An economic tool to assess AAL services

Throughout the COVID-19 pandemic, we all had to stay at home more than usual, our households becoming the ultimate refuge against the virus. Everybody felt safer in confinement, but especially vulnerable groups: the elderly, people with pre-existing conditions and some specific disabilities.

Elderly black woman talking to someone on her laptop

One of the striking revelations of this extraordinary period we are still living through is that active assisted living (AAL) services, which until recently could be defined as systems and equipment which help senior citizens, or people with disabilities to live independently at home, have saved many lives while costing less in terms of care. The definition of AAL services itself is becoming broader as a result of the pandemic. Those needing AAL services could now include single mothers with sick children who need to work from home, or single people who are confined but have sprained an ankle, for instance.

As we found out to our utmost horror, while watching news reports from around the world, elderly people living in care homes were much more at risk from the virus, as it spread like wildfire, reaping many deaths in its wake. One of the main advantages of care homes, the social aspect of living together, turned out to be an Achilles heel. To mitigate the risk, our parents and grandparents were forced to stay in their rooms for hours on end, isolated from one another and their own relatives.

The pandemic highlighted problems health professionals and governments are already aware of: on the whole and unless it can’t be avoided, it is better for elderly people to live in their own homes as long as possible, with the assistance of specific technologies and services. The same can be said for people with disabilities. Most of us found it in our interest to use telemedicine to contact our doctors, rather than risk being infected by visiting their surgery. AAL services are therefore becoming obvious alternatives for many of us. It also became evident that AAL services prevent social isolation rather than favour it. The older generation could use various teleconferencing tools to stay in touch with their families and medical staff, as we all did. Friends organized concerts, cooking recipes were shared and some even cooked together while several miles apart.

IEC expertise and economic evaluation

IEC is leading the way in developing standards relating to AAL services. It set up a systems committee, IEC SyC AAL, to promote safety, security, privacy and cross-vendor interoperability in the use of AAL services. SyC AAL has published three innovative publications, which are targeted at health funders, whether private or public, and manufacturers of AAL equipment. The first one is a technical specification, IEC TS 63134, which lists use cases of AAL services. “The document inventories near to fifty use cases and describes around 11 in detail. We were extremely careful to propose examples that are representative. The TS also establishes the terminology used throughout our publications,” explains Paul Boissoneault, one of the SyC AAL experts much involved in the development of the documents.

The two other publications are standards: the first one, IEC 63234-1, establishes a framework for the economic evaluation of AAL services, while the second, IEC 63234-2, looks specifically at the monitoring of patients with chronic diseases. “The idea is to make the full business case for AAL services, looking at different variables, including cost. We want to convince health funders that with AAL systems, you get the greatest benefits for the money you invest,” he says.

These standards are particularly innovative because they branch out into economics. “Economic evaluation is not something the IEC usually does but we felt that promoting AAL services in this way makes a lot of sense, especially after the COVID-19 pandemic,” agrees Chair of SyC AAL Ulrike Haltrich.

Evaluating the monitoring of chronic diseases makes a lot of sense as well. “Chronic diseases represent a growing percentage of illnesses in societies where people are living much longer than fifty years ago. Looking at how best to monitor these, and at what cost, can help health systems make the right decisions in an informed manner,” Boissoneault observes.

For Haltrich, it is all part of the new normal. “Ideally you will be able to hire services for whatever you need, using the IoT, artificial intelligence and, why not, robots. Cyber security will be an increasing issue for us, as well. Technology is moving fast and we are looking into all of this.”

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