Front-line research on smart old age: product is the foundation and service is the key

Smart old age: product is the foundation Service is the key

【Produced by Deep Hitomi Studio】

Written by: Intern reporter Su Jingjing

Planner: Liu Li

The coordinated development of the elderly care industry and the industry is related to the better life of the elderly group, and also has a far-reaching impact on expanding domestic demand and promoting employment. In this year's government work report, "strengthening the guarantee of old-age services" has become one of the priorities of ensuring basic people's livelihood and developing social undertakings.

A mattress that can monitor the heart rate and breathing of the disabled elderly in real time; A water meter that can sound an alarm when the elderly living alone do not use water for 24 hours; A watch can avoid the loss of the elderly with dementia, and can achieve one-click help in an emergency...

In China, most elderly people hope to enjoy their old age in their familiar home or community. How to make home and community elderly care services smarter and smarter? The application of science and technology, especially information technology, is expected to be high.

The coordinated development of the elderly care industry and the industry is related to the better life of the elderly group, and also has a far-reaching impact on expanding domestic demand and promoting employment. In this year's government work report, "strengthening the guarantee of old-age services" has become one of the priorities of ensuring basic people's livelihood and developing social undertakings.

However, some people believe that the current pension service is facing the dilemma of "hot policy, cold market, and difficult enterprise".

In China's smart and healthy elderly care, how is technology playing a role? How to solve the dilemma of "cold market and difficult enterprise"? To this end, the reporter of Science and Technology Daily walked into the front line of elderly care services to conduct research.

Family care beds: Institutional elderly care services are sent to the home

In ordinary households, family members are the main bearers of care for the elderly. For disabled elderly families, the dilemma of "one person is disabled, the whole family is unbalanced" is not uncommon.

Through the Internet of Things intelligent terminal and elderly care station care services, life care and rehabilitation nursing that could only be provided by elderly care institutions have entered the homes of the elderly and built "family pension beds".

Xicheng District of Beijing is a pioneer in the construction of elderly care beds, and in 2022, Xicheng District was selected as an excellent case of home and community elderly care service reform pilot work selected by the Ministry of Civil Affairs and the Ministry of Finance.

Lu Yajing, a care manager, works at a retirement station in Yuetan Street, Xicheng District. For more than two years, she has ridden an electric car every day through the streets of Yuetan to provide systematic health management and personalized home care solutions for the elderly, such as rehabilitation guidance, psychological comfort, safety assistance and life care.

Grandma Guo is one of the elderly people she serves.

Grandma Guo, 93, lives alone in an old community in Yuetan and has degenerative lesions in both knees.

In a home of more than 40 square meters, a wooden bed is the main furniture, and Grandma Guo spends most of her time in this big bed.

Under the beige mattress, a smart mattress is spread, a yellow wireless emergency caller hangs next to the bed, and there is an auto-sensing night light on the wall not far away.

These smart devices are connected with the intelligent network placed on the bedside table, monitoring Grandma Guo's multiple physical data in real time, if the data is abnormal, the alarm information will be immediately transmitted to Grandma Guo's children, Lu Yajing and the staff on duty at the Yuetan Street Pension Station. In an emergency, Lu Yajing or the staff on duty can come to the door in 15 minutes.

Grandma Guo's son Li Ming told Science and Technology Daily that the smart mattress can monitor the heart rate, breathing, and time in bed and out of bed of the elderly in real time, and these data can be viewed at any time through Lu Yajing and Li Ming's mobile phones.

"There is nothing special about the old man sleeping on it. We are not there at night, so we often check to see if her data is normal. If something goes wrong, the pension station and Xiao Lu can know, and I can also receive the alarm. Li Ming said.

Lu Yajing regularly visits Grandma Guo twice a month, and the rest of the time will come to her home according to Grandma Guo's needs. During each visit, Lu Yajing will check Grandma Guo's blood pressure, blood sugar and blood oxygen, and give a health assessment. After the examination, he will also help Grandma Guo lift her leg and give rehabilitation guidance.

Since 2019, more than 4300,2000 people have been contracted to serve family pension beds in Xicheng District, and due to the death and termination of some elderly people, more than 98,<> people have been actually served, of which the severely disabled elderly account for about <>%.

So far, this intelligent elderly care service model has been initially built, but it still faces multiple challenges to promote on a large scale.

One aspect of the challenge comes from the usefulness and sensitivity of the device itself. For the elderly who are permanently disabled, there are usually people at home to take care of, which makes the use of products including smart watches and wet sensing pads low. In addition, some products have limited sensitivity, which may cause false alarms, which will cause distress to families.

Another aspect of the challenge stems from the consumption mindset of the elderly. According to Xing Xinzhu, an associate researcher at the Beijing Academy of Science and Technology who participated in the research on smart elderly care in Xicheng District, the elderly with household registration in Beijing and living in Xicheng District, the elderly aged 60 or over with disabilities or disabled elderly and the elderly aged 80 living alone can enjoy the package service of family elderly care beds for free. "At present, the consumption concept of the elderly is relatively traditional, and the willingness to pay for upgrade services outside the scope of the government subsidy package is relatively low. The market is still in the cultivation period, so the development of enterprises is more difficult. Xing Xinzhu said.

"Takeaway" service in the medical industry: online ordering, medical care door-to-door

Disease diagnosis and treatment is an important part of the whole life cycle service of healthy old age, according to the needs of the elderly, through the Internet and information technology to provide accurate medical services, has become the direction of the combination of medical treatment and elderly care.

In Changsha County and Guiyang County in Hunan Province, a smart health elderly care service model of "children ordering online and the elderly enjoying services offline" is being implemented.

This service model relies on the Hunan Province Intelligent Service Platform for the Integration of Medical and Nursing Care led by the Laboratory of Mobile Medical Education of Xiangya Hospital of Central South University, Professor Huang Weihong is the executive deputy director of this laboratory, he vividly compared this service model to the "takeaway service" of medical and nursing care.

The elderly or children in need can "place an order" through the App or the "Health Aging Service" official account, and doctors, nurses, and rehabilitation therapists will be charged through the method of "medical service price + door-to-door service fee".

This smart health elderly care service model was selected as the first batch of demonstration cases of the National Development and Reform Commission in 2021 to use intelligent technology to serve the elderly.

Guoyuan Town, Changsha County, is the main pilot area for this model. Peng Yi, an officer at the local health center, told Science and Technology Daily that there are 4286,2023 elderly people in Guoyuan Town, and as of February 2, the number of registrations for this service platform is 4009,6000, and the number of services has reached more than <>,<> times.

In October 2021, Jiang Qinghui, a resident of Guoyuan Town, used his public account for the first time to "order" TCM rehabilitation services for his 10-year-old mother Grandma Li. Shortly after placing the order, Jiang Qinghui received a call from the dispatching center of the Guoyuan Town Health Center to confirm the door-to-door time. As it is the first consultation, the health center also has a general practitioner who visits the elderly to develop follow-up rehabilitation treatment plans.

The next day, a team of doctors came to the door and did a comprehensive examination of Jiang Qinghui's mother. The doctor diagnosed Grandma Li with Parkinson's disease and prescribed medicine to Grandma Li.

"After eating for a few days, my old mother's symptoms eased." Jiang Qinghui praised.

Since then, Jiang Qinghui has become a "loyal user" of the service platform. Over the past two years, Jiang Qinghui has "ordered" more than 20 orders for his mother, and the medical staff of the health center have made more than 120 door-to-door services.

"I'm old, I can't drive, and my old mother is in her 90s, so it's hard to get out and about. For us, this door-to-door service is really convenient. Jiang Qinghui said.

Every time the doctor came to the door, there would be many people "watching" near Grandma Li's house. Jiang Qinghui proudly told reporters, "The room can't be crowded, they all hope to use this platform, and I will teach them." My colleague's son used to learn from me, and now he often places orders for his father. ”

At present, Guoyuan Town Hospital has launched more than 20 "Internet + nursing/rehabilitation door-to-door" projects on the platform, covering basic nursing, wound maintenance, specimen collection and other projects, and 9 family doctor teams can also provide malignant tumor care and TCM rehabilitation treatment packages for the elderly.

In the county, through the two-way referral platform, the data of hospitals at all levels is interconnected, and the platform supports the referral of upper and lower hospitals.

For diseases that are difficult to handle in township health centers, health centers will help refer the elderly to higher-level hospitals. The health management and postoperative rehabilitation plans formulated after the diagnosis and treatment of higher-level hospitals can be implemented by lower-level hospitals adjacent to the residences of the elderly, eliminating the trouble of repeated visits to hospitals for the elderly in townships and towns.

"If there is a real need, patients can also achieve consultation between provincial and municipal hospitals or ministerial hospitals through the platform." Huang Weihong said.

Huang Weihong told reporters that at present, in all pilot areas, more than 1600,1 medical staff have been registered on the service platform, serving nearly 5,<> registered residents.

The process of rolling out this platform has not been easy. For Huang Weihong, the biggest challenge is how to mobilize the enthusiasm of medical care. "Previously, the internal incentive mechanism of primary health service institutions to carry out healthy elderly care services was insufficient. At present, Changsha County has explored a new model that links door-to-door services with medical income, title promotion, assessment and other aspects, and will attract more medical staff to participate in the future, so that the general public, especially the rural elderly, can enjoy high-quality health services. Huang Weihong said.

Government-led: Build a bridge between the elderly and elderly care service enterprises

Whether a society is happy is closely related to whether the elderly are happy. In the process of satisfying the happiness of the elderly, the government plays a leading role.

Bajiao Subdistrict, Shijingshan District, Beijing, has the largest elderly population in the district, with about a quarter of the 10,60 permanent residents being <> years old and over.

For more than ten years, Bajiao Street has gradually built a "smart elderly care platform" with the "government-enterprise-individual" model, and in 2020, it was selected into the fourth batch of pilot demonstration lists of smart health elderly care applications announced by the Ministry of Industry and Information Technology and other three ministries and commissions.

Yin Na, section chief of the People's Livelihood Security Office of Bajiao Street, told reporters that the "government-enterprise-individual" model refers to the government building bridges to connect the elderly and enterprises providing elderly care services.

In Bajiao Street, the elderly data is interconnected, and the elderly can brush their faces at the pension station, eliminating the trouble of carrying documents every day; Distribute health monitoring smart watches to the elderly who are guaranteed by the bottom line, which can accurately locate the elderly in case of emergency and achieve assistance within 10 minutes; The self-service elderly care service appointment platform and service hotline can also provide a variety of door-to-door services for the elderly...

In 2018, Bajiao Street led and enterprises participated in the joint development of home-based elderly care service appointment software, equipped with terminals placed in each community elderly care service station. The elderly can make reservations for meals, bathing, cleaning, walking, short-term care and other services on the terminal.

"In practice, we found that some elderly people are not accustomed to using these devices, and prefer to call and directly consult someone to place an order. Therefore, we later set up the Octagonal Street for the old service call center, and the elderly can directly make an appointment for service by calling the service hotline. "In the call center, we have connected more old service providers, and also added maintenance, nanny, housekeeping and other services." ”

"At present, the pension project in Bajiao Street covers a variety of service scenarios, and elderly care service enterprises provide elderly care services to the elderly under the supervision of the government. Most of these projects are initiated by the street according to the needs of the elderly. Yin Na said.

In 2021, Bajiao Street planned and launched the "Smart Safe Elderly Care Community Emergency Service Center" project in combination with the needs of emergency assistance for the elderly. The project is equipped with professional ambulance personnel. After receiving the alarm signal sent by the elderly equipment, the rescuers will contact the elderly at the first time and rush to the scene in time to help the elderly.

Grandma Su, who lives in Octagon South, is one of the users of this project. Grandma Su, 67 years old, suffers from polio, her legs are paralyzed, and her wife is also in poor health. Not being able to go downstairs became Grandma Su's main annoyance.

After receiving the service of the "Smart Safe Elderly Care Community Emergency Service Center", Grandma Su only needed to make a phone call downstairs, and someone came to help. In Grandma Su's home, a variety of home security equipment is also installed. She told reporters that these devices can call the police under abnormal circumstances, and after the alarm, there are rescue team members to help, and she and her wife are much more at ease.

Yin Na told reporters that most of the pension projects on the street are signed once a year, and if there is a problem, it can be corrected in time. If the elderly are generally satisfied with a project, the street will also renew the contract with the business that provides the service.

"We hope to dig out more high-quality elderly care service projects, so that the elderly can have more choices and be satisfied with elderly care services." Yin Na said.

"The process of building a smart elderly care service platform is a process of 'practice out of true knowledge'." Yin Na said with a smile, "The current generation of elderly people prefer to call directly or find someone to communicate in person. Therefore, we will simultaneously develop online and offline service business to meet the current and future elderly care service needs. According to Yin Na, this year, Bajiao Street will continue to promote the integration of regional pension resources and complete the construction of the street pension general service desk.

Breaking the dilemma: Adequate coordination of social resources is required

The exploration in the field of smart health and elderly care is in full swing.

"However, at present, smart health and elderly care services around the world are in the early stage of development, and related innovations are still based on the research and development and prototype testing of scientific research institutions, universities and enterprises, and some individual services have begun to be commercially applied, but the scale is very small and has not yet reached the stage of widespread application." Liu Jianbing, a researcher at the Institute of Smart Elderly Care of the Beijing Academy of Science and Technology, said.

In order to encourage the innovation of smart health and elderly care services and the development of the industry, the government has actively introduced a number of policies, but the cold market makes most enterprises only struggle on the edge of the "survival line".

To break this dilemma, more smart products that truly meet the needs of the elderly and are smarter are needed in the market.

Zuo Meiyun, a researcher at the National Institute of Development and Strategy of Chinese University and director of the Institute of Smart Elderly Care, pointed out that some smart products, the target group is young people, after the font enlargement or function deletion of the product, it "transformed" and became a smart elderly care product.

"If there is a rush and lack of research, then the effect of the product is naturally limited. Designers should calm down and 'eat, live and work together' with the elderly, in order to truly identify the needs of the elderly and make smart products and the elderly run in better. Zuo Meiyun said.

Not only that, some smart elderly care products are limited by technological development and lack practicality.

For example, in the reporter's survey, few elderly people took the initiative to use smart watches.

Liu Jianbing told reporters that the old man's watch is usually used independently and does not cooperate with the mobile phone, so it needs to integrate multiple functions, and under the existing technical conditions, it is difficult to make it as small as the watch used by young people. In addition, the accuracy of various functions of watches also needs to be continuously improved in practice, but many companies do not wait for the opportunity to practice and close or transform. As a result, there have been no fundamental technical improvements to the watch. "At present, most smart products are still developing along the original technical track and route, and they are not doing a good job in meeting the needs of the elderly or adapting to aging." Liu Jianbing said.

With the development of future technology, smart elderly care products will have greater application space.

"Many assistive technologies such as related equipment that can slow down hand tremor in Parkinson's patients, cognitive screening and intervention, life-oriented rehabilitation training, and video-based safety monitoring are at an inflection point from scientific research to commercial application." Liu Jianbing said, "China's elderly population is large and has the advantage of data resources. With the breakthrough of core technology, the data model we have established will be more accurate and promote the application of artificial intelligence in the field of elderly care services. ”

Breaking the dilemma also requires the full coordination of social resources.

According to Du Peng, vice president of Chinese Minmin University and vice president of the Chinese Society of Gerontology and Geriatrics, smart and healthy elderly care is to promote the integration of services and the docking of resources and needs. It cannot be done by one enterprise or one unit alone, and all social resources need to be fully coordinated and designed.

"Smart healthy old age, smart products are the foundation, the key depends on service." For example, if the product can alarm and the service response wirelessly, then smart and healthy elderly care has become a false proposition. Zuo Meiyun said.

Xing Xinzhu pointed out that local resources such as pension stations and emergency rescue stations are the basis of service response and the key to the realization of service closed-loop, but there are still some areas in China that have not yet been built.

In addition to local resources, human resources are also important. After all, elderly care services are inseparable from the involvement of caregivers and doctors. "At present, many practitioners in the pension industry are middle-aged and young elderly, and there is a lack of fresh blood such as young people. At present, the participation of medical staff is also relatively limited. Zuo Meiyun said.

"Human motivation is fundamental to innovation." Huang Weihong said, "Health institutions need a better incentive mechanism to carry out elderly care services, and the performance skew plan for medical staff participating in elderly care services needs to move from paper to reality." ”

A number of experts pointed out that the coordination of various social resources requires cross-departmental collaboration and institutional support. And the related actions are underway.

From the "14th Five-Year Plan" National Planning for the Development of the Elderly Cause and the Elderly Service System to the "14th Five-Year Plan for Healthy Aging", the state has carried out top-level design in the coordinated development of the elderly cause and industry, and the high-quality development of the elderly service system. Among them, "smart and healthy old age" has been mentioned many times and has attracted attention.

In March this year, the CPC Central Committee and the State Council issued the "Party and State Institutional Reform Plan", which specifically mentioned "improving the work system for the elderly", making active overall planning and coordination to effectively cope with the aging of the population.

The pilot of the long-term care insurance system has also become an important measure to promote elderly care services. The 2023 government work report proposes to "steadily advance the pilot of the long-term care insurance system".

Zuo Meiyun pointed out that long-term care insurance can "leverage" the ability of the elderly to pay, while realizing the accessibility of nursing services for disabled people, it will promote the development of the elderly care service market, attract more resources to converge, drive human resources and industry to form a benign interaction, and finally achieve the coverage of basic life care and related medical care needs of long-term disabled people.

According to data from the National Medical Security Administration, in 2021, among the 49 pilot cities, a total of 14460.7 million people participated in long-term care insurance, 108.7 million people enjoyed treatment, and the fund income was 260.6 billion yuan.

"Now, the concept of smart and healthy elderly care has been deeply rooted in the hearts of the people, the importance has been widely accepted by the society, China's smart elderly care products are dazzling, and the technological development in the field is basically synchronized with the world." With technological breakthroughs, institutional integration, system improvement and the improvement of the payment ability of the elderly, China's smart health elderly care undertakings and industries will achieve great development. Zuo Meiyun said. (Li Ming is a pseudonym in the article, and this version of the picture is provided by Visual China)

(Science and Technology Daily)