Elderly Health Information Management System

The core value of the elderly health information management system is to open up the health data islands scattered in community health service centers, elderly care institutions, tertiary hospitals, and family members' mobile terminals, and transform the logic of "passively waiting for the elderly to get sick and seek medical treatment" in the traditional elderly care scenario into a model of "actively predicting risks and preemptively intervening." According to the first batch of smart elderly care pilot implementation data announced by the Ministry of Civil Affairs in 2024, in communities that have maturely operated such systems, the timeliness of emergency medical treatment for disabled and semi-disabled elderly people has increased by 62% on average, chronic disease management compliance has increased by 47%, and the accidental death rate of elderly people living alone has dropped by more than 50%.

Last year, I stayed at the Hangzhou Zhaohui Street Community Elderly Care Service Center for three months to debug the system, and I felt particularly deeply about this. At that time, the center was in charge of 217 elderly people over 80 years old living alone in the area, 124 of whom had basic chronic diseases such as high blood pressure and diabetes. Previously, community doctors visited the homes for follow-up visits once a month. Small symptoms that the elderly people did not take seriously could easily turn into big problems. The one who impressed me the most was 76-year-old Aunt Zhang Guiying. She has a ten-year history of hypertension and her children all work in Shanghai. She was dizzy for a long time and did not dare to tell her children or call the community. In the end, a neighbor downstairs came by and noticed something was wrong and sent her to the doctor, which almost caused a cerebral hemorrhage. Later, the system was implemented and connected to the Bluetooth blood pressure monitor at her home. As long as her measured blood pressure exceeds the 160/90 threshold twice in a row, the system will simultaneously send early warnings to the contracted family doctor, community elderly care specialist, and her daughter’s mobile phone. Last month, her blood pressure soared to 187 when she woke up in the morning. The community doctor knocked on her door within 12 minutes and gave her antihypertensive medication in time, thus avoiding danger.

Interestingly, there have always been two completely different voices in the industry regarding the implementation logic of this type of system. One group is a practitioner of the technology stream. They feel that since it is a smart system, it must collect all data. It is best to equip the elderly’s homes with denomination oximeters, sleep monitoring pads, smart access control and even millimeter wave radars to monitor all health data 24 hours a day to achieve 100% early warning of risks. But the other group of people who provide front-line elderly care services do not see it that way. They think that too many complicated devices will cause a burden to the elderly. I have encountered this before in a private elderly care institution in Suzhou. At the beginning, the elderly were given smart watches with heart rate monitoring, positioning, and alarm functions. As a result, nearly one-third of the elderly refused to wear them in half a month, either because they thought it was too heavy on their wrists, or they thought it was too troublesome to charge every day. Some elderly people felt that wearing a watch looked like they were being monitored, so they just threw it in a drawer.

I was responsible for adjusting the system adaptation plan for that institution. After chatting with the institution's nursing staff for almost a week, I changed the plan: I replaced the smart watch with a micro locator that can be hung on a keychain or sewn into a coat. It can last for 3 months on a single charge. The non-essential heart rate monitoring function was cancelled, and only one-click alarm and positioning were retained.； The bedside warning button was also replaced with a palm-sized red physical button, which does not require Bluetooth connection. Pressing it directly leads to the community duty room. After the change, the device usage rate increased from 32% to 94%. Don't tell me, in many cases the more functions the better, the functions that the elderly can use are the ones that are useful.

Of course, there are many problems with the implementation of this type of system now. Survey data from the National Health Commission in 2023 show that more than 1,700 counties and districts in China have implemented different versions of elderly health information management systems, but less than 30% are truly adapted to the needs of aging, and nearly 40% of the systems have a "data sleeping" problem - that is, a large number of elderly people's health data are collected, but there is no supporting intervention process. No one follows up when the data is abnormal, and finally it becomes a "performance project" to show off. Privacy issues are also a concern for many elderly people. When I promoted it in a community in Ningbo last year, 78-year-old Uncle Wang refused to install it at first, saying he was afraid that his health data would be sold. Later, we showed him the permission settings of the system: he can turn on and off the data upload at any time, and only his contracted family doctor can see the complete health data. Even if his son wants to see it, he has to manually authorize it in the system. He agreed to install it on the same day, and now he often brings his old friend to experience the alarm button on his bedside.

In fact, I have been doing this for almost 5 years, and my deepest feeling is that the elderly health information management system has never been a high-end black technology. It is more like an "invisible escort" squatting beside you. It doesn't have to be smart, and it doesn't have to be in charge of everything. As long as it can remember the blood pressure warning line of the elderly, notify family members and doctors immediately when the elderly fall, and prevent children who are far away from home from getting frightened when they receive a phone call in the middle of the night, it is enough. After all, our original intention of doing this is to make the elderly have fewer surprises and more peace of mind in their later years, right?