Authors: Carmen van Egmond, Michiel Klitsie and Niels Langhout
Introduction
Within the Technical Medicine programme, there is a lot of focus on care in the hospital. Care outside the hospital is provided by GPs, in rehabilitation centres (medical specialist rehabilitation and geriatric rehabilitation care), in long-term care institutions and in neighbourhoods. This includes care for vulnerable elderly people, youth care, addiction care and mental health care, for example. Care, including non-hospital care, faces major challenges. The Integral Care Agreement (IZA) describes various tasks such as making optimal use of available capacity, reducing the administrative burden and stimulating data exchange. Many of these tasks assign a major role to technology. This therefore involves applying technology within healthcare, for which it is essential to be aware of the technological possibilities and limitations and the working methods and demands of the healthcare sector. While it is clear that the Technical Medic can contribute to improving care outside the hospital, only a small proportion of TG-ers work in this field. Examples of roles for TG-ers in elderly care are:
Consultant home automation & practitioner in nursing homes and community care
As a technical physician, you can play a valuable role in the medical treatment team of a VVT organisation, with wonderful opportunities for contributions, such as walking visits and utilising your technical background. Using healthcare technology from a treatment perspective offers a complementary approach to the biopsychosocial model, which can significantly broaden treatment options. With the rapidly growing healthcare technology market, complexity and implementation can vary, ranging from plug-and-play solutions to large-scale projects that require careful planning.
The deployment of healthcare technology can be divided into several areas, such as the use of glucometers and automatic blood pressure readings for vital signs, social robots to combat loneliness, or GPS trackers and smart doors to monitor living circles. These elements are all being integrated into both care and treatment plans.
A growing trend is the transfer of medical care to the home situation, allowing (outpatient) clinical equipment to go home with the client for long-term follow-up. With such applications, besides technical aspects, the scalability of the solution is also a challenge, given the tight labour market and the requirements of agencies such as the IZA. In addition to regular treatment packages, (healthcare) technology consultations can also be offered
Best use of available capacity in emergency care for the elderly
Staff shortages are a big one in healthcare. More money or people will not solve the problem: Currently, one in six workers in the Netherlands works in care. Even more workers in care means, by definition, fewer workers in other sectors. So we will have to care for more elderly people with fewer people.
Providing more care by fewer people does not necessarily mean working harder or compromising on quality. By taking a smart look at how we work, we can deploy doctors better. Collaboration and deployment of assistive technology are central to this. Not long ago, it was common for a doctor to be available in the evening and night for medical emergencies in his nursing home. Institutions started working together; the doctor is now on duty less often but across different locations. By working together at almost all institutions in a region, we are now able to predict at what times more or fewer doctors are needed. Peak workloads are distributed among different doctors in the region, whereby telephone consultations can also be handled by a doctor outside the region. The use of technology is essential not only to set up complex and dynamic rosters, and enable logging into the systems of different institutions but also to offer the doctor on duty appropriate directives at the right time
Advice and project management on implementing/scaling up technology
For elderly care, many technologies are already available to keep the elderly independent, live safely at home for longer and provide care at a distance. Examples include sensors that map out lifestyle patterns, automatic medicine dispensers and remote monitoring. Healthcare organisations increasingly realise that making optimal use of technology is one of the solutions to the exploding demand for care. Innovating, implementing, securing and scaling up technology in the care process is a challenge. This requires change of organisational structures, behavioural change of care staff and clients, cooperation with technology suppliers and collaboration with (regional) partners. A technical physician can advise on this, help bring about change and maintain cooperation between all domains.