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This information was published on May 5, 2022.
On the TV show “Malou efter Tio,” they discuss the group known as the “elderly elderly,” which refers to the frailest group of patients with different problems and needs compared to younger individuals. In this context, the role of caregivers becomes particularly crucial.
Dr. Göran Sjönell, a physician, is a guest on the show and discusses this topic.
In order to meet the increased demands on welfare, parts of the healthcare services need to be digitized. Medication robots are highlighted as crucial for improving efficiency and quality. The question is not if, but when the first major steps will be taken in Sweden.
This is the belief of Göran Sjönell, a general practitioner and creator of the medication robot Dosell, as well as Ludvig Arbin, former county councilor in Uppsala County, in a debate article in Offentliga Affärer. Both are board members of the life science company iZafe Group AB.
Here is the full debate article:
Those who understand the value of welfare technology and digital aids in healthcare also know that it is high time to introduce medication robots. They ensure that medications are administered at the right time and dosage, thus reducing the risk of medication errors. In Norway, this understanding has led to a joint procurement by 62 municipalities, showcasing commendable efficiency.
We are growing older. According to Statistics Sweden (SCB), the number of people over 80 years old is expected to increase by 50 percent between 2017 and 2027. Fortunately, the number of healthy life years is also increasing, but so are the needs for medication and care. This creates significant pressure on elderly care, and the risk of medication errors, already at an unacceptable level, increases.
Working smarter
Even with significant financial resources to meet these needs, there are difficulties in recruiting and retaining staff. Thousands of new healthcare assistants and nursing aides are needed every year. That is why the government’s investment in elderly care is an immensely important initiative. However, it is not enough to rely on the same methods as today. We need to work smarter and safer to ensure a secure elderly care system. This is where digitalization and medication robots come into play.
Assisting with medication
A medication robot helps care recipients to take their medications correctly and facilitates patient safety in self-care. The robot dispenses medications in the correct dosage and at the right time, and alerts the user when it is time to take the medications. If the user fails to take the medication, an alarm is sent to healthcare providers and caregivers. This ensures adherence to the prescribed medication regimen.
The Swedish National Board of Health and Welfare’s report “E-health and Welfare Technology in Municipalities 2020” confirms the trends observed in Norway in recent years. To meet the increasing demands on welfare, parts of the services and offerings must be digitalized. Medication robots are highlighted as important for improving efficiency and quality. The question is not if, but when the first major steps will be taken in Sweden.
The importance of human interaction
Welfare technology should not replace the human touch in care. Human interaction is a vital factor in health, especially for lonely elderly individuals. In Norway, the focus is not solely on the most advanced technology but on creating sustainable healthcare and social services. We should use technology and digitalization to enhance safety and free up time for what only we humans can do: take care of each other.
In March, Peter Larsson presented the report “Future Technology in the Service of Care (SOU 2020:14).” It states that digital technology releases resources that can be allocated to tasks that cannot be automated, such as human care. A medication robot allows the time currently spent on home visits to deliver medication to be redirected to visits with more care-related content.
Safer medication administration
The government is investing SEK 430 million in 2020 to strengthen digitalization in healthcare and elderly care. Within elderly care, this includes implementing digital solutions to make medication administration safer. Let us hope that these funds are invested wisely.
Technology that facilitates healthcare and social services is rapidly advancing. Norway has already taken significant steps by conducting a large-scale procurement of medication robots in a short period of time. In Sweden, the state has identified the great potential of welfare technology and allocated funds accordingly. It is now time for municipalities and regions to look west, get off the starting blocks, and realize the future of digitized healthcare and social services.
Göran Sjönell
General Practitioner, creator of the medication robot Dosell
Ludvig Arbin
Former County Councilor in Uppsala County
Both are board members of the life science company iZafe Group AB.
Last week, Socialstyrelsen (the Swedish National Board of Health and Welfare) published an interesting report on e-health and welfare technology in Swedish municipalities in 2020. The report confirms that mobile apps and digital technological solutions have become increasingly common in municipal healthcare. However, in many municipalities, these initiatives are still in the pilot phase.
Click here to access the report: Socialstyrelsen’s report on e-health and welfare technology in municipalities 2020.
Among other things, Socialstyrelsen asked home care services in municipalities about the use of “medical dispensers.”
Medical dispensers are digital aids that remind patients when it’s time to take their medication, dispense the medication, and notify healthcare providers of any deviations. Synonyms for this term include medication dispenser, medication robot, medication reminder, and medication vending machine.
- According to Socialstyrelsen, there are 878 “medical dispensers” in use across municipalities.
- 28 percent of Swedish municipalities use medical dispensers in municipal healthcare.
An excerpt from the report highlights what the interviewees consider most important to invest in regarding digitalization. Several interviewees emphasize the importance of investing in measures that improve the working conditions for staff. This includes:
- Building a digital infrastructure that ensures no employee is excluded.
- Enhancing the competence and thus the confidence of the staff, so that they do not perceive digitalization as a threat. This also enables social workers and service providers to promote positive attitudes towards digital interventions among social service users. Education and skills development are important for both staff and managers to ensure everyone is on board. Another important area mentioned is measures that lead to efficiency gains. This includes:
- Digital medication reminders that provide significant efficiency gains for the municipality and ensure quality for individuals using them.
- Anything that enhances quality and saves human resources, such as the possibility of digital meetings with individuals.
- Removing tasks that do not pertain to the profession, streamlining administration, and eliminating the need for staff to “run around with paperwork.”
- Technical infrastructure, such as Wi-Fi in special accommodations.
- Enabling staff to read and document information in operational systems and other systems while working remotely.
- Enabling home monitoring for regional healthcare services. Home care and the region can share equipment.
Socialstyrelsen notes that the risk of spreading infections can be reduced when healthcare and social care staff use digital technology whenever possible and appropriate. The data collection for this report was conducted in January and February 2020, before COVID-19 became a reality in Sweden.
In recent days, the media has reported on several elderly individuals living in their own homes who, without having any social contact other than with home care personnel, have been affected by COVID-19.
In an article titled “Home Care – a Deadly Trap for the Elderly,” published on April 1, 2020, in Aftonbladet, it is stated that two elderly women in Stockholm, who live in their own homes, have been confirmed as infected. One of the women has passed away, while the other is still at home with a fever, receiving care from home care personnel. In both cases, home care was the only social contact the women had had for at least a week before falling ill.
“Since home care personnel do not use any protective equipment unless the person they are visiting is already sick, and since home care personnel visit many elderly individuals in a single day, an impossible, life-threatening situation is created,” writes Lena Einhorn, virolog and author.
In other words, it is highly likely that both women were infected by the healthcare personnel who assist them – and who daily help many others, some of whom are sick with COVID-19. Just as the elderly are at great risk when receiving home visits, healthcare personnel can also be affected by the virus.
Requesting home care personnel not to work if they have cold symptoms is not considered a sufficient precautionary measure. It should also be noted that coronavirus infection is often asymptomatic, particularly among younger individuals.
Studies highlight the fact that young individuals rarely show symptoms and clarify that transmission can occur even from asymptomatic carriers of the coronavirus (studies cited in my signed op-ed article “Corona can spread even without symptoms” in Aftonbladet on March 25, 2020).
On April 31, 2020, SVT Nyheter published an article titled “Several Cases of Corona within Elderly Care,” stating that several elderly individuals infected with the coronavirus were discovered in Nässjö municipality. All the infected individuals are older persons living in their own homes with the assistance of home care.
“We have had three to four confirmed cases in the last 24 hours,” says Mats Petersson, social services manager.
Inadequate protective equipment puts personnel at risk of spreading the new coronavirus among the elderly and the sick, and of becoming infected themselves. “I am concerned that healthcare personnel will become severely ill or that personnel will die; we are currently witnessing this in Italy,” says Erik Salaneck, infectious disease specialist at Akademiska sjukhuset in Uppsala, in an interview with SVT on March 26, 2020.
Personnel cannot protect themselves or the elderly. However, by implementing the right aids and tools offered by many small businesses, it is possible to prevent the spread of infection and prevent further loss of lives.
In Borlänge municipality, several elderly individuals in care homes, including Hessegården and Kungsljuset, as well as elderly individuals receiving home care, have become infected. One of them passed away on Wednesday.
“It is frightening. Previously, the infection had been at a distance. Now, it is surrounding us,” says Ulrica Green, a home care nurse in Borlänge and union representative for Kommunal, in an interview with Aftonbladet.
In an article titled “Insufficient Protection for the Most Vulnerable: Personnel Infected – Elderly Die,” published in Aftonbladet on March 27, 2020, the unsustainable “personnel carousel” within home care is criticized, along with its increased danger during a pandemic, such as theone we are currently facing. In 2007, an elderly individual receiving home care had contact with twelve different personnel members over a span of two weeks. By 2019, this number had risen to sixteen people, representing a 33 percent increase. Municipalities have been slow to implement digital tools to alleviate the workload on healthcare personnel, resulting in high staff turnover. This is life-threatening for the elderly, especially during a pandemic.
References
Home Care – a Deadly Trap for the Elderly
Several Cases of Corona within Elderly Care
Insufficient Protection for the Most Vulnerable: Personnel Infected – Elderly Die
Stockholm, Sweden and Oslo, Norway – iZafe Group AB (publ.) (NASDAQ First North: IZAFE B) – a leading company in the digitization of medication dispensing, comments on the government’s investment of SEK 430 million in 2020 to strengthen digital healthcare and elderly care. This investment, which includes the implementation of digital solutions to enhance medication intake safety in elderly care, is part of the strategy adopted by the Swedish government and the Swedish Association of Local Authorities and Regions (SKR) in 2016, with the goal of making Sweden a global leader in e-health by 2025.
“The government’s implementation of the largest investment in e-health to date is excellent news for public health. Digital tools can contribute to increased safety and efficiency in healthcare. By digitalizing elderly care with solutions like medication robots and medication reminders, many individuals can continue to live independently at home and lead more fulfilling lives. Moreover, accidents and healthcare-related injuries resulting from medication errors can be avoided, reducing suffering. Digitalizing healthcare means utilizing our collective resources in a smarter way, while also enhancing safety within the healthcare system,” comments Anders Segerström, CEO of iZafe Group AB.
In light of the government’s investment, iZafe highlights its leading position with Dosell, a Swedish-developed and patented medication robot that enhances medication safety and adherence. With a steadily increasing and aging population, longer medication lists, and high demands for user-friendly technology, healthcare must adopt solutions like Dosell to achieve the goals of this investment. iZafe has already started delivering Dosell to 25 Swedish municipalities that have placed orders, and deliveries continue on an ongoing basis. Additionally, there are partner agreements and ongoing pilot projects with leading healthcare providers and distributors in Norway, Finland, Italy, and Germany.
Lund is one of the Swedish municipalities that has successfully implemented Dosell. Nicole Knutsson, district nurse and welfare technology project manager, comments on the current situation:
“Dosell is a fantastic tool for patients who need to improve medication adherence or manage their medication independently. By implementing Dosell in municipalities, patients who require medication in dose packages can continue to live independently and safely without being dependent on or limited to home care services. Dosell relieves healthcare personnel by reducing the scheduling stress of home visits, as visits consisting solely of medication handover can be replaced with more meaningful visits. The government’s current investment is timely and much-needed to maintain high-quality healthcare. We have successfully tested Dosell, and I would like to see multiple machines installed in patients’ homes by the summer,” says Nicole Knutsson.
Dosell delivers the correct medication through dose bags, ensuring that patients receive their medication in the right dosage and reminding them to take it at the right time. The service also informs healthcare personnel and other key individuals, such as relatives, directly if a dose has not been taken for any reason. Healthcare personnel and relatives can remotely monitor medication adherence. The robot dispenses only the intended dose, keeping the remaining doses inaccessible. Medication robots reduce the need for routine medication-related visits and simplify healthcare personnel’s scheduling, thereby improving the quality of home visits.
Some advantages of Dosell compared to other technical solutions include:
- The cost of a Dosell is approximately 60 percent lower than foreign medication robots.
- Attractive contractual conditions.
- Swedish digital technology, design, and production.
- The Dosell app integrates the medication robot with iZafe’s cloud-based solutions.
- Dosell is compact, small, and easily transportable or portable during travel.
- Easy for both patients and responsible healthcare personnel to use and install – Dosell requires no technical expertise.
- It cuts open the dose bag andprepares the medication for the patient.
- Easy integration with existing digital systems and products used in healthcare today.
In summary, Dosell is not just a robot that delivers the right medication to the patient. It also serves as a hub within a digital ecosystem that connects patients, relatives, and caregivers with medication supply. Dosell provides reassurance to all stakeholders by ensuring that the right medication is given in the right dosage, at the right time, and to the right person.
Watch the video clips for more information on how Dosell works.
Multimedication in Sweden is increasing. In 2016, 11.1 percent of Swedes over the age of 75, equivalent to over 95,500 individuals, were prescribed ten or more prescription drugs. This represented an increase of over 9,500 individuals compared to 2014. At the same time, more women than men in the same age group were taking multiple medications – over 59,000 women compared to over 36,000 men in 2016. This is according to new data compiled by the National Board of Health and Welfare on behalf of medical technology company MediRätt.
Nearly half, 48.1 percent or over 415,000, of all Swedes over the age of 75 are prescribed five or more medications. 11.1 percent, equivalent to over 95,500 Swedes in the same age group, are prescribed ten or more medications. This represents an increase of approximately one percentage point in both groups since 2014. Among women over the age of 75, 11.9 percent, equivalent to over 59,000 individuals, were prescribed ten or more medications. This can be compared to 9.9 percent, or over 36,000, of men.
“The fact that more Swedes are being prescribed medication is not inherently negative; it means that more people can treat illnesses and ailments and thus live healthier lives as they age. However, the risk of dosage errors and side effects increases with the number of medications taken concurrently. Therefore, it is important that Swedes have the tools necessary for safe and secure medication administration,” says Göran Sjönell, General Practitioner and founder of MediRätt.
An investigation by the National Board of Health and Welfare reveals that one in ten hospital admissions for individuals over the age of 75 is due to medication side effects, amounting to 35,000 cases per year in Sweden. This raises concerns for relatives and results in significant costs for public healthcare. Each avoided hospitalization leads to savings of SEK 55,330.
“With the right digital solutions for more reliable and error-free medication administration, we can prevent unnecessary and potentially harmful hospital care for healthy seniors. In doing so, we alleviate anxiety for older Swedes and their relatives while freeing up hospital beds, time, and resources for nurses, doctors, and healthcare institutions. This is a highly relevant issue at a time when healthcare is facing significant resource challenges,” says Göran Sjönell.
MediRätt is a Swedish medical technology company that develops digital solutions for safer medication management, including Dosell, a medication dispenser placed in the home. By automatically dispensing medication in dose packets according to the doctor’s prescription, Dosell ensures that the user receives the prescribed medication at the right time. The product is equipped with audio and visual signals that remind the user when it is time to take their medication and can also alert healthcare personnel if necessary. This minimizes the risk of overdosing, taking the wrong combination of medications, or forgetting to take medication altogether. Additionally, if desired, relatives can be informed about the user’s medication intake.
About the survey: The National Board of Health and Welfare, on behalf of MediRätt, collected information from the Swedish Prescribed Drug Register (which contains data on all prescriptions collected at pharmacies) on the number of Swedes prescribed five or more and ten or more medications between 2014 and 2016. The breakdown was done by gender and on a rolling five-year basis for Swedes over 55 years of age. The number of individuals in each age category and gender was then dividedby the population during each respective year.
During the autumn of 2017, clinical tests of Dosell were conducted in collaboration with Apoteket, which yielded successful results. The study compared the storage container Dosett with the dose packaging Apodos and evaluated the practical functionality of iZafe’s digital medication dispenser Dosell. The results of the study confirm the risk of medication errors associated with Dosett and Apodos. The study also identified other shortcomings in existing home dispensing aids – for example, it was found that Dosett boxes were cumbersome and time-consuming for district nurses to handle.
The Dosell medication dispenser functioned flawlessly in 98.5% of cases. The dropouts can be attributed to hardware issues that will be addressed in the production of Dosell. The alarm function performed flawlessly in all tests.
You can read more about the clinical study here.