number one to you victoria yes of course uh from uh from myself i think is very what i see from my perspective it's very interesting to to see and hear about the the what you were into when it comes to attitudes and values and and about the culture in organizations i know that a norwegian um va coefficients and roadmap for service innovation in the work of welfare technology program program in norway they have identified this as as crucial in the in the area and they they say that they they say that anchoring and insight in the organization is crucial to be to be successful so um it's not really a quest and it's just an and comment on that and and i i i think you agree on that this is extremely important and it's just so little about the technology it's more about the culture yes it's very true and what could we do about that working in when with the culture issues well this is a big issue in implementation research in place implementation innovations uh intervention sorry in large of course it's very important to to have the whole organization and have everyone that is involved but make them participate and being involved into the whole process of course and that they need to a need for this in innovation that we're implementing yeah yeah victoria before you leave the presentation mode there are i would like to ask you three small questions about the study you have been first author about uh first i think it would be interested for for the attenders to know how many publications were included in the study this study will result in two publication sorry what the first publication is about these factors that we have found and and another publication is about the the research gaps we have found during this review and the need for further research in the area yeah but this study you presented the finals from now how many uh archives are included in the interview analysis yes sorry i i misunderstood your question and finally it was 33 studies or articles that was included in this review we started up with about 3 000 yeah and uh a following question to that is um briefly which countries were included in in the representations of the included studies well it was a mix a large number of the included studies were from the united states and from the netherlands but there were some other articles from the nordic countries and i believe from germany too yeah so it was a mix yeah and uh the last question to you from your understanding what is the correct character the character of the included studies are there a majority of qualitative or quantitative studies well from these 33 articles there were 27 there were qualitative design it was used qualitative methods with interviews or focus groups and there were none a randomized control trial there were a couple of mixed methods and and descriptive methods yeah and i i think that's quite um to say describing the situation we are in the field of health and welfare technology at the moment and maybe we need to take a new step into trying to find funding for larger studies to be able to to have more data to analyze maybe in rct studies yes yeah and some of the include articles also requested more long longer and more rct studies yeah okay could i just ask this question a very short question where have you published the article victoria oh it's not yet published it's submitted so we are waiting for reply so soon i hope thank you very much thank you victoria and we will now move on to the panelists discussion based on the presentation we heard but as bank informed you earlier there is also possibility to ask questions to all attenders or to the panelists and uh i think we will start with a question to the panel and and then banks will add quite with questions from the chat is that okay with you banks yep absolutely yeah and we have a very nice panel here with the researchers representing the countries which are involved in this health and welfare technology research network we have helena melkas which you have met earlier in the intro introduction we have laila oxenberry from copenhagen university hospital in denmark we have gunhind rotswald from norwegian center for e health research and we have banked as having the more nordic overarching perspective and uh i'm also a part of the panel and i'm a researcher from madeleine university in sweden and as you see in this slide we have uh are found we are founded in different disciplines and that's one of the strengths of the network that we are um intra interdisciplinary in this field so maybe the panelists could turn on their cameras yes and thank you and welcome to the discussion and now gun hill day is here as well so the aim of the network is to consolidate and disseminate research-based knowledge and in one way serve the practice of elderly care and disability practice and what are your understanding and comments based on the study victoria presented what is the contribution with this kind of research to the practice field of elderly care and disability practice uh i can start and ask lila what is your comments in this matter yes first of all thank you very very nice presentation um yeah i think it's very it really shows that it's very important that we sort of do these reviews and to to condense our knowledge um it's very important that we we move forward within these fields and it's very interesting that even though you take literature from various fields it's actually the same kind of of issues coming up and and it really calls for for major steps forward when it comes to more research both when it comes to methodology but also the way that we we address these uh yeah gaps in in knowledge um so so it really shows that that we we have a a a common cause here that we can we can address and helena from a finnish perspective and also your disciplines perspective well i would say that um when we talk about health and welfare technology or welfare technology as in this article um it's a very wide issue in the society really requiring systemic understanding and it's also something that is uh related and studied in quite many scientific fields with even with many different concepts and approaches so um it's really really valuable to have studies that synthesize other studies and then also help us in building up this wider understanding together and hilda from a norwegian perspective yeah i thank you for a very nice presentation and i i agree with both lila and helena and but i'm a little bit surprised that the findings were so much in usa and the netherlands and so few in the scandinavian countries my impression is that uh the pilot process or the use or the trials within welfare technology in the nordic countries are has been ongoing for several years so but i don't know if the term welfare technology is difficult to to make search on because it it's uh it's so wide so to speak and and the term is used in the different ways even within the nordic countries uh that's one point and another point is the the word implementation and the practice it's difficult words to make search on so yeah i need we need to perhaps we need to to split them and to be even more precise and narrow the questions research questions for each each search so i i think you're kind of highlighting one of the the problems in the field is that the way we use concepts and and also conceptualize them in the research area and also again if we look at the manuscript there were quite many hits from the start there were thousands of articles and studies but then um by working with the inclusion uh process it should be about implementation and and all these limitations we set as inclusion criterias so so maybe that's one of the a explanation but then again when you combine the areas of health and welfare technology elderly care and disability practice and implementation it's kind of a narrow the area but we we again there are some knowledge in the area but then again if we look at which what are the aims of using welfare technology as victoria said in the end of the presentation that one of the goals is to to increase health to increase independency to increase security and safety there are actually not research instruments measuring these values as we say should be the goal of using the welfare technology and i think that also contributes to the area when we talk about the implementation that we have problems to to measure of the expected goals of it but being if we kind of um take a view from an overarching nordic perspective what are your comments and and understanding of the review study that victoria presented well i'm just for the first time so happy that that's this kind of review is done because we've been talking uh on a practical level uh for uh several years about that it's uh 80 90 percent about other things than just 10 10 15 about the technology how difficult it is to to implement welfare technology and have to have these kind of overuse help help us to see what what is where is the the the the the bottlenecks uh to go go further so uh it's it's very very important to have these kind of of we've done and and public publications made to to to help us go go further and that's it doesn't matter which of the countries we are in we have the very very similar problems uh dealing with this so we put the very good that we highlight this as this is done but one of the the main ideas having this nordic network is that we have similar welfare systems but then if we look into for example the usa the united kingdom germany there are different welfare systems and do you have any thoughts about that when we looking to the findings we need to have impact on their work with implementation the welfare systems the funding for for this kind of welfare technology today is quite expensive many of these welfare technologies devices yeah are you asking me well i'm asking everyone okay then someone else can answer please if you have any thoughts or comments it's a tricky question i think uh i said i say no i don't think really the systems really matters so much here but of course about the socio-economic economy and economy and investments who is going to do the investments of course that's important in fact that goes into uh one of the questions we have got here is that about the legislation and support of use technology also if you interesting if you have to compare it with conventional activities um so so we sort of we need to prove everything uh that is works with the welfare technology but uh the traditional way we're doing it yeah we are doing it so so uh yeah i don't know if that was a going from your question but i think that's interesting and we've got a question about that how we see about that question back to you i can please please try to comment a little bit on this i think in in the nordic countries we are um similar in the way that we have a lot of the same values and the victoria pointed on attitudes and values as one of the areas important for planning the implementation process one of the areas to take to consider as important and we in the nordic countries we are really focused on the accessibility to to healthcare independent in where you are living what kind of [Music] resources you have and so on and the in equality in in health uh is um something that we really have focus on and we also adopt this when it comes to e-hub and to the world health and welfare technologies that the accessibility should be taken care of uh also when you are using technology so the infrastructure part and the literacy and all that things that could hinder people uh access to health service uh because or views of the technology will be very important for us to to uh consider when we are implementing i don't know if this is specific for the nordic countries but it's obviously very important for us to make sure that technology doesn't make the service and harder to access or poorer quality for the service that's true yes laila yeah i agree that i think we do have some advantages when we look at our nordic countries as a unity within this field because we do have similar systems for supporting and if you look at this review it's not not just the personal circumstances that defines whether you're going to be user of health and wealth where technology is also the system surrounding you and the the professionals surrounding you and i think when you build technology you also have to think of the system that it's going to be used in so i think that being similar yes we can perhaps do some better business cases going from pilot studies to to actual studies and then to to to real products being out on the market we can we can if we join together we can we can have more power within this kind of development of of technology and development of evidence-based technology in the future so i think definitely yes we should we should join up for some between nordic research projects also and development development projects yeah yes helena yes thank you i agree with lila i think it's quite important to focus on the nordic countries as also as one um unity because um you know when you think about the global uh perspective the nordic systems are so uh so different and so unique and um they have a very different history uh from those of the other countries they have a very different uh comprehensiveness or or let's say breadth uh than those of the other countries and we also have this um let's say uh aim of bringing social care and health care closer to each other and in general we have more social care than in than than other countries globally have so these kinds of issues make it important to also know this context very well and not sort of uncritically take lessons learned from from countries with completely different welfare systems that's true and and another aspect of that is also maybe cultural similarities um about this to the very high cultural value to be independent uh in the society and and that's one of the goal with using healthy welfare to to technology to stay independent and in your own home like in the policy of aging in place for example bank do we have a question from the chat maybe we should highlight in the panel discussion yeah i have a question here is if there are areas that you see i think it's it's connected to to victoria's presentation if the areas we see that there is a lack of research well i i could start with one view of this that actually i would say there are not so much evidence uh research-based evidence of the effects of welfare technology uh if you look looking into measurements of the goals we want to reach by using health and welfare technology so that's that's one aspect and one way to start with that is to [Music] develop a validated instrument to measure the values we want to reach with well health and welfare technology any other comments lila yeah i agree with you with that being being an issue we have to address but also when we actually look at this um review uh it could be interesting to look more into what are actual examples of successful implementation and and find out where where to go and and do more of that um actually also when we when we talk about the research and publications and so on i could also sometimes i i'm wondering whether we also have a publication bias within this field that people are not that keen to present perhaps not very successful projects uh and so and if we don't do that we don't get to look into the the the all the the the difficult issues that we need to address we we definitely have to look at our success but we also need to address when are we not successful with implementation and looking into the details of that so i think we have to address yeah implementation from a very broad perspective when it comes to we come to research that's true you kneel there you have your hand raised there so yeah yeah uh i would like to uh add something when it comes to the transition from the pilot phase of the implementation process to the scale-up and the large scale-up phase and i think there are some interesting research done in england showing that there are factors that influences the ability to scale up as vitudia had the tisha greenhalg referenced in her um description uh i know and there are also other researchers who have studied this dallas program in england i think it was in 2016. and they have very interesting findings when it comes to the role of the champions and the champions uh in in norway for instance we have a lot of protests going on and uh but we there's a challenge to to uh to make the transition from the project and to the scale of phase and within the project phase the the champions has a very important role and the article i read from england pointed on the same thing but as you scale up and as you manage to scale up and implement this is an ordinary part of the service the role of the champions decrease the importance of their role decrease and it seems like it's a natural development looking into the projects that they're running i think still even at least in norway all champions that are involved are really important at the stage of all the projects uh today so they're my point is that if the champions are very important then um the project is not mature enough to be implemented in the organization yeah and from a swedish perspective we also have this organizational view that the municipalities self-governance in sweden in sweden there are 290 municipalities and they are self-governing and and i have experienced that sometimes every single municipality have to conduct their own um evaluation of different welfare technology so from a swedish perspective we kind of miss the national guidance the policy or the national knowledge center to support the municipalities who are responsible of the social care disability practice and elderly care in sweden so we're kind of living with the issue that everybody has to invent the wheel 290 times to to have these large-scale implementations i saw that helena raised the hand yes um we i i recognized that situation from finland to that you describes christine [Music] i was delighted to see this word implementation in the title in in general in victoria's and your study because i think that um simply the words the choice of the word also is important because implementation refers to a process a long longer term process and longer term use so pilots are important but they're not enough so this is really really vital to focus on the implementation and returning to this question of what kind of studies would be needed on the basis of this this study that we heard about i think that also for instance the perspective of informal caregivers and also people with disabilities they have been highlighted much less than elderly older people's views and needs and experiences so in general those two groups of people also would would deserve to be focused on in greater detail that's true as i was referring to the the one of the questions which we raised before that um there might be some bias in the existing research and and one of them is uh what i have experienced there is some kind of welfare technology optimism if we look into the studies and i would say there is a majority of studies where the participants in this study are people who chose to use welfare technology we don't know so much about the groups of people who didn't choose or don't know about the existence of welfare technology as well so that's also an area we need to explore and i can see there's a question in the shot from helene von granitz who asking who will be disadvantaged with the development of welfare technology who are the losers in in this field of development of elderly care and disability practice yes please lyla yeah i don't know if there are any losers but we need to be able to support everyone who would like to use and have a need of this kind of technology and it should also be um uh it should be allowed to not not choose technology so i think that's the the balance that we need to have also when you talk about um the the optimism around technology and technology use i definitely definitely agree that we have to address all the the things that are problematic and and see how many can we help if they would like to use technology how how good implementation can we actually do to support them and and how can we support the people who would not like to use technology uh it should be an option and not an an and yeah be an option and not something that you should do just because you are a fragile uh person who needs help it should be optional with what kind of help you would like to have um yeah close now i have another comment but i'll just say that later yes helena yes this actually what lyla said brings to my mind the concept of informed choices so that's something that we should be able to to encourage and support that informed choices would take place at all levels the societal level more generally speaking about implementation of welfare technology also at the organizational level that the that each organization would have sufficient knowledge and sufficient um sort of a foundation for making these important choices for them appropriate for them and then also at the individual level uh the end users yeah and helena we have discussed this before in another project the orient project that um the some of the participants especially the the all the people who were are informers that said it's it's hard to ask for something you don't know exist so we also have an or your orientation issue to work with to inform the society or potential user what is available in in the words of welfare technology or digital support in in daily life so so literacy is is an important area to work with yes and i completely agree of course with this importance of orientation but it's something that should be first of all identified as a key activity with regard to using welfare technology and its various types and there are really great knowledge needs we have found that in our studies over the years that for instance these informal caregivers they have really really great knowledge needs there is no usually no neutral and easily available information around so that they could have have learn more and and be able to make these important choices yeah and i also think it's an assignment for maybe academia or different professionals to to work also with the ethical aspects of using welfare technology are there ethical problems we need to consider and also respect when we discuss the implementation of welfare technology there are rules and legislations who are supporting us in our work and all the implementation work but there are also more ethical aspects we also need to consider when we're talking about for example informed consent to use welfare technology again for example in dementia care when it might be a problem to have a what should i say ordinary um yes or no i would like to use it and and that's the nausea i i know it has been on a governmental level about these future contracts that you maybe before you develop some kind of dementia disease or condition you you kind of give your approval to use welfare technology is as a support in your daily life has that been an issue in in finland norway and denmark talking about these ethical issues for example for example when you have a condition when it might be hard to to have the full approval yes it has not only for welfare technology but in in many other areas which are important when you are in a stage not able to take care of yourself and not able to um take good decisions by yourself there's an ongoing debate all the time i guess on this but within welfare technology i think this has been mainly when it comes to use of the gps in the dementia care yeah how is it in denmark is this an ongoing discussion well it is the discussion that it could be even even uh addressed even more but when it comes to sort of what we call safety technology and yeah gps's so we have a new legislation in denmark that gives caretakers some options if if the person with dementia is not able to to give their consent to it so but i'm not an expert in that but but i know there's a new legislation that that moves this field forward because sometimes it's also a matter of of the best intent and the ability to to actually help people in the best possible way through health and welfare technology but yeah it is a difficult uh discussion but uh but and that's also another issue that that this there's all the the ethical issues but also the legislative uh issues that we need it needs to sort of um be at the same level as the development of technology and i think that we could actually address that discussion even more also and and learn from each other in the nordic countries also how to how to address these issues how about uh in finland helena well yes it's a discussion in finland too and it certainly could be focused even more um i would actually highlight this this proactiveness that is in the name of our or is focused on in in this project that i briefly uh introduced so um proactiveness in the sense that people would be uh would be able to start using welfare technology early on and not at the stage that is when they are already too frail that's true bank is this uh an issue that is discussed on the nordic welfare center level absolutely we have a network with nordic network for for dementia and called cognitive so so uh absolutely we discussed that and we discussed that together with the with the senior advisor in the networks that work with that combined with welfare technology so we follow that closely what happens on all levels in in in every country do we have a question from the shop maybe yeah i have questions and i have comments no comments from myself no i just want to comment i just want to comment you said this i go back to what you said about the municipalities in sweden and municipalities everywhere i think they want to invent their own wheel i see from a nordic perspective the same thing i have seen that there are pilot projects going on in in in one country and then they say we don't have any reachers on this area but there is a reaches from a neighboring country and then they say oh that's from that country we we don't trust that so we really i with this network we also want to to make it everything that comes from nordic countries could be used for sort of proving that you should go on working with what you're working with even if it's not from your owner's own researchers in your own country so that's our one of the really target uh main main main goals for for us at the nordic welfare center to to highlight this uh i go to uh to another question let's go back to helena that they asked about uh if there are any ones there will be disadvantages you uh she also added if not only users but also providers or i understand it as the people working with this and and with that again that this network is not is for all all users of welfare technology is for the end users but also for for the staff the professionals working in this area and i would just like to add that we have been looking into that in a project we're working not the research project just to see if the distance spanning solutions or digital solutions the welfare terminology sort of have an impact on recruitment and comp competence provision and what we come up with with there we will publish a report here in march is that the the the the most positive thing is the the the environmental work their work situation are more positive and we have done interviews in exote in finland and north here london mark and song if you're down in norway and and we are when you ask this the people working we say if we want to go back to how they used to work they said and there's no one that said yes everyone think that this is a national development of using the digitalization or technology of today so but i think there is a lack of research in this area when it comes to to provide this and stuff and when talking about exotic we have pentaitconner with us and here puts the question uh uh all countries are in nurses and practical nurses and staff in general at the same time we're adding investments in new technology how long our system can stand this kind of development and when can we see result of research work on operational level difficult question we have parallel development here so to speak yeah well maybe that's just one perspective maybe it's not the opposite because maybe technology don't always have to replace human resources maybe adding things up you can just make even better quality of life for these people who needs this kind of care and help but yeah i know there's also an issue of of have we got the resources but we do have an issue a very very strong issue coming up with not having enough people to take care of elderly and disabled in the society so so maybe we have to keep on doing this for a while until we can see well where can we actually have technology replace human resources in a sensible and and and and user-friendly way um so yeah that was my view on that yeah and i i have a similar comment to that that we are facing a serious staff problem in in all nordic countries i will say that and to be able to to have the human resources for the patients or the older people or people with disability who really needs the human care we need to locate that kind of care to these people persons and where it's ethical and possible i think we should replace someone with something actually i saw helena i i'm sorry i interrupted your no no no no not at all um well um i think that the key issue in addition to implementing well whatever is taken into use whatever technology is taken into use a key issue is also to really depart from needs what are the the precise needs for the precise care tasks in different kinds of services because we're talking about a very wide sphere of social and healthcare services and even other services actually so uh there are many different types of services with many different types of tasks and what are the needs and what so this this needs uh base basis is is really vital also when we think about these investments and the funding difficult funding questions and i think one of the the questions to work with if we if we're looking into the uh growing group of people older people i think one of the key factors to work with is prolonged independent life to stay independent as long as you can if we could move that year when you kind of enter the social care a couple of years and push it forward a couple of years there are many benefits for all parts of this area because i think it's a very common attitude that you want to stay independent if you could and i would say that the majority would say that if i could have the choice between staying independent or need support and help by by social care or maybe also my my relatives or friends i prefer to have the technology that makes me independent can i just add something christina yes i also think that uh technology will develop and we will have um better interoperability uh and more the technology will be more like seamless and um yeah the interaction between different kinds of technologies will be improved and this will also improve the workflow i guess and the work process for healthcare personnel and some of the benefits from the technology i think is in the information flow and in the work and the workflow can improve and that we will hopefully maintain uh to give patients the necessary attention that they need to have independent of the technology i have two questions here i don't know or should helena say yeah you abide yes i was actually going to uh if i may uh answer to this question oh yeah to me so um uh that the the people with disabilities and also the informal uh are less emphasized in health and welfare technology research no i don't have a single literature reference to that proving that but it's based on my my uh field experience in this field yeah but am i wrong if i recall that you have conducted some kind of review of health and welfare technology research in the area of disability practice no you're not wrong we have done actually a colleague of mine and indian economic and me did and together with mariana trump we did a little review not a systematic review but we did a more like a scoping review i guess and we identified a lot of articles uh ended up with i don't remember the exact number now but i think it was about 30 articles we we went through read the full text and there are a lot of research within some areas of welfare technology when it comes to children and adolescents with disabilities with cognitive disabilities and uh i we don't we only have this article in or report we didn't write an article we have a report written in norwegian but this brings me to to the next seminar and maybe banked will say something about it because the next seminar will actually focus this topic yeah it was a very nice bridge how was one question that we missed in the beginning i think that just one question in the chat that we have that uh highlighted hello i'm starting my thesis related to walking robotics with neurological patients i'm only a very pla in i'm only a very preliminary stage i'm a partly interested in experiences and perceptions of the neuro neurological patients do you know where any patients experiences of walking robotics have studied i don't know so much about that yeah i think helena might know something about that field well actually well perhaps it's um it's an occupational disease kind of that i don't remember many details so i know that there is research but i cannot give any references directly yeah but maybe the the use of the word exoskeletons might be useful in in that area this kind of robotic trousers you you put on yeah and also brand names like locomots [Music] yeah ruined you're very nice hey christine are we yeah maybe we are discussed here for for a couple of hours but i don't think we where the time is running running and yeah i think it's time to kind of closing this discussion and and thank you very much for all this interesting the interesting question that has been addressed in the shot and also thank you very much to the panelists who has shared their experiences and and insights and knowledge in the area and this is one of the aim of the health and welfare technology research network to kind of consolidate our knowledge and research in the area but we also have an assignment or task to try to disseminate this knowledge to the the field of elderly care and disability practice and and this might be a challenge but we will try to work with that queen in um with our channels and also with support from the nordic welfare center so thank you very much for this and now i'll leave the floor for paint yeah and and you can hang on so you could you could comment uh on what you're going i'm going to be up to the next time and i will share my screen here yeah uh save the date for the next webinar is on in one month 18th of uh march at this same time one o'clock to half past two we will have a webinar called health and welfare technology for children and young adults with disabilities and uh there we will listen to two presentations yeah we uh we will um plan for two presentations uh and uh we are not sure if we would like to how we will build this um seminar if we are going to have presentations after each and discussion after view presentations we need to to think a little bit more about it but we will have two different kind of focus very interesting one of them is a user-centered approach um we are going to present the research that has been done at the norwegian center for e-health research for five years following some municipalities in norway in their implementation early implementation process of the different kinds of health and welfare technology to children and adolescents with community disabilities indian economic will be the main presenter and the other presentation uh is focusing more on the user-driven innovation and the design process and how they have involved young adults in the design process of designing technology for for this target group and this presentation presentation will be done by chris safari from the university of ogder so i think we will have two interesting presentations focusing on a very vulnerable group of users that are not often in scope in this kind of discussion that sounds very good i'm looking forward to it and i hope you're all looking forward to it as well and come come with us on the 18th of march we will send you information about this then you could sign up and but say the date already now and um okay that was all for now i thank you all for a very for a very concise contribution and chat and on all the panelists and see you again on the 18th of march thank you bye

2021-04-30 01:49

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