Revolutionizing aged care through Smart AI

With the rise of technological and medical advances and raised awareness of nutrition, personal hygiene, and the environment, life expectancy has increased globally (United Nations ESCAP, 2016). The proportion of Singaporean residents aged 65 years and over sits at 17.6% (as reported on 13^th November 2021). This rate is expected to increase to about 25% by 2030, of which many will require care. According to census data, approximately 70,000 Singaporean seniors struggle to carry out daily activities (Lim, 2021).

Likewise, in Australia, the percentage of those aged 65 years and over is projected to increase by more than two times by 2057 (Australian Institute of Health and Welfare, 2021). Across the world, in the United States, it has been projected that by 2040, the country will have almost 81 million adults aged 65 years or more. This increase is not balanced by healthcare staffing, as it was reported in September 2021 that 59% of nursing homes had severe staffing shortages (McLaughlin, 2022). The increase in the ageing population leads to rising costs associated with elderly well-being and healthcare, which places an additional burden on the healthcare system.

Though countries like Singapore have a range of initiatives to support the elderly well-being, there is a global demand from seniors that would like to age in their own homes. To respond to this need, for instance, Singapore’s House and Development Board (HDB) has rolled out Community Care Apartments, which allows the elderly to live on their own and receive care when required (Lim, 2021).

Smart AI is a solution to the healthcare staffing shortage, to assist seniors in living independently and safely, and to provide unobtrusive and cost-friendly healthcare solutions.

This article will discuss several smart initiatives that are currently utilized to support the elderly.

 

Smart Initiatives

The term “Smart AI” is based on the technology, “smart machines”, which are devices embedded with machine-to-machine and/or cognitive computing algorithms such as AI, machine learning (ML), or deep learning, that are utilized to solve problems, derive big data insights and take knowledge-based actions (Pratt, 2017). These devices range from cars to phones to soccer balls that can respond to conversation and guide our behavior. Technology is “Smart” when it can work and communicate with other technologies to enable remote accessibility and operation as well as automated or adaptive functionality.

This section covers a range of Smart initiatives – IoT, wearables, Digital Portals, Robotics, and AR and VR, that have been implemented to enhance senior well-being and safety, focusing on examples within Singapore. How these technologies are used in each step of an elderly patient’s journey is summarized in the infographic in Figure 1.

Figure 1: Infographic summarizing how Smart-AI driven healthcare augments elderly wellbeing and safety (Inspired (Reference: https://www.visualcapitalist.com/sp/7-ways-artificial-intelligence-is-improving-healthcare/)

 

Internet of Things (IoT)

IoT represents a network consisting of chips, sensors, online connectivity, and software to bring life to inanimate objects. IoT sensors can be utilized in preventative healthcare for the elderly.

Aligned to Singapore’s goal to move closer to a Smart Nation, the government has a range of IoT initiatives that are being worked upon to support elderly Singaporeans. One such system is the Elderly Monitoring System, designed to enhance daily living for the elderly. IoT motion and door contact sensors are utilized to learn the daily habits of the elderly. Any irregular patterns in behavior or lack of movement for a given period will alert the elderly’s caregiver (HDB Smart Enabled Home, 2021).

Other IoT solutions available in the market that assist with elderly well-being are (Age Space, 2021):

• A video doorbell – detects motion when people come close to the door and sends instant notifications to the smart device, enabling one to to see who is at their door without having to open the door.
• An automatic pill dispenser can be pre-programmed times to dispense the required dosage and serve as a reminder for the elderly to take their medication. It also has the functionality to send text messages to family members or carers to confirm that the medication has or has not been released from the device at the specified times.
• TrueLoo – a smart toilet seat, takes a toilet bowl scan that can be used to examine the color, size, shape, frequency, and consistency of its contents. The information is then provided to aged care residential managers to monitor residents’ health. Information gleaned from these scans can point to issues such as urinary tract infections, dehydration, and diseases like norovirus and Clostridium difficile, which often lead to hospitalization amongst the elderly(Halpert, 2019).

 

Wearables

Like IoT devices, wearables, such as fitness trackers, can be used in preventative healthcare by assisting in the early detection of illnesses. They are commonly used to monitor activity, sleep, and heart rate. However, to support the elderly, they can be used to collect additional heart rates data such as ECG and HRV, brainwave information (EEG), and muscle bio-signals (EMG) to obtain information that can be utilized to address health concerns in the elderly. For instance, abnormal ECG patterns can indicate high blood pressure, high cholesterol, and a predisposition to strokes or heart attacks.

Wearable technology, such as the Qwell Wearable Pain Relief Technology Kit, has also been developed for pain relief, which uses wearable intensive nerve stimulation. Another example is the Omron Healthcare Avail TENS Units, developed to assist with arthritic pain.

Vision impairment is a common concern amongst the elderly. As such, braille has been integrated in several smartwatches. On the same note, hearables have been developed as technically advanced hearing aids that can include connectivity with smartphone apps and biometrics (Sardis, 2019).

Digital Portals

Digital portals can come handy during doctor visits. They are used as a one-stop shop for the storage of a patient’s medical history. Singapore’s HealthHub stores lab test results, personal hospital records, medical appointment information, and referral letters. It can also be used to set medication reminders (Smart Nation Singapore, 2022). Digital portals not only save time as information is available at one’s fingertips instantly, but also prevent the elderly from retelling their medical histories, reduces errors, and ensures subsequently that the elderly receive good care.

Digital systems allow for the sharing of medical information between GPs, aged care facilities and pharmacies to enhance medical safety, which is essential for hospital admission, both emergency and planned ones. Digital records can also assist with maintaining compliance against regulatory standards, which becomes useful during hospital audits. As more data is collected on patient records, aged care facilities can use this rich dataset to assist in more informed decision-making for healthcare practitioners. Other benefits of digital portals include transparent, more robust, and more meaningful reporting (Telstra Health, 2020).

 

Robotics

Post doctor visits, a patient may require treatment and rehabilitation. This is where robotics comes into play. Singapore is exploring the use of robotics to enhance patient care. For instance, robots in the form of automated bathing machines or droids that monitor progress in mobility can be used. Robots can also assist with exercise for patients recovering from a stroke. In addition, robots can remind early-stage dementia patients to take their medication.

The healthcare staffing shortage can be supported by delivery drones that dispatch equipment and medicine. Additional uses of robotics include industrial robot arms that can pick and pack-objects and automated guided vehicles for food, linen, documents, and heavy item transportation.

Finally, robots, such as RoboCoach Xian, can facilitate physical exercise classes to the elderly, both individually and in groups. Equipped with sensors, it offers customized, low-impact and low-risk routines for the elderly. RoboCoach Xian also provides cognitive and physical therapy for those who are suffering from Alzheimer’s or Parkinson’s or have suffered strokes. The Singaporean government is currently looking at enhancing RoboCoach Xian to assist the visually impaired with their communication by adding a screen reader (Smart Nation Singapore, 2022).

The use of robots in assisting older adults is not new. In 2016, Intuition Robots launched a product called ElliQ, which assists the elderly in combatting loneliness and social isolation. This cognitive AI product initiates conversation with the senior to keep in touch with loved ones and includes nudges to take medication (Halpert, 2019). According to the company, ElliQ has shown the ability to decrease loneliness by 80% (Burky, 2022).

Another product to foster meaningful connections for the elderly is the robotic pet, with the view that this item will provide companionship and invoke feelings of happiness and relaxation in the elderly living independently or in care communities (Halpert, 2019).

 

AR and VR

In addition to robotics, Virtual Reality (VR) and Augmented Reality (AR) tools have a place in the treatment and rehabilitation of an elderly patient’s care plan. These technologies can assist the elderly with physical fitness, rehabilitation, and therapy to support healthcare workers in assessing balance and fall risks. An example is Neuro Rehab VR catered for the elderly undergoing physical therapy following a brain injury, spinal cord injury, a stroke, or suffering from neurodegenerative diseases. It uses ML to provide customized exercises to the patient’s specific therapy needs and abilities. The product records kinematic and physiological movements, which are subsequently utilized to determine the patient’s progress with metrics and scores over a period (Halpert, 2019).

The Elderly can use VR to engage in experiences remotely, such as visiting foreign locations or seeing shows. Research has shown that regular engagement in virtual experiences can enhance mental well-being and relaxation in the elderly (McLaughlin, 2022).

An example of AR is ‘Tovertafel’, a projector utilizing interactive technology that enables low-risk play and entertainment for the elderly. This not only encourages physical activity but is also likely to lead to happiness by reducing apathy (Aged Care Decisions, 2022).

This article aimed to map out the need for digitization in the aged care sector for improved elderly safety and wellbeing and to demonstrate how the healthcare sector can be supported in adopting Smart AI. We described at least five types of Smart Initiatives – IoT, robotics, AR and VR technology, wearables, and digital portals – that have demonstrated their value in the healthcare industry. The second part of this article series covers the future of Smart AI adoption and Infosys’ role in enabling its adoption within the healthcare sector.