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Keynote Lectures

Senior Citizens’ Use of Digital Health Services Prior to and During the Covid-19 Pandemic
Sabine Koch, Karolinska Institutet, Sweden, Sweden

Leveraging Existing Technologies and Functionality for Active Ageing
Arlene J. Astell, University of Toronto, Canada, Canada

Digital Health Equity for Older People
Ray Jones, University of Plymouth, United Kingdom, United Kingdom

Emotionally Sensitive Assistive Technology for Ageing
Jesse Hoey, University of Waterloo, Canada, Canada

Senior Citizens’ Use of Digital Health Services Prior to and During the Covid-19 Pandemic

Sabine Koch
Karolinska Institutet, Sweden

Brief Bio
Sabine Koch is the Strategic Professor of Health Informatics at Karolinska Institutet in Stockholm, Sweden and director of its Health Informatics Centre. Dr. Koch received both a M.Sc. and a Ph.D. degree in Medical Informatics from Ruprecht-Karls University Heidelberg, Germany. Her early research was in dental informatics, especially dental imaging and IT supported integrated care concepts for dental offices. Her fields of interest include models for collaborative care, especially homecare, human factors/ usability and evaluation of information systems. Current research concerns a socio-technical perspective on integrating health, social and selfcare but also guideline-based clinical decision support and information visualization for enhanced decision making. Dr. Koch is the Past President of the International Medical Informatics Association (IMIA) and Editor-in-Chief of Methods of Information in Medicine. She is a frequent member of the Scientific Program Committees for different international conferences in the field, associate editor of Applied Clinical Informatics and member of the editorial board of the International Journal of Medical Informatics. She also acted as external expert for EC DG SANTE – Assessing the impact of digital transformation of health services.

Abstract
Digital health services (DHS) aim to improve care and health system performance, offering new opportunities for delivering health and social care (from prevention and health promotion to curative interventions, rehabilitation, and self-management). Supporting the decentralization of healthcare, higher patient involvement and increased societal demands, DHS targeting patients and citizens have been developed globally in a rapid pace. Such DHS include, for example, citizen portals, patient-accessible electronic health records, virtual visits, remote monitoring services, chat bots, m-health applications for self-management, and more.
Senior citizens’ use of DHS has historically been lower than the use in other age groups. During the COVID-19, use of DHS has increased globally. This keynote will give an overview of senior citizens’ use and perceptions of DHS over time, based on different case studies and international research, and the analysis of Swedish National Citizen Surveys.

Leveraging Existing Technologies and Functionality for Active Ageing

Arlene J. Astell
University of Toronto, Canada

Brief Bio
Arlene Astell is Director of the Dementia Aging and Technology Engagement lab at University Health Network, Toronto and Professor of Neurocognitive Disorders at the University of Reading, UK. She is also Associate Professor in the Departments of Psychiatry and Occupational Sciences & Occupational Therapy at the University of Toronto. Arlene has been co-producing technology for people to live and age well, especially individuals living with dementia, for over 20 years. She is currently engaged in multiple national and international projects and leads the Staying Connected Challenge Area of AGE-WELL, Canada’s aging and technology network. Arlene is a previous chair of the Alzheimer’s Association Technology Professional Interest Area (PIA) and is current Vice Chair of the Nonpharmacological Interventions PIA. She has authored more than 240 peer-reviewed publications plus contributions to professional and practice journals, and a 2019 book on everyday technology in dementia care.

Abstract
Existing devices contain functionality that can support active ageing if people can access it. Commonly identified barriers include lack of knowledge, lack of support, and lack of resources, particularly for purchasing and maintaining consumer goods, such as smart phones and tablets. The lack of a technology-ready workforce in health and social care plus lack of planning for integrating and supporting technology compound the issue. This presentation will consider examples from recent projects leveraging existing devices to promote cognitive, physical and mental health and lessons learnt about implementation in real-world settings.

Digital Health Equity for Older People

Ray Jones
University of Plymouth, United Kingdom

Brief Bio
Ray Jones, is Professor of Health Informatics at the University of Plymouth. He was awarded an MBE for services to digital health and social care over a 45-year career that has seen him lead multi-million pound projects and engage with people across the SW England. These projects have included pioneering initiatives, working with postgraduate students and younger researchers, in promoting the use of video calls and smart speakers to help care home residents stay connected with their family and exploring the use of robotics in care homes. Jones has tried to tackle digital health inequalities, for example, by giving patients access to their own records and helping older people make use of technology, including use of video calls and companion robots.In 2017, Professor Jones secured £2.7m funding from the European Regional Development Fund for the project E-health and Productivity in Cornwall and the Isles of Scilly (EPIC). It has involved working with health and social care professionals and service users in the region to identify healthcare problems, then provide funding to local businesses to design and make potential digital solutions. The aim is to address regional inequalities, improving the eHealth sector in Cornwall. The first three years of EPIC funded more than 40 projects. In March, 2020, EPIC received a three-year, £4m extension, to continue the work, and a second 3-year project – the £1.6m GOALD (Generating Older Active Lives Digitally) – a collaboration with University of Stirling - was separately funded in 2021 by UKRI and launched alongside. Jones believes that our health and care students can be a major way of addressing digital health inequalities in the region, and promoting the use of evidence-based information in public debate about health. Through his teaching, he pioneered Digital Health Professionalism including a Digital Health Champions scheme and use of Twitter as part of the Plymouth undergraduate nursing curriculum in 2014, predating the ‘every nurse an e-nurse’ objective set by the Royal College of Nursing in 2017. Since then, every Plymouth nursing undergraduate has been required to use the platform using the prefix @PUNC (Plymouth University Nursing Cohort) to engage with patients, professionals and healthcare forums to supplement their learning. Digital Health Champions from nursing and other health studies have volunteered to find ways of helping local groups and communities make better use of technology.

Abstract
Having equal opportunity to use digital in all its forms to maintain health and lead a full life in older age can have obstacles. Broadband access is still variable by geography with, for example, some rural areas with poor connection. Cost can be a barrier on limited budgets when digital is competing with heating. But many older people lack skills and confidence in adopting technologies that they did not grow up with. Digital designers often lack insight into the needs of older people, particularly those with limitations of vision, hearing or touch. Ability to filter key information from the ‘noise’ of the Internet is difficult for all and may become more so as people age.

This presentation will describe various initiatives to address digital health equity for older people.

This includes a focus on co-design with older people. The higher use of tablet computers by older people is well known and easily explained. Some of our work in robotics showed age-related differences such as preference for voice among older and younger while middle-aged people preferred keyboard interaction. Other work with robot-pets showed older people wanting life-like pets while younger roboticists favoured more mythical appearance.

In our GOALD (Generating Older Active Lives Digitally) project we are setting up inter-generational co-design groups to consider how digital can be used for various purposes. For example, how can virtual reality be used in care homes to give residents the chance to ‘visit’ places they can no longer physically access, and perhaps exercise while they do so? How can family carers use linked smart speakers to be assured of their loved ones safety and stay in contact without being intrusive?

We have been working in a project called EPIC (eHealth Productivity and Innovation in Cornwall) with small companies to develop the eHealth ecosystem in Cornwall. Although this is across the age range, because of the demography of Cornwall there has been a focus on older age. So the co-design questions above are collaborations with small companies where not only do we want to develop new products and services we want to use that in the ‘levelling up’ of Cornwall.

Addressing digital health equity has included the use of digital health champions and volunteers. For example, volunteers in Plymouth SeniorNet helped older people get online with impact on their mental health probably through family and social connections. We have tried to promote digital health professionalism among nursing students and for them to become digital health champions supporting, for example, the use of smart speakers in care homes.

The UK still has poor access and use of the medical record directly by patients. Other countries do this better. Studies we completed twenty years ago showed the benefits of using the medical record to tailor and filter information for patients. This is particularly useful for older patients and needs more attention.
Finally, although this is more of a national or supra national issue (e.g. through EU supported ‘Superfast Cornwall’ broadband roll out), ensuring equitable internet access can be addressed (still) through the use of kiosks as well as local hubs including ‘roof top’ local area wifi to help with lack of infrastructure as well as economic barriers.

Emotionally Sensitive Assistive Technology for Ageing

Jesse Hoey
University of Waterloo, Canada

Brief Bio
Dr. Jesse Hoey is a professor in the David R. Cheriton School of Computer Science at the University of Waterloo, where he leads the Computational Health Informatics Laboratory (CHIL). He is a Faculty Affiliate at the Vector Institute, and an affiliate scientist at KITE/TRI, both in Toronto. Dr. Hoey holds a Ph.D degree (2004) in computer science from the University of British Columbia. He has published over one hundred peer reviewed scientific papers. His primary research interest is to understand the nature of human emotional intelligence by attempting to build computational models of some of its core functions, and to apply them in domains with social and economic impact. He is an associate editor for the IEEE Transactions on Affective Computing and an Area Chair for the International Joint Conferences on Artificial Intelligence (IJCAI).

Abstract
Artificial intelligence may hold a key for alleviating the increasing burden of care for persons with age-related cognitive disabilities, such as Alzheimer's disease. While artificially intelligent assistive technologies have been developed, most have not been widely adopted. In this talk, I will discuss computational models of emotions and of emotional identity, and how these models may provide an important (currently missing) component for assistive technologies. I will argue that technologies which are able to align with users on an emotional level will be more readily adopted.