Background:

Ageing societies in western countries lead to more people with chronic health conditions and in need of care. Recent developments in technology have led to more devices supporting elderly people. They provide health care and enable elderly people to maintain their autonomy and allow them to live independently for a longer period of time. These technologies are subsumed under the term “telecare”. Trials have shown that hospital admissions and mortality can be re-duced by such devices. Telecare may therefore unburden the health care system and serve at the patients’ best interest in allowing them to live for a longer period of time independently and in-crease

quality of live.

Telecare includes technical devices and assistive technology as well as professional health care services to assist, monitor and care for people from a distance. Telecare includes a variety of

services such as communication, monitoring, consultation, diagnostics and training.

Goals:

The main goal of this study is to give an overview of existing telecare technologies for the elderly and future developments and tendencies in this field in Europe. The study results will be used for a scenario workshop within the PACITA (Parliaments and Civil Society in Technology Assessment) Project. The project has the goal to provide insight and experience in technology assessments for stakeholders from European countries that currently don’t have parliamentary technology as-sessment institutions.

Methods:

A literature review was conducted on current telecare technologies and future trends. The search was conducted in five databases: Ageline, CINAHL, Abstracts in Social Gerontology and Medline. In accordance with the mandate of the literature review, articles not concerning Europe or dealing with ethical or societal issues of telecare were filtered out in a second step. Furthermore, 61 experts from the fields of research, gerontology, engineering and from technology assessment institutions from the various European countries were invited to participate in a survey conducted by e-mail. Experts were asked to give their insight on current developments and future trends in telecare and provide further information about regional differences in the use of telecare.

A summary was compiled from the results of the literature review and the expert interviews.



Results

A vast amount of 635 articles were identified in the literature review. However, after selecting only articles with a European focus and a focus on elderly people only 77 articles remained for review. Another 15 articles recommended by the experts were taken into account for the review.

17 experts participated in the survey and answered the six questions in regard of telecare in Europe.

For the current state of telecare a great variety of devices and health care services delivered over distance through technology were found. Services included: Monitoring, consultations, diagnos-tics, prescriptions filling, disease management, support through communication and interven-tions, such as training of motor functions or surgeries. Devices belong for the most part to the following categories: Sensors and monitoring devices, detectors, alarm systems, communication devices, video or imaging devices, smart phone apps and specialized medical devices connected with the internet. More advanced devices often use more than one technology and have more than one function. Technologies described in the literature were either made for home use, clinical use or increasingly also for mobile use.

Experts pointed out that many devices belonging to the first generation of telecare, such as alarm buttons or sensors, are in use. However, market penetration varies greatly from country to coun-try. Newer and more complex devices, which encompass some form of ICT, are not yet in wide use.

For future trends in telecare demographic, social, political and technological trends have to be taken into account for predictions of future developments in the use of telecare. As telecare is continuously developing, it is difficult to pinpoint specific products or technologies, which may be wide spread in the future in Europe. Telecare technology is expected to grow in Europe and become a part of healthcare delivery. Reasons are a growing population in retirement age, changing family structures with low birth rates, more mobility and more women in the profes-sional work force and therefore less private care givers. At the same time, there is a lack of care professionals that could step in and economic pressure on the health care systems of European countries. These developments on the level of society are currently stimulating the development of telecare solutions. However, ethical, legal and provision issues have to be addressed in order for telecare to further grow in Europe.