Field Of Home Care Research Articles

Research on Load Decomposition and Optimization of Intelligent Elderly Care Service Based on Heuristic and Event Detection Algorithm

Against the backdrop of the digital age, the openness, equality and interaction of the Internet economy have injected new vitality into China’s traditional industries. The application of big data technology, especially in information integration and analysis, has become a key force in promoting the sustainable and healthy development of the national economy. This study focuses on the “Internet +” environment, discusses the impact of the aging problem of community workers on home care services, and proposes an optimization scheme based on a heuristic algorithm. The heuristic algorithm, inspired by the foraging behavior of ants in nature, optimizes the route selection problem by simulating an ant colony to choose the path with a high concentration of pheromones and shows outstanding application potential in the field of home care. The accuracy of the event detection algorithm is directly related to the performance of the load decomposition algorithm, and the change point detection algorithm can effectively identify the change point of the probability distribution in the time series data, which provides important input data for unsupervised clustering. Advanced computer theory, including the Hidden Markov model (HMM) and swarm intelligence optimization algorithm, is used in this research. By comparing different swarm intelligence algorithms, we find that the standard Gray Wolf optimization (SGWO) model is better than the basic Gray Wolf optimization (BGWO) algorithm and the improved Gray Wolf optimization (DGWO) algorithm in terms of stability and output results. The SGWO model significantly improves the efficiency of the load decomposition algorithm, which has been verified in the application of the smart elderly care service platform. The platform not only supports the operation of related technologies and information products but also realizes the seamless integration of information among various subjects of elderly care services. In addition, the factor hidden in the Markov model that can be selectively activated effectively monitors equipment status in the Internet of Things environment, provides real-time monitoring of user consumption behavior and fault information and further enhances the quality and efficiency of smart elderly care services.

Microenterprise and home care for older adults in England and Wales: A partial revolution?

Paid carers play an important role in helping older adults with care needs to remain living in their own homes. This paper examines changes in the home care field, specifically the emergence of self-employed care entrepreneurs ('microentrepreneurs'). To do this, it employs Bourdieu's concepts of field, capital and habitus. Drawing on 105 semi-structured interviews with stakeholders working in home care, the paper describes how the interaction of changes to field structures, and altered practices of care have challenged the taken-for-granted acceptance of traditional, transactional forms of care provision. This process has been highly dependent on local state actors, their ability to mobilise relevant forms of capital and the factors which shaped their habitus. It should be seen within the context of changes to local field structures and the hierarchical classification processes which underpin them. These changes threaten the distribution of capital in the home care field in ways that are beneficial to microentrepreneurs. Bourdieu might categorise these developments as 'partial revolutions', which do not challenge the fundamental axioms of the field. However, for care entrepreneurs, formerly employed as low-paid home-care workers, a revolution that is only partial may be better than none at all.

Defining practice variation and exploring influencing factors on needs assessment in home care nursing: A Delphi study.

To describe a Delphi study regarding practice variation in needs assessment by Dutch home care nurses, to define practice variation in home care nursing and explore which factors may have a role in this needs assessment. A Delphi study was conducted with the participation of home care representatives. A Delphi questionnaire was developed, preceded by literature research and an expert meeting. The Delphi study took place between December 2020 and February 2021. The goal was to achieve a consensus level of at least 70%. After three rounds, 32 experts reached a consensus about definitions regarding variation in needs assessment, warranted and unwarranted variation. In total, 59 factors were determined related to (1) the client and health, (2) the clients' context, (3) nurses and (4) the nurses' context. Thirty-four factors scored warranted of influence and 18 (of 34) were client related. Most of the factors that scored unwarranted influencing needs assessment (17 of 26) were related to the home care nurses' context. Having a consensus about the definition of practice variation in needs assessment and possible influencing factors support the professionals to discuss and improve the unity and quality of their decision-making process in home care. This may contribute to more righteous care for clients in need of home care. Since 2015, home care nurses in the Netherlands are responsible for determining the amount, type and duration of care for clients in need of home care. This so-called needs assessment legitimizes the payment by health insurers. Signals of practice variation in needs assessment are heard in home care field. Although practice variation may be justified, it can lead to over or underuse of care, which may affect clients' outcomes. If we can identify influencing factors and find patterns that contribute to practice variation, we might gain a better understanding of the process and improve home care. In this study, there was no patient or public involvement. Client representatives were included in this research as experts in the home care field, and they participated in three rounds of the Delphi study. They contributed by sharing their expert opinion on the definitions presented and the factors possibly influencing needs assessment.

Same but Different: Variations in Reactions to Digital Transformation Within an Organizational Field

Researchers and practitioners are increasingly interested in understanding how organizations transform their value propositions and practices using digital technologies. While the extant literature offers important empirical and theoretical insights into digital transformation in individual organizations, we know little about how adopting organizations within an organizational field react differently over time to the same digital transformation initiative. This is unfortunate, as such insights could help scholars and managers understand option repertoires and constraints in handling digital transformation ideas that travel into organizations. Against this backdrop, we had access to a unique case over an eighteen-year period, which shows how organizations within the Danish home care field reacted differently to a nationwide digital transformation initiative on mobile technology use. To analyze this case, we applied virus theory as a promising perspective for examining how and why the same digital technology and transformation idea occasions different reactions in similar contexts. Our analysis highlights the emerging, fluctuating, and consequential nature of digital transformation within the Danish home care field, which has led to very different reactions across adopting organizations. Drawing on this analysis, we contribute to the expanding literature on digital transformation by providing theoretical and practical knowledge about variations regarding how organizations within an organizational field react over time to digital transformation ideas.

Home Care Services for Seniors: A Typology of Instruments and Administrative Burdens in Industrialized Countries

This contribution has two key objectives. First, inspired by earlier studies in comparative welfare state and in (social) gerontology, we develop a conceptualization of autonomy that is rooted in its social dimensions. This concept is then deployed to assess its policy considerations within the field of home care, both with regards to access and generosity in 21 industrialized countries. Second, this contribution performs a comparative assessment of the key factors resulting in a prioritization of the social dimensions of home care and social services in long term care. This study involves an-depth analysis of policy instruments deployed by public authorities to enhance the (social) autonomy of older adults, complemented with interviews with policy makers in diverse home care policy settings (Canada, France, South Korea, Sweden, and the United States). As such, this study features an evaluation of the presence of social elements in the definition and supply of care needs across 21 countries. It leads to the construct of a social dimensions of autonomy index based upon these instruments and the budgetary prioritization of home care within long term care policies. Among core findings, one discovers broader access and more generous funding when home care responsibilities are firmly embedded at the local level.

Multidirectional Idea Travelling Across an Organizational Field

Organizational scholars are increasingly interested in understanding how ideas travel across an organizational field. While most studies focus on how travelling ideas translate into organizational practices, we lack insights into the broader issue of how ideas translate as they move among heterogeneous actors across the field. To explore this multidirectional travelling of ideas, we build on the notion of translation ecology to capture the ongoing interactions among field members as they are involved in translation work within and outside adopting organizations. To develop our argument, we draw from a longitudinal, 20-year case study of a public sector digital transformation programme in Denmark through which ideas about mobile technology use for caregivers spread across the entire homecare field. By following the mobile technology initiative over time, we show how ideas travelled in multiple directions as adopting organizations and other influential field actors participated in and contributed to diverse practices across organizations. Based on our analyses, we identify three distinct forms of multidirectional idea travelling – reinforcing, complementing and polarizing – and describe how they together shape the morphing of ideas as they move among heterogeneous actors in a translation ecology. As a result, we advance knowledge about multidirectional idea travelling as an under-theorized and important perspective in the translation literature.

Sensory ways of knowing care: possibilities for reconfiguring ‘the distribution of the sensible’ in paid homecare work

Calls for the professionalising of homecare are often driven by a perceived gap in knowing ‘good care’. However, many training solutions are underpinned by a cognitivist notion of knowing as a rational process of making sense of sense. A different approach to knowing homecare is provided in this article, based on a very different set of assumptions on knowing and knowledge. Suggestions for researching homecare are provided, underpinned by the notion of sensory ways of knowing. These other ways of knowing ‘good care’ potentially reconfigure who and what are able to be attended to in the field of homecare.

User involvement in the implementation of welfare technology in home care services: The experience of health professionals-A qualitative study.

The aim of this study is to learn more about factors that promote or inhibit user involvement among health professionals when implementing welfare technology in home care services. It is a health policy goal to increase the use of welfare technology in order to address some of the challenges that healthcare services are facing. Health professionals' involvement is important for the successful implementation of welfare technology in home care services. The study has an explorative and descriptive longitudinal design based on a qualitative approach. Five focus group interviews were conducted with 16 nurses and assistant nurses from three different municipalities over a period of 2years. The data were analysed using reflexive thematic analysis. The COREQ checklist was used. The analysis led to five main themes: competence a critical component, information and information lines, new ways of working, choice of welfare technology and change in patient services. From health professionals' perspective, there appeared to be a lack of preparedness for the change in the implementation of welfare technology entailed for home care services. The respondents experienced limited facilitation and opportunities for user involvement. Health professionals want to be more involved but emphasised that competence, information and collaborative arenas are necessary factors if involvement in the process is to be increased. Competence affected some of the respondents' attitudes and willingness to use the technology. The respondents also experienced that the managements' focus on facilitation and interest in user involvement in addition to infrastructures that functioned in various ways had an impact on user involvement. The knowledge gained from this study about factors that promote or inhibit user involvement among health professionals could contribute to better preparedness for further implementation of welfare technology in the field of home care.

Improving Heart Failure Patient Transitions of Care and Reducing Readmissions with a Structured Hand-off Process

Purpose Heart failure (HF) patients have the highest 30-day readmission rates of all Medicare discharge diagnoses. Excessive readmissions can result in reduced reimbursement (lost revenue) under pay-for performance programs. Inadequate discharge preparation and problems with care transitions increase risk of readmission. Our purpose was to reduce readmissions of HF patients by improving transitions of care with a novel, structured and directive discharge handoff process. Objectives Our aim was to improve HF patients transition from hospital to homecare by providing a structure to ensure that: 1) HF patients' discharge readiness was assessed prior to discharge; 2) risk factors for readmission were systematically evaluated and addressed prior to discharge, and 3) communication and collaboration between nurses from the inpatient and homecare setting was facilitated. Methods Input was sought from clinical nurses on our hospital's HF unit and from homecare nurses from the units preferred (and most utilized) vendor. At a meeting, nurses from both settings were polled using audience-response technology, about: 1) their perceptions of the factors that contributed most to HF patients' readmission; 2) what type of communication between settings would improve transitions and reduce readmissions, and 3) current communication practices between settings. Nurses perceptions were combined with known risk factors for readmission from the HF literature to a create an in-person, bedside handoff between inpatient nurse and homecare intake nurse, performed on the day of discharge, in the presence of the patient, requiring completion of a checklist that forces review of risk factors for readmission (from the literature and polling results). Each item on the checklist links to specific actions to be taken for problems identified, prior to discharge. The checklist is embedded in a one-page form, which includes key metrics (most recent EF and weight) and contact information of the discharging RN, NP, and patient PCP, to make communication easy for the homecare RN. The process takes 5 minutes to complete. Both nurses sign the form. A copy is forwarded to the homecare field nurse, and one is kept on the unit for reference. The process was developed in late 2015 and implemented over several months in early 2016. Results Readmission rates for the HF unit were evaluated for 12 months prior to implementation (1/1/2015-12/31-2015) and for 12 months following implementation (5/1/2016-4/30/2017) allowing 4 months for complete integration into practice (1/1/2016-4/30/2016). For the 12 months prior to implementation the unit's HF patient readmission rates were: Unit rate=17.4% (79 readmits/455 HF discharges); discharged to homecare=20% (49/241); regular discharge=13% (20/156.). For the post implementation 12 months, HF readmit rates were: unit= 12.9%(67/519); homecare=14%(47/256); regular discharge=11%(22/202.) Readmission rates were substantially reduced in the post-implementation period, although the total number of HF discharges was greater than in pre-implementation. Feedback from nurses was positive. Subsequently, the vendor implemented the handoff in other hospitals in NYC. Conclusions A structured handoff at the time of discharge, between nurses from two different settings, can contribute to substantial reduction in HF patient readmissions. This nursing practice improves patient outcomes, and by reducing readmission, prevents revenue loss, in effect, generating value. Table/Image 171627-2-54356.pdf Table/Image: Primary Author Registrant ID: 5632479 First Name: Arlene Last Name: Travis Phone Number: 9179453226 E-mail: arlene.travis@mountsinai.org Credentials ANP-BC, CHC, CHFN-K Affiliation Name: Mount Sinai Hospital Affiliations Address 1: 3210 Arlington Ave. Address 2: Apt. 6H City: Bronx State: NY Zip Code: 10463

HOME CARE IN THE REPUBLIC OF MOLDOVA: THE CHALLENGES FOR HEALTH AND SOCIAL POLICIES

Home care responds to people's health and social needs by offering quality services where the recipient lives. Demand for these services is steadily increasing, especially due to the aging population. The purpuse of this study is to analyze the situation in the field of home care in the Republic of Moldova. The study is based on a methodological approach focused on the analysis of the normative framework, the opinions of the service providers (public and private), but also of the representatives of the local public authorities, including the beneficiaries. Quantitative and qualitative research methods have been used. Sociological survey based on a questionnaire was applied to 84 home care providers from 23 out of 35 Moldovan administrative territorial units. In-depth individual interviews were conducted with 2 categories of people: 20 home care beneficiaries and 24 mayors. The results of the assessment reveal shortcomings and achievements in the field of home care in the Republic of Moldova and gives recommendations for governmental and local authorities, public and private providers in order to develop home care services and policies in the field of home care, organization of advocacy activities.

Older people living alone (OPLA) \u2013 non-kin-carers\u2019 support towards the end of life: qualitative longitudinal study protocol

BackgroundA growing number of older people, mainly women, live in single households. They represent a vulnerable group as staying at home may turn out challenging when care needs increase, particularly at the end of life. Non-kin-carers can play an essential role in supporting individuals’ preferences to stay at home. In research little attention has been paid to non-kin-carers, such as friends and neighbors, yet. Thus, the Older People Living Alone (OPLA) study will evaluate whether non-kin support is robust enough to enable care dependent people to stay at home even at the end of life. This paper aims to introduce the research protocol.MethodsWe plan to apply a qualitative longitudinal study to better understand how older people living alone and their non-kin-carers manage to face the challenges with increased care needs towards the end-of-life. We will conduct serial interviews with the older persons living alone and their non-kin-carers. A total of 20–25 complete data sets and up to 200 personal interviews were planned. These will be complemented by regular telephone contacts. All interviews will be analysed following the grounded theory approach and strategies for reconstructing case trajectories, supported by MAXQDA software. In the course of the study, inter- and transdisciplinary workshops shall assure quality and support knowledge transfer.DiscussionThis study protocol aims to guide research in a field that is difficult to approach, with regard to its topic, methodology and the interdisciplinary approach. As this study introduces longitudinal qualitative research methodology in the field of home care in Austria, a deeper understanding of (end-of-life-) care trajectories will be enhanced, which is of major relevance for future care planning. With investment in additional reflexivity and communication procedures innovative results and robust knowledge are expected outcomes.

Research on an Information Sharing System using COI Specialized for Urgency in the Home Care Field

In Japan, rapid aging is a big problem. Particularly, medical care for elderly people at home requires cooperation of workers of multiple job types. However, since these workers take care of many elderly people and deal with enormous information, information sharing on the elderly is not sufficient. In this research, each worker always obtains important information for individual elderly persons in a timely manner and proposes a method for leading to appropriate medical care for the elderly. It is characterized in that important information is preliminarily set in a strange form for each elderly person, and the relevant information is promptly pushed to the workers

Effects of an interprofessional educational program for homecare professionals on building social capital: a trial in an urban area

Objectives The importance of social capital in promoting interprofessional collaborations is well known. This study examined the effects of an interprofessional educational program for homecare professionals on building social capital in terms of homecare in an urban area.Methods The program was conducted at Kita Ward, Tokyo, from July 2014 to January 2015. We used a self-administered questionnaire before and after the program to collect data from homecare professionals in the ward, as well as from those who were interested in providing homecare. Physicians attended a five-day program, while other professionals attended a four-and-a-half-day program. Participants' attitude toward homecare practices was assessed to evaluate their motivation level for the job (i.e., the formation of a practical view of homecare and efficacy to engage in homecare practices). Regarding social capital, we assessed trust and norm of reciprocity for those in the same profession as the respondent (bonding and cognitive social capital) as well as for those in a different profession (bridging and cognitive social capital). Additionally, to professionals other than physicians, we asked about trust and norm of reciprocity regarding physicians (bridging and cognitive social capital) and collaborative conditions with physicians, which included the two sub-domains of cooperation and interaction (bridging and structural social capital). A generalized estimating equation was used to detect the effect size.Results Of the 54 program participants, 52 (including two physicians) completed both the pre- and post-program questionnaires. Participants' practical view of homecare was formed after the program, although their efficacy for homecare practices was unchanged. With regard to social capital, scores for both trust and norm of reciprocity for the same profession (bonding and cognitive social capital) increased, while those for different professions (bridging and cognitive social capital) were unchanged. Scores for both trust and norm of reciprocity regarding physicians and cooperation with physicians (bridging and cognitive social capital, and bridging and structural social capital) also increased. Finally, trust and norm of reciprocity for the participants improved after the program.Conclusion The interprofessional educational program for homecare professionals may foster social capital among the participants. The study results imply that this program can be a possible strategy to foster social capital in the field of homecare.

A Quality Model for the Evaluation AAL Systems

The Ambient Assisted Living (AAL) domain aims to support the daily life activities of elders, patients with chronic conditions or disabled people. The need to support these elderly, in difficulty has prompted researchers to focus on the field of home care. Several platforms have been developed over the last two decades, based on several functionalities to the improvement of their quality. Hence, Quality Criteria (QCs) must be identified and well defined to successfully achieve the system purposes. The goal is to obtain a set of data quality characteristics that would be applicable to the context of AAL systems and evaluate them using data coming from multiple sensors. To do this, we based our work on ISO/IEC 25012 and ISO/IEC 25010 standards that establish QCs respectively on system and software product quality and data quality, to extract the most relevant QCs that could be more fitting for AAL systems. We have applied an approach to extract the most important criteria than can be associated with AAL system based on the acquisition, the transmission, and the treatment processes. To convince all stakeholders including both technologies and end users of AAL systems, high quality must be guaranteed, but measuring quality in AAL system is difficult because of the variety of stakeholders. To evaluate the entire data quality model for AAL system, we will apply an evaluation procedure on this model, which consists first make our model hierarchically, then evaluate it using the metrics based on the sensor data and the concept of fuzzy logic.

Detecting fall at home: User-centered design of a pervasive technology

Falling is the main cause of domestic accidents and fatal injuries to seniors at home. In this paper, we describe the design process for a new pervasive technology (CIRDO). The aim of this technology is to detect falls (via audio and video sensors) and to alert the elderly's family or caregivers. Two complementary studies were performed. Firstly, the actual risk situations of older adults were analyzed. Secondly, social acceptance was investigated for the different homecare field stakeholders. Our results highlight the tensions among social actors towards the tool and their impacts on technology acceptance by the elderly. Also, we show a significant change in the fall process due to the device. In actuality, the social functions associated with CIRDO implementation and the necessity of iterative design processes suggest that the CIRDO system should be more flexible and versatile to better fit the risk behaviors of seniors that evolve using this device.

Photonic non-contact estimation of blood lactate level.

The ability to measure the blood lactate level in a non-invasive, non-contact manner is very appealing to the sports industry as well as the home care field. That is mainly because this substance level is an imperative parameter in the course of devolving a personal workout programs. Moreover, the blood lactate level is also a pivotal means in estimation of muscles' performance capability. In this manuscript we propose an optical non-contact approach to estimate the concentration level of this parameter. Firstly, we introduce the connection between the physiological muscle tremor and the lactate blood levels. Secondly, we suggest a photonic optical method to estimate the physiological tremor. Lastly, we present the results of tests conducted to establish proof of concept to this connection.

Obstacles and Facilitators in Developing Integrated Team Based Home Care Services in Lithuania

Introduction. The development of innovative high quality care forms is a challenging issue in rapidly aging society of Lithuania. The new shape integrated homecare services for people with chronic conditions have been constructed and have been functioning over the year as the pilot projects in the 21 municipality around Lithuania. In almost all integrated care pilot municipalities except two regions (in Alytus and Sakiai, with primary health care units as integrated care providers) the initiative to develop team based integrated homecare services to persons with chronic conditions has been taken by departments of social services. The purpose of this study is to identify the key contextual elements and related strategic, organizational processes from pilot municipalities as facilitators and obstacles in developing mobile team based integrated homecare services as contrast to traditional institutionalised care. Theory/Methods. Pettigrew and Whipp's context, content and process model of strategic change was used as theoretical framework for the case studies of team based integrated homecare pilots. According this framework the data collection focused on three entities: what external and internal contexts instigated municipalities and service providers to take the challenge to develop the new shape integrated team based homecare services and how service providers perceive, construct and implement integrated team based homecare; and finally, what outcomes have been shaped with new form integrated care. Data were analysed from transcripts of 20 focus groups with administrators, social and health care providers and 12 in depth interviews with care receivers (informal caregivers and patients) in ten purposively sampled municipalities: pilots executed by municipality social provision departments in partnership with private and state agencies, directly by social services departments and by primary health care unit. The findings were compared with factors and dimensions of Normalisation Process Theory (May et al. 2007). Results and discussion. The study revealed the obstacles and facilitators related to individual and different organizational levels in constructing team based integrated homecare. The study 15th International Conference on Integrated Care, Edinburgh, UK, March 25-27, 2015 1 International Journal of Integrated Care – Volume 15, 27 May – URN:NBN:NL:UI:10-1-117127– http://www.ijic.org/ revealed individual level topics such as trust and collaboration building between integrated team care providers and informal caregivers, challenges in building new routines and habits for patient in homecare process, resistance and adaptation to presence of constant changing strangers’ at home. The study exposed the organizational issues related to interaction between team members and administration, tensions issues in status difference between social and health care providers, tasks distributions between team members, perception diversity of team and care, lack of teamwork experience and sense of shared responsibility, issues of staff commitment due to termed pilots. The inter-institutional and intra-institutional hindering tensions between social and health care providers unclosed the competition over the homecare field; new institution as threat to monocracy of health care; lack of skills and early transition from hierarchical to dialog based horizontal structures; inequality of resource distribution between integrated team members uncompensated travel costs for social care providers vs. car with fuel coverage for health care providers. The mentality of monolog culture with highly hierarchic structures in health care system hinders recognition of nursing as separate profession with certain competencies: avoidance by nurses to take decisions on nursing issues without consultation with physician even in areas of their professional competence supremacy as care of bedsores. The important facilitators were the support of municipality in service development and participatory involvement of the unit from the beginning of project planning. The professionally organized integrated homecare services facilitated transition to collaborative relationship between health care and social care providers. The requirement to follow literally description of project activities even the performance of planned activities contradicted the reality in practice hinders development of new service. As study limitation is the administrators gatekeepers’ role in accessing research participants: patients, informal caregivers, health and social care providers. In some municipalities the presence of head of the unit in the focus group suppressed openness of the staff. The study had insufficient data on patients’ experience of care as the integrated care pilots addressed severely ill patients with limited communication abilities. Conclusions. The study revealed micro, mezzo and macro levels obstacles and facilitators in constructing team based integrated homecare. The distinction of developed models of team based integrated homecare services participatory interaction between stakeholders of the care with the traits of patient centred approach and collaborative practices between existing social and health care structures. The move from the tradition of hierarchical model of service development ( i.e. from “above” perspective constructing orders of ministers with limited perception of reality and municipalities as executive committees with resistance performing commandments and shaping service delivery imitation) grounded the participatory practice in service development.

L’apparition d’organisations marchandes dans le domaine de l’aide et des soins à domicile en Suisse romande

Cet article porte sur le developpement d’organisations marchandes dans le domaine de l’aide et des soins a domicile aux personnes âgees en Suisse romande. La litterature internationale souligne une orientation vers la marchandisation de la prise en charge des personnes âgees en perte d’autonomie au niveau europeen, une tendance favorisee notamment par des mesures visant a renforcer le pouvoir d’achat des usagers et usageres. Nous faisons l’hypothese qu’en Suisse, ce sont les limites du maillage des politiques de la vieillesse autour de la prise en charge de l’aide et du travail domestique qui profitent aux organisations a but lucratif. C’est a partir de cette breche et pouvant s’appuyer sur des politiques liberales concernant l’obligation de prise en charge et la reglementation du travail, qu’un marche prive de l’aide et des soins a domicile se developpe en Suisse romande.

The Regional ICT based Clusters for Healthcare Applications and R&D Integration (RICHARD) Project

Introduction: The use of Information Communication Technologies (ICT), in particular telehealth, can be clinically effective for the treatment and management of individuals with a number of longterm conditions (McClean et al, 2011). However, the integration of scalable telehealth technologies and interventions into clinical practice has been slow to develop; due in part to a lack of regional organisational models that facilitate the reorganisation of health provisions. In order to meet the challenges of switching from an application based model of care to a comprehensive and sustainable chronic care model the RICHARD Project has been developed. The Regional ICT based Clusters for Healthcare Applications and RD Italy, United Kingdom (UK), Sweden and Poland. Aims and objectives: The consortium aims are to enhance and promote the study of new or promising European territorial clinical models of ICT-based in the field of home care applied to the management of chronic conditions. To this end a number of work packages were proposed including (WP1) Project management, (WP2) SWOT analysis of regional ICT models for the delivery of care in chronic pathologies, (WP3) the development of a Joint Action Plan (JAP), (WP4) Measures towards the implementation of the JAP, (WP5) Mentoring activities and (WP6) Dissemination and communication. Results: A strong coordination of research resources and innovation stakeholders has been clearly identified. A JAP has been developed inspired by medium-long term vision that looks at ehealth services into perspective of economic growth for the European regions along the principles of open competition for better and pan-European healthcare services. United Kingdom partners have taken the lead on (WP4) ‘Measures towards the implementation of the JAP’. The work package comprises the organisation of a number of regional healthcare manager study tours on ICT applications and multiple research brokerage workshops; the latter has been developed with the purpose of creating networks and stimulating collaboration, resulting in developed research applications for regional, national and international bids. Finally, to further develop and raise the profile of less advanced regions involved in the project a series of mentoring activities are underway. A significant output from the project is the Ready, Steady, Go toolkit for telehealth deployment at scale http://www.richardproject.eu/richard/publications.html

Wireless Networking Credibility, Device Interoperability and Other Important Issues to Take into Consideration for the Deployment of a Homecare Service Provision Model

The proposed article aims to provide a discussion on the issue of the utilization of wireless technologies, for the deployment of monitoring wireless personal area sensor networks for the unobtrusive monitoring of patients, aiming to answer some of the fundamental questions raised by this, including which is the most appropriate technology for such a networking architecture, what is the best topology for home monitoring wireless sensor network solutions, and what is the performance of the wireless networking technologies. In addition, it aims to initiate some brainstorming as regards how many interoperability protocols are actually need, presenting the strong and weak points of most of the current interoperability standards utilized in the field of homecare, with emphasis on the encoding and formatting of ECG waveforms. Last but not least it aims to pinpoint other important issues in the field of homecare, such as legal and safety issues which are worth of consideration.