Smart and inclusive - A comprehensive ecosystem for digital technology-based elderly care services

Aging is a major global trend of the 21st century. The United Nations recently published World Population Prospects 2022. The report shows that 10% of the world's population are aged 65 and above, and this number will grow to 16% by 2050. East Asia, Japan, South Korea and China have already become so-called aged societies. In particular, Japan has become a super-aged society, where the degree of aging is the highest in the world, and South Korea will also soon become a super-aged society. Considering that these countries all have very low fertility rates and might fall into the Low Fertility Trap, they may have to confront particularly challenging problems involving high degree of aging and rapid paces of aging.

Another major trend in today's global development is scientific and technological progress, especially when it comes to digitization. New technologies like the Internet of Things, Cloud Computing and Artificial Intelligence are developing rapidly. These technologies facilitate the growth of the online economy, digital society, and create new tools and demands for tech-governance. Technological progress and digitization are changing the fabric of our society and economy, and will also significantly affect elderly care and the nature of aged societies.

A smart and inclusive aged society is what we wish for the future, yet we are still a long way from reaching that goal. The transition towards a smart aged society requires continuous investment in the research and development of technologies and in the real-world application of those technologies. A general transformation of our society and economy is in order.

With its roots in the research and development of smart technologies, smart elderly care improves the existing service system, helps match up the supply and demand in the elderly care market, and reconstructs lifestyles in an aging society. A good framework for smart elderly care has five components. Firstly, smart technologies can provide high-quality services for the elderly and satisfy their diverse needs. Secondly, as the technologies serve the elderly, wearable devices and the Internet of Things can collect data on the elderly and their interactions with their surroundings. Thirdly, the collected big data can form a platform on the cloud. The standardization of the data and the construction of data storage infrastructures can help promote the sharing of data between different contexts. Fourthly, data mining, machine learning, model simulations and artificial intelligence can build on the data to improve the development of a smart service system. Finally, we can apply smart elderly care under different scenarios, increase the supply of smart elderly care, and bolster the application of information technology in all stages of the life cycle. Such smart technologies can be used in preventive care, medical treatments, restorative care, nursing and hospice care. By adapting to the lifestyles of the elderly as well as their specific needs, smart technologies can provide variegated, personalized and targeted services.

Scientific and technological innovations can continuously enhance the capabilities of smart elderly care. A smart aged society can keep on making progress thanks to the application of technological innovations like robots, Artificial intelligence, the Internet of Things, genetic technology and human enhancement technology, to make the smart aged reach a higher level.

The transition towards a smart aged society depends on the development and application of smart technologies. This process is not simply a matter of innovation. Research and development in smart technologies, as well as the operation of high-tech platforms, need to occur in tandem with economic and industrial development, with improvements in the social system, and with institutional construction in management capacities. To build a smart aged society, we need to establish and improve an entire ecosystem with technological, economic, social and institutional dimensions.

According to existing estimates, smart health care and elderly care will create an industry of considerable size. This industry involves the production and sales of smart technological products, such as chips, sensors, wearable devices, domestic service robots, etc. The industry also involves the service sector, as in health care services and medical care services. In areas such as pharmaceutical production,medical instruments, biotechnology, as well as health and medicine, smart elderly care will draw financial resources from a large and diverse array of funders to support entrepreneurship. This industry has the potential to become the backbone of a country's economy. We can learn from past episodes of industry growth driven by technological innovations, as in the case of iPhones, WeChat and Alipay. Experience has shown that the development and application of individual technologies, products and services alone cannot change or create lifestyles. Multiple technologies, products and services would need to come together to form an entire industry. We often worry that aging would impede economic growth, but the development of smart health care and elderly care has shown that aging can endogenously increase consumption by the elderly, motivate economic growth and form a new type of demographic dividend.

To build a social service system featuring smart elderly care, smart technologies should be well integrated into different scenarios and concrete social life. Smart elderly care could be used for at-home care, community services and institutional care to better satisfy the specific needs of the elderly. For example, for elderly folks who stay at home within their communities, we can develop smart health care and elderly care that features virtual care centers, as well as remote tele-health services and medical care. We can also conduct household and neighborhood renovations that use smart technologies to make the environment more hospitable to the elderly.

One prominent challenge for the development of smart technologies and the aged society is the digital divide. The digital divide may exclude the elderly, especially the eldest of the elderly, from a digitalized society. It will create new forms of inequalities, impede the transition towards a smart aged society and prevent the elderly from achieving greater wellbeing in digitalization. There are three types of digital divides. Firstly, there is the digital divide between the "haves" and the "have-nots". This is about whether the elderly have access to the Internet and smart devices like smartphones. This divide is clearly affected by social stratification and regional inequalities, and to mend this digital divide, we must see Internet service and other smart infrastructures as public goods. Secondly, there is the digital divide between the "cans" and the "cannots." This divide has to do with whether the elderly know about smart technologies, and we will need to educate the elderly in using digital technologies. Finally, there is the digital divide between "users" and "non-users." Even if elderly people have smartphones, they will not necessarily use smart apps on their devices. This digital divide has to do with whether smart technologies are adapted to the specific needs and habits of the elderly, as well as the elderly's attitudes towards smart technologies. For example, the elderly are less likely to use online taxi services. This may not be because they cannot use the app but because they rarely engage in social activities and do not need the services. The development of inclusive digital technology requires society itself to be inclusive and to include the elderly in economic and social activities. Only then can we generate the need for smart elderly care, and only then can we develop smart technological services to meet those needs.

In addition, a smart aged society is a society where smart technology serves people by meeting the needs of the elderly, and by bolstering social engagement among the elderly. People's lives cannot be controlled by technology and data systems, and technology cannot be allowed to become a force that controls human society.

As smart aged societies develop, institutions must update themselves for digital governance. For example, as we apply smart technologies to elderly care, we collect a large volume of big data on demographic and behavioral information. This creates risks for data security and individual privacy. Without effective institutional oversight and legal protection, fraud and financial harm may result from data breaches. As governments deal with aging through smart elderly care, they need to adopt reforms in public management. To support a smart aging society, the government needs to establish service standards, feedback routines and supervision systems for smart health care and smart elderly care, both in terms of the provision of services and in terms of the operation of the market in the elderly care industry.

Thus, as we transform towards a smart and inclusive aged society, we shall not only actively pursue technological advancement but also direct energy towards innovations in industry norms, in other related institutions and in society as a whole. Again, we need to establish an ecosystem with technological, economic, social and institutional dimensions. Governments, companies, social organizations, research centers, educational institutions, as well as other entities all have a role to play in this process. Only then can we use smart technologies to improve elderly care services and build a smarter, wealthier and livelier aging society.

Since the 2010s, China has started to place emphasis on the integration of the Internet, the Internet of Things and elderly care. In 2017, the Ministry of Industry and Information Technology, the Ministry of Civil Affairs and the National Health Commission jointly embarked on an action plan of Intelligent HelpAge Initiative. The first phase of the program went from 2017 to 2020, and Phase 2 is currently under way from 2021 to 2025. Building upon the concept of Internet Plus and other smart technologies, this initiative has established numerous and various experimental programs and model programs across China. Some of these programs occur in companies, and some involve communal elderly care in neighborhood committees. Some involve the establishment of smart elderly care centers, and some feature the creation of smart elderly care industrial parks.

With these exploratory efforts, China is moving towards a smart aged society. As people take stock of what occurred in these explorations and tackle specific problems that emerge from these trials, knowledge about smart elderly care can spread across society. These efforts can also advance researches and generate new knowledge, as they provide us with data, with research questions and with new demands. Research and application shall follow one another in a virtuous cycle. When it comes to smart elderly care, Japan, South Korea and other countries have accumulated rich experiences in technological innovation, service application and institution building. This means that there are many opportunities for industrial and broader social cooperation between countries. By learning from one another, all countries can benefit as they develop smart technologies for their aging populations.

From a progressive point of view, aging is just a shift in the demographic structure and should not be seen as a crisis. The future of human society will be smarter, more enjoyable and more inclusive. With progress and reforms in our technologies, our economy, our institutions and our society as a whole, we will continue to upgrade the smart aged society as our populations continue aging. All members of society, including the elderly, will benefit from this development.

Ren Yuan, professor at Fudan University's School of Social Development and Public Policy, and senior fellow of Institute of Population Research.

This article is the author's public speech at Jeju Forum for Peace and Prosperity 2022 conference "Trilateral Cooperation for Smart and Inclusive Solutions Towards Age-Friendly Society" symposium held on September 14.

The views don't necessarily reflect those of China Daily.

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