Leocadio Rodríguez Mañas
maintaining and imPrOving the intrinSIc capaciTy Involving primary care and caregiVErs
POSITIVE is a comprehensive system to bring care home by constantly monitoring a patient’s intrinsic capacity and sounding an alarm when a decline in that capacity may indicate the onset of a disease or disability. The system unites a person’s full community of carers, bringing together the patient, caregiver and primary and specialised care professionals.
Extending life expectancy is not as much of a challenge for medical science as it once was. The real challenge with our ageing society is to increase the quality of life of the years to be lived. Preventing disability is crucial to achieve such goal. To do this a paradigm change is needed to shift the focus from disease to capacity, from diagnosing diseases to monitoring trajectories across the course of a person’s life.
POSITIVE is led by SERMAS, through its EIP-AHA reference site (Getafe University Hospital). All partners involved are among the leading institutions in the relevant segments in their countries. They also represent a broad range of European locations: UPM and ATOS in Spain, Karolinska Institut in Sweden and the Medical University of Lodz in Poland.
Using remote monitoring of a person’s intrinsic capacity, POSITIVE provides a technological infrastructure to enable a new organisational model for elderly care – a model that involves all the relevant actors: patient, caregiver and primary and specialised care.
The WHO has defined intrinsic capacity as a composite of all the physical and mental attributes on which an individual can draw, and studies have shown that it is a reliable predictor of a person’s well-being. By monitoring intrinsic capacity, POSITIVE not only provokes a shift in the care setting but also shifts the focus from disease to capacity, from diagnosing diseases to monitoring trajectories across the life course, centring care on the person in an integrated way.
Patients are assessed constantly, and, as needed, a tailored physical activity programme is automatically prescribed to maintain or improve their condition. Caregivers are aware of any decline and can check whether the senior being monitored is alright at any given time. Primary care professionals can process alarms related to dangerous declines of intrinsic capacity and adjust treatments accordingly, with the assistance of a decision support system. As the remote system keeps them in regular contact, primary carers can involve specialised care if needed.
POSITIVE will have positive impacts on patients and their families because it brings management of frailty closer to the elderly, offering specialised and primary care at home. The benefit for patients, and therefore also payers, will be reduced costs: the innovation promises to help patients obtain a 10% reduction in costs related to hospitalisation and emergency and specialised care, as well as a 3% reduction in total health costs annually.
Why this is an EIT Health Project
POSITIVE advances the EIT Health goal of promoting active ageing by monitoring warning signs of frailty and permitting prevention. It directly addresses the EIT Health focus area of “Bringing Care Home”, because it allows carers to constantly check on a person in their home, and also lets them remotely prescribe solutions to changes in the person’s condition.