Which place for Artificial Intelligence in the concept of “the nursing home of the future”? Intel@Care project in the region of Nouvelle Aquitaine in France

C. Gayot, Johann Ribet, Justine Trimouillas, Ludovic Micallef, A. Tchalla
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Abstract

While the needs of dependent seniors needs are important in Nursing Home (NH), the medical resources are low in residences located in a medical desert. Access to care in these NH is very unequal and can result in a loss of chance for residents who are immediately transferred to emergency with a risk of iatrogeny or inappropriate hospitalization. Objective: We aim to find new models of care organization to optimize management of elderly in NH thanks to new technologies Artificial Intelligence (AI) associated to telemedicine. Method: Intel@Care is a 3 steps program planned over 5 years : 1- faisability study : Intel@Med-Faisa (2019-2020); 2- proof of concept : Intel@Med-POC with socio-environmental study (2020-2022); 3- efficiency study with medico-economic assessment Intel@Med-Efficiency (2022-2024). Results: Intel@Med-Faisa : 18 residents were included in 2 NHs; 20 additional diagnoses were created to adapt the Artificial Intelligence algorithm to the clinical characteristics of the elderly. Intel@Med-POC: (study in progress): 306 residents to be included to validate development of evidence-based decision tool to help physician to make decisions to manage healthcare interventions, verify the acceptability of the new care organization. A medico-economic study is also conducted. Perspectives : This program aims to secure the use of this tool by professionals and to identify the obstacles and levers about use, perception and find an economic model for the deployment on the territory. In parallel, a clinical research will be conducted in order to adapt this organization to elderly people living at home in medical desert areas.
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人工智能在“未来养老院”的概念中处于什么位置?Intel@Care项目在法国新阿基坦地区
虽然受抚养老年人的需求在养老院(NH)中很重要,但位于医疗沙漠的住宅的医疗资源很低。在这些国家卫生保健机构获得护理的机会非常不平等,可能导致居民失去机会,他们被立即转到急诊室,有医源性或不适当住院的风险。目的:利用人工智能(AI)与远程医疗相结合的新技术,寻找新的护理组织模式来优化NH老年人的管理。方法:Intel@Care是一个为期5年的三步计划:1-可行性研究:Intel@Med-Faisa (2019-2020);2-概念验证:Intel@Med-POC与社会环境研究(2020-2022);3 .效率研究与医学经济评估Intel@Med-Efficiency(2022-2024)。结果:Intel@Med-Faisa: 18名居民被纳入2个NHs;创建了20个附加诊断,以使人工智能算法适应老年人的临床特征。Intel@Med-POC:(研究正在进行中):将包括306名居民,以验证基于证据的决策工具的开发,以帮助医生做出决策,管理保健干预措施,验证新的护理组织的可接受性。还进行了一项医学经济学研究。视角:该项目旨在确保专业人员使用该工具,并确定使用、感知方面的障碍和杠杆,并找到在该地区部署的经济模式。与此同时,将进行一项临床研究,以便使该组织适应生活在医疗沙漠地区家中的老年人。
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