Questions/Answers

The death rate of Thai citizens from non-communicable diseases is as high as 75 percent of all the cases of deaths (or 320,000 patients per annum). In addition, the numbers of the groups of people with high risk and the group of patients are rising consistently. Consequently, work burdens on medical personnel increase. In the overview of the country, the operations to monitor, prevent and control such non-communicable diseases are insufficient to manage the problems and reducing the effects from such non-communicable diseases with sufficient coverage and efficiency. To build awareness and to reduce risk factors are significant means for monitoring, preventing and controlling non-communicable diseases. Thus, this project has the objectives as follows: 1) to study on appropriate factors, technologies and innovations to improve people’s life quality with the system of Internet of Thing (IoT) for relevant health sensors and smart technologies for monitoring and anticipating health conditions of members of the prototype community and to connect health-related information to local hospitals in order to enable the locals to know about their own health data and to raise the awareness and cautiousness to the risk of non-communicable diseases; 2) to build a complete ecological network of the community with the elder with skills of communication and dissemination of knowledge among one another so that they can access, know, and benefit from technologies and innovations; and 3) to set up a prototype city of the complete ecological network of community for ensuring the healthy aging society with the health policies or commercial drove from innovations.

This initiative aligns with the selected category as follows. It delivers inclusive and equitable services for all because this initiative allows people to have more channels to access and learn about their own health data in a consistent manner using health sensors and smart technologies for monitoring and anticipating health statuses in order to generate awareness of risks of non-communicable diseases. The target groups in the early phase were the elder who can access to technologies less than other age groups. This would fill the gap of access to technologies for monitoring health status.

This initiative aligns with the Agendum of Sustainable Development 2030, Target 3: Good Health and Well-being, with the aim of reducing the rate of premature death caused by no-communicable diseases with prevention and treatment. This initiative emphasizes adding more channels in order to enable people to consistently monitor and learn about their own health data by using health sensors and smart technologies that raise awareness of risk factors of non-communicable diseases, as well as providing advice and suggestions of proper behaviors. From the operations, it is discovered that volunteers consume less salt and sodium, have more physical activities, and apply health sensors to reduce high blood pressure and diabetes.

The societal drives that enable this initiative to be applied in a long-run are: 1) the development of a network to disseminate bodies of knowledge of the use of health sensors and smart technologies for monitoring and anticipating health status; and 2) the assignment of governmental agencies such as Ministry of Public Health to drive and extend the initiative in order to set up new policies with regards to monitoring, preventing and controlling non-communicable diseases by allowing people to access and know their own health data in a consistent manner.

Based on the problem of the increasing number of patients of non-communicable diseases, the workloads of medical personnel increase and the operations such as triad and medical service provision are not efficient enough. This initiative will promote the prevention and risk reduction that are primary prevention measures by boosting people’s health literacy through the consistent monitoring and awareness of health data. People’s awareness leads to behavioral changes which will reduce the risk for non-communicable diseases such as lacking of physical activities, high blood pressure and high blood sugar level/diabetes/obesity. Primary prevention reduces the number of patients of non-communicable diseases effectively and sustainably and boosts the effectiveness of public health management in terms of problem management and reduction of effects from non-communicable diseases.

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A target group is a group of 30 elders with chronic diseases such as diabetes (at least one disease); the age of the elders is above 60 years. This initiative has positive impacts toward the target group as follows: 1) the use of salt detector enables the target group to know the level of the salinity of foods they consumed, which leads to the decrease of salt/sodium consumption; 2) the smart wristband enables the target group to know their own behaviors of sleeping and body movements, after the use of which, it was discovered that the target group showed higher tendency to have more physical activities; 3) the monitoring of blood pressure and blood sugar level with blood pressure monitor and smart glucose meter enables the target group to consistently monitor these parameters, making the target group change their behaviors. It is also found that the targets with high blood pressure and high blood sugar level decreased blood pressure and blood sugar levels 3 months after using health sensors to monitor the aforementioned parameters.

The execution of this initiative has begun since September 2017, with the following steps: 1) studying the forms of the needs for technologies (user experience) from the target group, and to select health sensors and smart technologies that fit the target groups before installing health sensors and smart technologies to 30 households; 2) training and demonstrating the use of all equipment and to make user manuals for health sensors and smart technologies in the easy and comprehensible styles, together with the operation team’s fieldwork to meet with each household of the volunteers at least once a week during the first month of the use in order to follow-up and solve problems; and 3) setting up the Internet of Things (IoT) system for the related health sensors and smart technologies to monitor and anticipate the health statuses of the members in the prototype community and to connect health-related information to local hospitals. During the data collection from health sensors and smart technologies, the team has to follow-up and check the data from the databases continuously. If it is discovered that some data are missing, the team will contact the volunteers to ask about the problem that occurred and solve such a problem at the earliest. In addition, the team also visits the volunteers to provide advice to change behaviors in order to reduce risks for non-communicable diseases. Afterward, the evaluation of the outcomes from the study on the health data from health sensors and smart technologies was conducted.

Problems and obstacles found in the operations involved with the building of knowledge and understanding hoof the use of health sensors and smart technologies to monitor health statuses because the elder is not accustomed to the use of technologies and cannot remember how to use them. The solutions are as follows: 1) making user manuals for health sensors and smart technologies in easy and compressible styles; 2) arranging training programs and demonstration on the use of the equipment; and 3) allowing a field team to visit the household of each volunteer at least once a week during the first month of the use of the equipment in order to track and solve problems.

This initiative is a procedural innovation that reduces risk factors for non-communicable diseases using health sensors and smart technologies to monitor and anticipate health statuses, which concurs with the contexts and problems of people’s lacking of health-related knowledge and data such as data of physical activities, consumption of salt/sodium, blood pressure and blood sugar level; therefore, the risk for NCDs disease is high.

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This initiative won the first prize of the IDC SMART CITY ASIA PACIFIC AWARDS and the prize in the category of PUBLIC HEALTH AND SOCIAL SERVICES. The concept for participation in the contest is the integration of operations through the establishment of a system that links all the sectors that are related to the health system with digital technologies. Furthermore, this initiative was exhibited in order to disseminate knowledge in many exhibitions and conferences domestically and internationally, such as, 1) WHO Healthy Cities Conference, Belfast, Northern Ireland, 1-4 October 2018; 2) HIMSS AsiaPac18 Conference & Exhibition, 5-8 November 2018, under the ‘Healthcare anytime anywhere’ theme, Brisbane, Australia; and 3) International Forum on Quality and Safety in Healthcare 2019, Taipei, at Marriott Hotel, between Wednesday 18 - Friday 20 September 2019 , Taiwan. 4) Digital Solutions for Livable Asian Cities Forum, the Asian Development Bank and The Asia Foundation, November 12-14, 2019 San Francisco, USA.

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The budget of 10 million baht was invested for this initiative. The propose of the budget is for research activities from Thailand Science Research and Innovation (TSRI) The budget was granted to Khon Kaen University to purchase health sensors and smart technologies. Human Resources is the research team consisting of researchers with different fields of expertise, from different universities. Khon Kaen Provincial Health Office is in charge of people’s health data while DEPA provides supports in the form of promotion and publicity of the initiative. In addition, many private organizations also assist in installing health sensors and smart technologies.

In the dimension of society, there is synergy from many sectors including public, private and people. This leads to integrated operations that emphasize user-centered problem-solving. In the dimension of policy/management and operation, there are the signature of MOUs and integrated collaboration among Nakhon Khon Kaen Municipality, DEPA, Khon Kaen University and National Health Security Office News Center.

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The evaluation of this research work is an internal evaluation whereby the research team follows-up and evaluates the outcomes from the operations by asking the target group for the opinion through the User Experience Questionnaire directly. There are also the following-up and assessment of health status s of the target group from data attained from health sensors and smart technologies.

Indicators from the User Experience Questionnaire are the opinions in the lowest to the highest level which is related to the usefulness of smart technologies and sensors. As for the evaluation of the health statuses of the target group before and after the use of health sensors and smart technologies, the data are processed with statistical techniques.

The results from the evaluation of data from the User Experience Questionnaire revealed that Smart Wristband is the most useful gadget because it allows the users to recognize the sleeping and body movements, which leads to the motivation to have more body movements. According to the assessment of target group’s health before and after the use of health sensors and smart technologies, it is discovered that the target group with high blood pressure and blood sugar level have decreased blood pressure and blood sugar level after monitoring the parameters with health sensors for 5 months. The decrease of all risk factors for non-communicable diseases is the prevention of NCDs diseases in a sustainable and effective manner and the reduction of death rate from such diseases. Furthermore, if there are continuous collection and storage of health data from health sensors and technologies in the long-run leads to the capability of the model for anticipating health statuses.

This initiative is operated with collaboration from public sectors, private sectors and people. Regarding the public sectors, it consists of the research team with experts in different fields from different universities planning the operations and field works, Khonkaen Provincial Health Office and DEPA serving to promote this initiative. In addition, governmental organizations in Khon Kaen Province have driven this initiative to be included in the strategic plan of Khon Kaen Province, which facilitates the operations. According to the private sectors, private organizations play roles in building the Internet of Things (IoT) system for health sensors and smart technologies. Meanwhile, concerning the people sector, community leaders and volunteers have been very collaborative in this initiative development while the people sector takes important parts in designing this initiative. For instance, the health report form is adjusted to fit each volunteer’s knowledge background so that each volunteer can understand his/her health statuses in the language and form that are easily comprehensible.

This initiative is run with the building of the network of researchers with various fields of expertise and from many universities who brainstormed in the topics that concur with the implementation of technologies to the monitoring of health conditions. Also, governmental agencies granted sources of funds to raise awareness on the importance of the integration of basic research work with applied research work in order to create innovations that meet the needs of Thai society which is rapidly becoming the aging society. Consequently, this initiative has been operated as planned. The operation is well-collaborated by various groups of people including community leaders and volunteers. The field team visits volunteers regularly to ask about information to be used for designing and planning the initiative to meet the needs of real users as much as possible. Also, the team has monitored, solved problems, and provided advice to volunteers. Furthermore, governmental agencies have offered supports, resulting in the connection of health data and local hospitals, and have driven the initiative to be included in the policy and strategic plan of the province.

The main lesson learned from the execution of this initiative is the building of knowledge, and understanding of the use of technologies in the elder is a challenging task that requires perseverance. Therefore, the site implementation requires the knowledge in the target group, so that the research team can understand all the limitations and plan the operation in an effective manner. The future plans to develop the project are: 1) to make this initiative a government’s policy so that it can be applied to the elder who have poverty or who do not have anyone to take care of; and 2) to promote the initiative so that people can have inexpensive health sensors and smart technologies to monitor and anticipate health conditions in a long-run because this platform can be used for people in different age levels.