INNOVATION INCUBATOR: Deployable Health Care Platform (DHCP)
One of the opportunities that developing parts of the world such as Ghana present is that they are looking for solutions to improve
medical care. Traditional medicine is very much active in Ghana, while better integration with the Western medicine is needed. In
Ghana, there is a chance to work outside of rigid categories that confine the Western medical practice, and to develop and prove
new models for delivery of healthcare. With the idea that medicine is just one of the healthcare deliveries, we will seek new methods
and collaborators for healthcare provision as well as working relationships between them.
Architecture is one of the necessary collaborators in achieving new modes of healthcare. Infrastructure is essential for the provision
of high quality healthcare to the population in the resource-restricted locales. Local building materials, traditional and new
construction technologies, specific cultural practices that require special spaces are considerations that the discipline of
architecture is equipped to address. Anthropology, economics and other social sciences are well positioned to conduct in-depth
inquiry into what modes of healthcare will work in the context of Ghana, while all the disciplines work toward common design
solutions.
A flexible, responsive healthcare system can greatly improve Ghanaians' health and the society as a whole. Furthermore, economic
well being that is provided by innovative, entrepreneurial opportunities is an essential preventative tool, and the design of the care
system should be pursued from an entrepreneurial perspective. A care facility should be 1) affordable 2) adaptable 3) sustainable
and 4) contextual, and it should be designed to save space and material while providing comfort and function. Specific possibilities
and limitations of Ghana will inform our design strategies in order to best serve its population, at once conveying a potential for
application in other parts to the world once they have been initiated.
The Deployable Health Care Platform (DHCP) is a project under development led by Kevin Lair of MOD-ECO Design LLC and Indiana University. Precursors to the Deployable Healthcare Platform began in 2003 as a collaboration with the Ghana Education Project for an Epidemic Prevention Vehicle (EPV). The idea of the EPV was an extension of a small format retail start-up that used prefabricated, modular structures as part of a turn-key solution for rapid retail expansion from 1998-2002. The small format retail venture integrated design, manufacturing, real estate, financing, and operations. The EPV was positioned to leverage lessons of the retail business and explore a different context to help reduce obstacles a mass-customizable, architectural system. In addition it became clear that health was the critical inroad for sustainable development.
The Deployable Health Care Platform (DHCP) is a project under development led by Kevin Lair of MOD-ECO Design LLC and Indiana University. Precursors to the Deployable Healthcare Platform began in 2003 as a collaboration with the Ghana Education Project for an Epidemic Prevention Vehicle (EPV). The idea of the EPV was an extension of a small format retail start-up that used prefabricated, modular structures as part of a turn-key solution for rapid retail expansion from 1998-2002. The small format retail venture integrated design, manufacturing, real estate, financing, and operations. The EPV was positioned to leverage lessons of the retail business and explore a different context to help reduce obstacles a mass-customizable, architectural system. In addition it became clear that health was the critical inroad for sustainable development.
The program of the course is to design strategies for a healthcare facility that will accommodate frontline, primary, preventative, surgical, trauma, diagnostic functions in a compact and deployable unit. Within this set of specialties there are two primary areas: 1) Care, 2) Primary Care and supporting programs. The Intensive Care unit has to be able to address both patients that are infectious and patients that need to be protected against infection. This requires a different level of environmental control than the rest of the facility including Primary Care.
While the health care facility has to be flexible to accommodate a range of needs, a key focus will be on "safe motherhood" (obstetrics, gynecologists) in prenatal care, births and early childhood. The facility needs to be able to accommodate counseling, treatment, education and emergency conditions for motherhood as appropriate to the needs of Ghana. One of the key functions of this unit will be a training ground for new health care professionals in both the US and Africa. These care providers are going to be trained specially to meet the needs in Ghana and also support innovative practices in the US.
Interdisciplinary collaboration is active in the design process in developing, refining and detailing design criteria. The proposed design will be a framework in which changes, improvements and detailing will be included to meet or exceed the needs for Ghana stakeholders. The course will examine the deployable unit in Ghanaian context, therefore medical procedures as a series of design problems. Each design consideration will have to be thoroughly documented and reasoned on an individual level as well as overall integrated solutions which will be offered by small and large groups. Finally, each discipline provides a role in the evaluation of specific solutions.
While the health care facility has to be flexible to accommodate a range of needs, a key focus will be on "safe motherhood" (obstetrics, gynecologists) in prenatal care, births and early childhood. The facility needs to be able to accommodate counseling, treatment, education and emergency conditions for motherhood as appropriate to the needs of Ghana. One of the key functions of this unit will be a training ground for new health care professionals in both the US and Africa. These care providers are going to be trained specially to meet the needs in Ghana and also support innovative practices in the US.
Interdisciplinary collaboration is active in the design process in developing, refining and detailing design criteria. The proposed design will be a framework in which changes, improvements and detailing will be included to meet or exceed the needs for Ghana stakeholders. The course will examine the deployable unit in Ghanaian context, therefore medical procedures as a series of design problems. Each design consideration will have to be thoroughly documented and reasoned on an individual level as well as overall integrated solutions which will be offered by small and large groups. Finally, each discipline provides a role in the evaluation of specific solutions.
Deployable Health Care Platform (DHCP) for Innovative, Decentralized Health Services in Resource Constrained Locations
Health Systems for Maternal and Child Health
Women's health status is affected by complex biological, social and cultural factors which are ) interrelated and can only be addressed in a comprehensive manner. (1997, The Right to Reproductive and Sexual Health, United Nations Department of Public Information)
This report adopts the WHO definition of the health system: “all the activities whose primary purpose is to promote, restore, or maintain health” (WHO 2000b). This includes interventions in the household and community and the outreach that supports them, as well as the facility-based system and broader public health interventions, such as food fortification and anti-smoking campaigns. It includes all categories of providers—public and private, formal and informal, for-profit and not-for-profit, allopathic, and indigenous. It also includes mechanisms such as insurance by which the system is financed, as well as the various regulatory authorities and professional bodies that are meant to be the “stewards” of the system.
Health systems must be understood not only as mechanisms for delivering technical interventions but also as core social institutions that are indispensable for reducing poverty, social exclusion, and inequity and advancing democratic development and human rights.¹
For health systems to increase inclusion and close the equity gap, policies implemented in the context of good governance must:
Strengthen rather than undermine government legitimacy.
Prevent excessive segmentation of the health system.
Increase the power of the poor and other marginalized groups to make claims for healthcare.
Solving the problems of the health workforce in poor countries is a global responsibility. Donors must shift toward funding long-term investments rather than providing short-term, front-end investments.¹
Health systems must be understood not only as mechanisms for delivering technical interventions but also as core social institutions that are indispensable for reducing poverty, social exclusion, and inequity and advancing democratic development and human rights.¹
For health systems to increase inclusion and close the equity gap, policies implemented in the context of good governance must:
Strengthen rather than undermine government legitimacy.
Prevent excessive segmentation of the health system.
Increase the power of the poor and other marginalized groups to make claims for healthcare.
Solving the problems of the health workforce in poor countries is a global responsibility. Donors must shift toward funding long-term investments rather than providing short-term, front-end investments.¹
Environmental
In many places, women are the primary custodians of environmental resources by virtue of their position in the household, giving them responsibility for managing energy, water and farming among other things. They are often the repositories of indigenous knowledge and the promoters of biodiversity conservation and environmentally-friendly management.
Environmental hazards comprise a significant portion of the health risks facing the poor, and children bear the brunt of this. Although children constitute only 10 percent of the world’s population, they suffer 40 percent of the environment-related burden of disease. This disease burden is closely associated with environmental management practices and the opportunities available to poor people.
In the absence of alternative livelihood opportunities and strategic management of the environment, this rapid population growth and urbanization has resulted in environmental degradation and resource depletion. Between 1990 and 2000, Africa lost 52 million hectares of forests: this amounts to a decrease of 0.8 percent per year and 56 percent of the global total.
Youth are becoming increasingly important in natural resource management. The lack of employment and other livelihood opportunities, as well as setbacks in education, health and other capabilities, may mean that this generation will have increased natural resource dependence and pose new threats to the sustainability of marine and terrestrial ecosystems. Degraded environments may spur further social and economic conflicts and hardships.²
Inadequate sanitation and unclean water are still major threats, causing the deaths of an estimated 1.8 million people worldwide each year, of which 1.6 million are children. Improving water quality can produce major improvements in child mortality rate.²
Indoor air pollution presents a major health risk for poor people dependent on fuelwood for energy, and children under five account for more than half of the related 1.6 million deaths per year.
To communities, high costs of prescription drugs, high transportation costs, and difficult road conditions continue to be the main deterrents to accessing health facilities. Socio-economic and cultural factors are still driving low utilization of maternal health services.
(Improving Access to Life Saving Maternal Health Services: The Effects of Removing User Fees for Caesareans in Mali. Marianne El-Khoury, Timothee Gandaho, Aneesa Arur, Binta Keita, and Lisa Nichols, 2010)
Environmental hazards comprise a significant portion of the health risks facing the poor, and children bear the brunt of this. Although children constitute only 10 percent of the world’s population, they suffer 40 percent of the environment-related burden of disease. This disease burden is closely associated with environmental management practices and the opportunities available to poor people.
In the absence of alternative livelihood opportunities and strategic management of the environment, this rapid population growth and urbanization has resulted in environmental degradation and resource depletion. Between 1990 and 2000, Africa lost 52 million hectares of forests: this amounts to a decrease of 0.8 percent per year and 56 percent of the global total.
Youth are becoming increasingly important in natural resource management. The lack of employment and other livelihood opportunities, as well as setbacks in education, health and other capabilities, may mean that this generation will have increased natural resource dependence and pose new threats to the sustainability of marine and terrestrial ecosystems. Degraded environments may spur further social and economic conflicts and hardships.²
Inadequate sanitation and unclean water are still major threats, causing the deaths of an estimated 1.8 million people worldwide each year, of which 1.6 million are children. Improving water quality can produce major improvements in child mortality rate.²
Indoor air pollution presents a major health risk for poor people dependent on fuelwood for energy, and children under five account for more than half of the related 1.6 million deaths per year.
To communities, high costs of prescription drugs, high transportation costs, and difficult road conditions continue to be the main deterrents to accessing health facilities. Socio-economic and cultural factors are still driving low utilization of maternal health services.
(Improving Access to Life Saving Maternal Health Services: The Effects of Removing User Fees for Caesareans in Mali. Marianne El-Khoury, Timothee Gandaho, Aneesa Arur, Binta Keita, and Lisa Nichols, 2010)
Social
Address inequity by improving access for the poor and marginalized.¹
Signal commitment to inclusiveness and redistribution.¹
Increase trust and strengthen government’s ability to regulate effectively.¹
Enhance the legitimacy required for the ministry of health to improve its status among other government departments.¹
The acquisition of literacy and numeracy, especially by women, has an impact upon fertility
Cognitive skills required to make informed choices about HIV/AIDS risk and behavior are strongly related to levels of education and literacy. ¹
Poor access to accurate information about sexuality, and the power imbalances in sexual relationships that leave many women vulnerable.¹
Labor divisions may also be gendered. In rural Africa, for example, women and girls are almost always the exclusive suppliers of water for household use. They play a lead role in the provision of water for animals, crop growing, and food processing. It is often women who decide where to collect water, how to draw, transport and store it, what water sources should be used for which purposes, and how to purify drinking water.²
Social factors associated with child trafficking
A major observation made was the large number of girls who became victims due to the influence of peers and or family members eager to send off their daughters to acquire some of life’s basic necessities such as utensils for marriage.
Polygamous families, single parents, mainly female headed and or are orphans who have either received basic or no education at all. These factors increase their vulnerability to traffickers who lure the victims and or their families/ guardians with promises of a better life in the urban areas.
They prefer to have their children in the big cites since it was a form of prestige having your child in the big city specifically Accra.
The children were their sources of income whilst others saw them as a liability (Agreds Internal Report, 2009)
Signal commitment to inclusiveness and redistribution.¹
Increase trust and strengthen government’s ability to regulate effectively.¹
Enhance the legitimacy required for the ministry of health to improve its status among other government departments.¹
The acquisition of literacy and numeracy, especially by women, has an impact upon fertility
Cognitive skills required to make informed choices about HIV/AIDS risk and behavior are strongly related to levels of education and literacy. ¹
Poor access to accurate information about sexuality, and the power imbalances in sexual relationships that leave many women vulnerable.¹
Labor divisions may also be gendered. In rural Africa, for example, women and girls are almost always the exclusive suppliers of water for household use. They play a lead role in the provision of water for animals, crop growing, and food processing. It is often women who decide where to collect water, how to draw, transport and store it, what water sources should be used for which purposes, and how to purify drinking water.²
Social factors associated with child trafficking
A major observation made was the large number of girls who became victims due to the influence of peers and or family members eager to send off their daughters to acquire some of life’s basic necessities such as utensils for marriage.
Polygamous families, single parents, mainly female headed and or are orphans who have either received basic or no education at all. These factors increase their vulnerability to traffickers who lure the victims and or their families/ guardians with promises of a better life in the urban areas.
They prefer to have their children in the big cites since it was a form of prestige having your child in the big city specifically Accra.
The children were their sources of income whilst others saw them as a liability (Agreds Internal Report, 2009)
Economic
Align funding from donors and international financial institutions with national health programs to meet the (MDG) goals.¹
Remove regressive user fees.¹
Encourage progressive financing mechanisms.¹
Base allocation on measures of equity and capacity to benefit.¹
Create transparency in allocation and expenditure.¹
Provide incentives for the privatesector to provide comprehensive care, including preventive and promotive care where probity is established.¹
Increase trust and communication between public and private sectors, which reduces complexity and transactions costs.¹
Expose the middle class to issues of the poor rather than excluding the poor from the system.¹
Promote competition where it acts to root out poor-quality providers.¹
Subsidize community insurance for the poor and provide direct transfers to the poor to enhance capacity to pay.¹
In Akotokyir, for instance, a survey we conducted in July 2009 found that over 65% of the inhabitants were unregistered. For most people, the reason is financial: many found even the subsidized price (about $9) to be prohibitively expensive.3
Ghana introduced free health care for all pregnant women in 2008.
Women consistently lag behind men in formal labour force participation, access to credit, entrepreneurship rates, income levels and inheritance and ownership rights.4
A lower portion of women, 8.6 percent are estimated to be in paid employment compared to men 26.9 percent in Ghana 2005/06. ((ghanaweb.com)
The proportion of women who were unpaid workers, indicating that the proportion increased from 24.5 percent in 1998/1999 to 28.5 percent in 2005/2006. (ghanaweb.com)
Remove regressive user fees.¹
Encourage progressive financing mechanisms.¹
Base allocation on measures of equity and capacity to benefit.¹
Create transparency in allocation and expenditure.¹
Provide incentives for the privatesector to provide comprehensive care, including preventive and promotive care where probity is established.¹
Increase trust and communication between public and private sectors, which reduces complexity and transactions costs.¹
Expose the middle class to issues of the poor rather than excluding the poor from the system.¹
Promote competition where it acts to root out poor-quality providers.¹
Subsidize community insurance for the poor and provide direct transfers to the poor to enhance capacity to pay.¹
In Akotokyir, for instance, a survey we conducted in July 2009 found that over 65% of the inhabitants were unregistered. For most people, the reason is financial: many found even the subsidized price (about $9) to be prohibitively expensive.3
Ghana introduced free health care for all pregnant women in 2008.
Women consistently lag behind men in formal labour force participation, access to credit, entrepreneurship rates, income levels and inheritance and ownership rights.4
A lower portion of women, 8.6 percent are estimated to be in paid employment compared to men 26.9 percent in Ghana 2005/06. ((ghanaweb.com)
The proportion of women who were unpaid workers, indicating that the proportion increased from 24.5 percent in 1998/1999 to 28.5 percent in 2005/2006. (ghanaweb.com)
Health Care Providers
The health workforce must be developed according to the goals of the health system, with the rights and livelihoods of healthcare workers addressed.
These principles must also inform strategies to address brain drain, low morale, and loss of productivity due to illness and death (often from HIV/AIDS), factors that are limiting the ability of governments to provide their populations with access to good-quality healthcare.¹
Effective management and operational systems that seek to improve quality and increase trust in the health system should accompany the development of the health workforce.¹
Medium- to long-term plans for building a cadre of skilled birth attendants—the health workers key to reducing maternal deaths—must form an explicit part of all health workforce plans.¹
“Scope of profession” regulations and practice must be changed to empower mid-level providers, including skilled birth attendants, to perform life-saving procedures safely and effectively.¹
Child health interventions must be increasingly offered within the community. Policies need to be reformulated to allow services to be delivered as close to patients as possible. Community health workers need to be trained and permitted to encourage preventive behaviors, to care for a larger portion of nonsevere childhood illnesses, and to ensure early referral to appropriate facilities for the treatment of severe illnesses.¹
The system should supply, support, and supervise the skilled birth attendants who should be the backbone of that system, whether they are based in facilities or in communities.¹
Strategies to ensure skilled attendants for all deliveries must be premised on integration of the skilled attendant into a functioning district health system.¹
For example, between 1993 and 2002, Ghana lost 630 medical doctors, 410 pharmacists, 87 laboratory technicians and 11,325 nurses; in 2002 alone, 70 doctors, 77 pharmacists and 214 nurses left Ghana. Zimbabwe, South Africa and Nigeria have all suffered significant losses of health-care personnel. The 27 most powerful countries – also members of the Organization for Economic Cooperation and Development (OECD) – saved a “staggering” US$552,000 million by employing professionals trained in developing countries. (Environmental change and socioeconomic factors in Africa. United Nations Environment Programme, 2010)
These principles must also inform strategies to address brain drain, low morale, and loss of productivity due to illness and death (often from HIV/AIDS), factors that are limiting the ability of governments to provide their populations with access to good-quality healthcare.¹
Effective management and operational systems that seek to improve quality and increase trust in the health system should accompany the development of the health workforce.¹
Medium- to long-term plans for building a cadre of skilled birth attendants—the health workers key to reducing maternal deaths—must form an explicit part of all health workforce plans.¹
“Scope of profession” regulations and practice must be changed to empower mid-level providers, including skilled birth attendants, to perform life-saving procedures safely and effectively.¹
Child health interventions must be increasingly offered within the community. Policies need to be reformulated to allow services to be delivered as close to patients as possible. Community health workers need to be trained and permitted to encourage preventive behaviors, to care for a larger portion of nonsevere childhood illnesses, and to ensure early referral to appropriate facilities for the treatment of severe illnesses.¹
The system should supply, support, and supervise the skilled birth attendants who should be the backbone of that system, whether they are based in facilities or in communities.¹
Strategies to ensure skilled attendants for all deliveries must be premised on integration of the skilled attendant into a functioning district health system.¹
For example, between 1993 and 2002, Ghana lost 630 medical doctors, 410 pharmacists, 87 laboratory technicians and 11,325 nurses; in 2002 alone, 70 doctors, 77 pharmacists and 214 nurses left Ghana. Zimbabwe, South Africa and Nigeria have all suffered significant losses of health-care personnel. The 27 most powerful countries – also members of the Organization for Economic Cooperation and Development (OECD) – saved a “staggering” US$552,000 million by employing professionals trained in developing countries. (Environmental change and socioeconomic factors in Africa. United Nations Environment Programme, 2010)
1) Rosenfiled, Allan. Coordinator. Who’s Got the Power? Transforming Health Systems for Women and Children. 2005.
2) African Water Facility. Gender and Social Equity Strategy. 2010.
3) Kotin, Timothy, Health Insurance in Ghana, 2009
4) Hajia Hawawu Boya Gariba, Deputy Minister of Women and Children 's Affairs, 2011
2) African Water Facility. Gender and Social Equity Strategy. 2010.
3) Kotin, Timothy, Health Insurance in Ghana, 2009
4) Hajia Hawawu Boya Gariba, Deputy Minister of Women and Children 's Affairs, 2011
Innovation Systems for Adaptable, Affordable, and Sustainable Health and Wellness
Affordability and sustainability are replacing premium pricing and abundance as innovation’s drivers, but few executives know how to cope with the shift. Companies must make their offerings accessible to a greater number of people by selling them cheaply and must develop more products and services with fewer resources.
- Innovation’s Holy Grail. C.K. Prahalad and R.A. Mashelkar, 2010
mHealth
Health care’s new leaders must organize doctors into teams; measure their performance not by how much they do but by how their patients fare; deftly apply financial and behavioral incentives; improve processes; and
dismantle dysfunctional
- Thomas Lee. " Turning Doctors into Leaders " Harvard Business Review, 04/2010.
dismantle dysfunctional
- Thomas Lee. " Turning Doctors into Leaders " Harvard Business Review, 04/2010.
Many patients suffer from four or more interacting diseases, and many have conditions for which there is no definitive treatment. Patient-centered care is where mHealth provides real-time information that is critical to address individualized needs where standard protocols are costly and ineffective. In collaboration with other deployable strategies, mHealth provides a comprehensive approach for resource constrained locations and a path to sustainability for health care.
mHealth enables organizations to track, assess, and monitor the physiological results of health behaviors using data from communications (via phone, text, email), interests (via search, social networking) and from medical apps and peripheral devices that monitor physiologic parameters (e.g. heart rate, blood pressure, temperature, respiration, ECG, glucose, exercise, etc).¹
Mobile devices are increasingly incorporated into activities of daily living, the deployment of mHealth technologies could help transform medical and public health management, thereby:
Empowering patients and health workers to provide efficient, low-cost, convenient health services through real-time delivery of intelligence to guide better choices (evidence-based medicine & knowledge-based prompting)¹
More timely treatment facilitated when logistical obstacles are removed¹
Fewer communication delays and breakdowns among clinicians will result in better outcomes¹
Multidisciplinary visual assessments of visual data lead to better patient care¹
Remote capability allows specialty referrals to stay in system, regardless of geography, and increases revenue for service lines¹
Helping health-related services/communications focus on “wellness” rather than disease management, as
coaching and guidance can be provided by appropriate subject matter experts, and not necessarily highly-trained health professionals¹
Providers spend time more appropriately making them more efficient¹
Competency assessment/enhancement support leads to better clinicians, who in turn provide better patient care.¹
Faster achievement of all stages of meaningful use and clinical decision support requirements¹
Faster achievement of all stages of meaningful use and clinical decision support requirements
Enhancing compliance by reminding patients to take their medications, keep appointments, or schedule immunizations
(like flu shots)¹
Automating medical exception management that can algorithmically:
Identify abnormal health status
Predict potential for clinical deterioration
Correlate these potentials with patient behaviors and planned interventions
Alert patients and providers of actions to take if physiologic monitors fail¹
Health care provider satisfaction, sustainability and development¹
Better clinical outcomes lead to fewer clinical complications, fewer malpractice cases, and lower costs of care delivery¹
Multitasking by employed physicians means greater revenue to hospital at lower cost¹
Multitasking by non-employed physicians means greater revenue to them¹
Providers spend time more appropriately making them more efficient¹
Virtual bedside effect drives satisfaction and loyalty in nurses and physician¹s
Physician self service leads to fewer MD calls to nurses to check status and nets more RN time at the patient’s bedside.¹
Ambient Intelligence
Ambient Intelligence (AmI) is growing fast as a multi-disciplinary topic of interest which can allow many areas of research to have a significant beneficial influence into our society. The basic idea behind AmI is that by enriching an environment with technology (mainly sensors and devices interconnected through a network), a system can be built to take decisions to benefit the users of that environment based on real-time information gathered and historical data accumulated. AmI inherits aspects of many cognate areas
Protocols such as Bluetooth and Zigbee have removed the need for physical connection. This technical possibility is being explored in an area called Ambient Intelligence (AmI) where the idea of making computing available to people in a non-intrusive way, minimizing explicit interaction is at the core of its values. The aim is to enrich specific places (room, building, car, street) with computing facilities which can react to peoples’ needs and provide assist
There are important socio-economic and political forces driving influencing the move towards decentralization of health care and development of health and social care assistive technologies for independent living. The electronic health (e-Health) paradigm moves the citizen away from the hospital-centric health care system, hastening this shift of care from the secondary and tertiary care environments to primary care. Subsequently, there is an effort to move away from the traditional concept of patients being admitted into hospitals (which are potentially dangerous places due to the potential for cross-infection) rather to enable a more flexible system whereby people are cared for closer to home, within their communities. Smart Homes are one such example of a technological development which facilitates this trend of bringing the health and social care system to the patient as opposed to bringing the patient into the health system.²
The most profound technologies are those that disappear. They weave themselves into the fabric of everyday life until they are indistinguishable from it.
- Weiser, "The computer for the twenty-first century," Scientific American, 1991
Protocols such as Bluetooth and Zigbee have removed the need for physical connection. This technical possibility is being explored in an area called Ambient Intelligence (AmI) where the idea of making computing available to people in a non-intrusive way, minimizing explicit interaction is at the core of its values. The aim is to enrich specific places (room, building, car, street) with computing facilities which can react to peoples’ needs and provide assist
There are important socio-economic and political forces driving influencing the move towards decentralization of health care and development of health and social care assistive technologies for independent living. The electronic health (e-Health) paradigm moves the citizen away from the hospital-centric health care system, hastening this shift of care from the secondary and tertiary care environments to primary care. Subsequently, there is an effort to move away from the traditional concept of patients being admitted into hospitals (which are potentially dangerous places due to the potential for cross-infection) rather to enable a more flexible system whereby people are cared for closer to home, within their communities. Smart Homes are one such example of a technological development which facilitates this trend of bringing the health and social care system to the patient as opposed to bringing the patient into the health system.²
The most profound technologies are those that disappear. They weave themselves into the fabric of everyday life until they are indistinguishable from it.
- Weiser, "The computer for the twenty-first century," Scientific American, 1991
1) Use Cases for AST Products. AirStrip Technologies, 2011.
2) Juan Carlos Augusto and Paul McCullaghAmbient, "Intelligence: Concepts and Applications," ComSIS Vol. 4, No. 1, June 2007
