The rapidly aging Dutch baby boom generation threatens to overwhelm the healthcare system in the Netherlands (Hoedeman & Koki, 2020). The elderly, more than any other age group, are more prone to experiencing a steep decline in physical and cognitive health during hospitaliz
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The rapidly aging Dutch baby boom generation threatens to overwhelm the healthcare system in the Netherlands (Hoedeman & Koki, 2020). The elderly, more than any other age group, are more prone to experiencing a steep decline in physical and cognitive health during hospitalization (Brown, 2020; Mathews, Arnold & Epperson, 2014). 61% of the elderly Dutch are unnecessarily admitted to emergency wards (G. de Kousemaeker of Fluent, personal communication, January 16, 2019). Likewise, the elderly, especially those from rural areas, are fueling more than a 50% increase in the number of persons 65+ who require nursing care at a home (CBS, 2019).
A complex network of stakeholders interacts in the healthcare value chain to provide interventions for this vulnerable group. Yet, healthcare providers (HCPs) who collaborate together to diagnose, treat or adjust medications for the elderly are under immense pressure (SCP, 2019a). With its technology-enabled services, DiaMediPort aims to solve the shortages of HCPs by sending triage nurses to the homes of the elderly in distress and by virtually connecting them to general practitioners and medical specialists via information logistics.
The research section of this project highlights the advantages of ensuring person-centered triage care in the Dutch elderly person’s home during the period of 2020. I conducted secondary and primary research (e.g. ethnographies, contextual maps, qualitative interviews) with an elderly couple in their extramural home, informal caregivers, district nurses and elderly care specialists from intramural facilities, ambulance and mobile night teams and elderly call centers.
Five key conclusions are made based on the insights generated on triage moments, information flow, technology and the healthcare value chain.
1) There is an obvious disconnect between the government’s response to the elderly and what the elderly want. The Dutch Minister of Health, Sports and Wellbeing stated the role of each Dutch person is to care for other persons in the community; while the elderly interviewed state that independence is a core value and it must be accounted for during the development of an elderly triage service.
2) Triage moments are a source of needless and redundant suffering for the elderly person who lives in an extramural home. The informal caregiver must communicate with HCPs during these moments so that the decisions made on behalf of the elderly person are dynamic. Although nurses can handle a litany of triage moments, the healthcare system prohibits them from taking action without the supervision of a medical doctor.
3) The mobile night team becomes a part of the traditional medical system. When an informal caregiver or district nurse is unavailable, triage nurses perform unexpected tasks at night.
4) Information flow and open communication reduce the usage of human and financial resources and improve the elderly person’s medical outcomes.
5) The nurses who work at elderly care centers rely on ICT system information. Often the elderly’s digital records and other necessary information are not yet entered or updated. Hence, triage nurses must act in an information vacuum. The appearance and complaints of the person suffering from old age is the only information at their disposal. It is very difficult to read him. Sometimes, he lacks the words to express what is wrong. As a result, nurses cannot make informed medical decisions. DiaMediPort is ideally poised to tackle these issues and concerns. Besides, its services give reassurance to beneficiaries (e.g. elderly person and informal caregiver) and facilitate their independent living at home.
The design section offers 2 tools that I created for DiaMediPort. Their 2 objectives were to 1) visually inform how HCPs and beneficiaries interact within the existing healthcare system and 2) convince HCPs and decision-makers (e.g. insurance providers, hospitals, governmental bodies) to adopt DiaMediPort’s services. The tool Stakeholder Perspectives has two components: 1) “DiaMediPort in Film” presents short films of elderly persons in triage situations; these stories are produced with cartoon cutouts and voice-overs. And 2) “DiaMediPort Platform” will be used in a co-creational workshop. It gives an overview of the DiaMediPort beneficiaries and stakeholders, their social context and how DiaMediPort acts as intermediary. The tool Layered System Overview illustrates the triage phases wherein DiaMediPort is capable of providing services.