The aging problem has become a global issue, which is driving an increasing demand for long-term care services for the elderly. Care planning, as an essential support to ensure a high standard of safe and responsive care, is therefore drawing attention from academia and health care providers. To handle the increasing care service demand and enhance the care service quality, a support model in care planning is needed to handle episodic visits, to integrate the care plan with all of the relevant data, and to allow all stakeholders to view and contribute to. In this study, the above described supporting model is formulated through a blockchain-internet of things (BIoT) based care planning analytics model (BCPAM). Embedding blockchain into IoT allows collecting patient's data in real time and decentralizing such data in the nursing home network to achieve effective care planning. In addition, such information is further utilized for healthcare analysis to predict the long-term needs of the elderly.
TopIntroduction
Declining fertility rates and longer life expectancies are driving the fast growing elderly population (i.e., those aged 65 or above) compared to other age groups. Globally, the elderly population was 727 million or over in 2020, and it is expected to reach 1.5 billion in 2050 (United Nations, 2020). Population aging is poised to become one of the most significant issues around to world, including in Asian contexts. The expected age profiles of selected Asian economies in 2025 is revealed in figure 1. The aging issues are clearly a pressing problem in Japan, Hong Kong and in Singapore that around 7 to 15 percent of the population is expected to be seventy-five years old or older by 2025. Moreover, in Hong Kong, the elderly population reached 13 percent in 2013, and the numbers are expected to increase to nearly 27 percent by 2033 and nearly 33 percent by 2041 (Loo et al., 2017). This aging population trend puts a lot of pressure on care services providers as the elderly use far more health care services than other age groups. Elderly care is complex as different patients have diverse and unique service profiles. Moreover, the requirements and appropriateness of care services are dynamic as their health deteriorates overtime. This makes the demand for healthcare resources for the elderly relatively ñuctuating. Therefore, maintaining adequate care service quality for the elderly is always a challenge for care service providers.
Figure 1. Age profiles of selected Asian economies, 2025 (Loo et al., 2017)
To ensure a highly responsive and safe health care service, nursing homes should develop individual care planning for fundamental aspects of a patient’s everyday life, such as eating, sleeping, bathing, and dressing (Leopore, et al., 2018). By doing so, nursing homes can set elderly centered goals, develop strategies, outline tasks, and set schedules in order to accomplish the goals. Hence, utilizing care planning can enhance the quality of care for the elderly. However, owing to the absence of adequate and effective healthcare system to meet the soaring aging population with chronic diseases, the healthcare service to the elderly is difficult to manage (Farahani et al., 2018). In the past, the development of electronic health record (EHR) systems provided improvement of data security and user experience in the healthcare sector by enabling care providers to store data and to capture the state of an elderly patient across time (Shahnaz, et al., 2019). Under the increasing demand for care services, EHR systems still face the issue of the security of medical records, user ownership of data and data integrity. Moreover, EHR is not suitable in supporting episodic visits, nor is the idea of integrating the care plan that draws all the relevant data about an individual at any point in time, enabling all care team members to view and contribute (Ciami et al., 2021).