FRANCE. Site: Région Pays de la Loire: Centre D Expertise National des Technologies de l Information et de la Communication pour l Autonomie (CENTICH)

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1 FRANCE Site: Région Pays de la Loire: Centre D Expertise National des Technologies de l Information et de la Communication pour l Autonomie (CENTICH) CENTICH is an information and communication technologies national center of expertise for independent living. It brings together research labs, manufacturers, SMEs, as well as user associations in order to accelerate the development and the use of ICT to increase independence among elderly people and people with disabilities. The candidacy submitted by CENTICH is strengthened by the involvement of the gérontopôle of Pays de Loire, a multidisciplinary institution, for autonomy and longevity. Regional House for Autonomy and Longevity and the Living Laboratory «Lena» The Regional House for Autonomy and Longevity is a showcase dedicated to the economic and societal challenges of demographic ageing. It informs and advices through exhibitions, seminars etc about structures and assistive technologies designed to improve the quality of life of the elderly. The living lab Léna provides information and advice on how to adapt one s home with new technologies dedicated to independent living and health. 400 persons a year receive such information and advice. Léna integrates more than 30 technologies dedicated to independent and assisted living and to telehealth ranging from safety tag to ambient or digital equipment for the kitchen monitoring systems. It is partner in a number of European projects that develop, integrate and facilitate access to technologies dedicated to independent living and health. Hearing Impairments and Low Vision Regional Centre The centre offers a new approach that optimises the use of residual functional hearing or vision and the development of other possible substitution sensory capacities and promotes compensation techniques, with the aim of increasing patient s independence and quality of life. It has visits a year, which corresponds to about 600 patients. For further information: 12 European Guide in Excellent innovation for ageing

2 Région Pays de la Loire : CENTICH (Centre d'expertise National des Technologies de l'information et de la Communication pour l'autonomie) Good Practice: Regional House for Autonomy and Longevity and the Living Laboratory (Lena) (GP1) Reference Site : Region Pays de la Loire, FR: CENTICH (Centre d'expertise National des Technologies de l'information et de la Communication pour l'autonomie / Information and Communication Technologies National Center of Expertise for Autonomy) Contact information: Jawad HAJJAM 51, rue du Vallon, Angers, France Jawad.hajjam@centich.fr Short description of your good practice: The Regional House for Autonomy and Longevity (MRAL) is a showcase dedicated to the economic and societal challenges of demographic ageing. It informs and provides advice through exhibitions, seminars etc. about structures and assistive technologies designed to improve the quality of life of the elderly. The living lab (Lena) offers assessment to the elderly on individual basis; it then provides personalized information and advice on how to adapt one s home with new technologies dedicated to independent living and health. 400 persons a year receive such information and advice. "Lena" integrates more than 30 technologies dedicated to independent and assisted living and to telehealth. Partners in the coalition: Lena is managed by CENTICH and the MRAL is managed by the Pays de la Loire Autonomy and Longevity Gerontopole. CENTICH brings together research labs, manufacturers, SMEs and user associations and is managed by the Mutualité Française Anjou Mayenne, which also manages more than 100 health care and social care institutions. The Pays de la Loire Autonomy and Longevity Gerontopole, a multidisciplinary regional institution, is supported by the Pays de la Loire Region and the Pays de la Loire Chamber of Commerce. Start date: Lena was inaugurated in 2012; MRAL will be inaugurated and fully operational in December 2013 Project duration: permanent initiative. How we did it: The good practice was initiated by the CNSA in 2009 during the creation of the Information and Communication Technologies National Center of Expertise for Autonomy. Built and well fitted into the heart of the Innovation district of Nantes, the MRAL was initiated by the Pays de la Loire Region, the hospitals of Nantes and Angers and the regional chamber of commerce. The Léna Living Lab laboratory is supported by the Mutualité Française and the CNSA - National solidarity fund for autonomy. The Regional House for Autonomy and Longevity is supported by the Pays de la Loire Regional Council and implemented by the Gérontopole with a view to reaching regional magnitude and national dissemination. Léna has been designed thanks to the contribution and the expertise of several large companies and SMEs such as Legrand, Btcino, Linak, Wincare, Sarlam, Elderis, Santinel, and a partnership with Cirmad, a real estate developer of the Bouygues group, as well as the contribution of the Angers Hospital as regards cognitive disorders.

3 The MRAL Regional House for Autonomy and Longevity is financially supported by the Pays de la Loire Region and by the partners of the Gérontopole for a global budget of 2 million euros. All the services promoted by MRAL and Léna are supported by national, regional and local funds. the issues related to active ageing, longevity and independent living. It is a meeting place to discuss and exchange between private companies, public research, care workers, teachers, civil servants, associations of elderly people and family carers in order to formulate and to carry out common actions in support of the longevity and the autonomy of the elderly. The Regional House for Autonomy and Longevity is supported by the Pays de la Loire Regional Council and implemented by the Gérontopole with a view to reaching regional magnitude and national dissemination. The «scaling-up» strategy at regional level relies on a series of seminars and events that will be organized at the end of 2013 and beginning of 2014 in order to present the Pays de la Loire Gérontopole and its areas of expertise in research, economic development for companies, training and territory planning thus contributing to disseminating this knowledge in the whole Region. The roll-out of the Léna Lab is already planned for two other locations in the Pays de la Loire region and for at least one other region in France via the Mutualité Française network. Finally, CENTICH is a national center of expertise managed by a bi-departmental union within the National Federation of the Mutualité Française. The Mutualité Française is a key player in the field of health prevention and complementary insurance, gathering 38 millions of French protected via its system but, above all, it is a national network of 2500 non-profit making healthcare and support institutions. Such a tight territorial networking will support the national dissemination thanks to the departmental affiliates of the Mutualité Française. Our results: Coverage: Lena services approx. 10% of the elderly population of the Region, while MRAL addresses the whole population of the Region. - Lena and the MRAL create resources, expertise and means dedicated to ensuring ageing populations remain independent and in good health. - Léna and the MRAL, integrated in the healthcare and social care support system, aim at bringing together the community, the mutual insurance system, the companies and research in order to develop, integrate and ease the access to technologies focused on autonomy and health, while taking into account the quality of use, the universal access and adding the users needs to the economic distribution model, particularly trough the national network of the Mutualité Française. - The House for Longevity will give information and advice through exhibitions, sensorial spaces structures designed to improve the quality of life of the elderly. It provides information to professionals and individuals via conferences, seminars, joint workshops about products and innovative services which help improve the quality of life of the elderly. It provides a collaborative work space, equipment and common tools, training facilities in order to address - Léna welcomes per year more than 400 elderly persons who are losing their autonomy, with their relatives. These people are provided with information, advice and support in the implementation of their compensation plan and in the adaptation of their housing. - So far Lena has integrated more than 30 technologies dedicated to autonomy, remote assistance and telehealth ranging from safety tag to ambient or digital equipment for monitoring systems; - Lena evaluates, develops or integrates, on average, 20 such technologies per year. Page 27 of 181 Added value: - Léna, which is a true Living lab combining the actions of public and private stakeholders, companies, associations and individuals in order to integrate, assess and develop «real life scale» interoperable solutions, services, tools or new uses. - Lena helps research to leave the labs in order to come into the everyday life while keeping a strategic view on the potential uses of such technologies. It sponsors open innovation, networks sharing and users involvement throughout the whole designing process. - It combines business, research and users with the view to integrating and developing interoperable solutions. Success factors: The Léna Lab is considered successful and its roll-out is already planned in two other locations in the Pays de la Loire Region and in at least one other region in France via the Mutualité Française network. The Regional House for Autonomy and Longevity is also considered successful involving as effective and active partners all the concerned organizations in the level of the region of pays de la Loire (universities, SMES, industries, hospital and local and regional administrations). Barriers to innovation: Time, financial and expert resources are significant barriers to innovation. Generally, innovation is seen to be too expensive for businesses or services to get involved in. However, there are cost effective ways to generate new ideas and managers need to look at the potential benefits that come as a result of investing in innovation. For the Lena and MRAL project these barriers can be overcome when projects: - are initiated by public and private organizations - have political support - bring together industry and research organizations

4 - integrate end users in the whole process Lesson learnt and recommendations for others: The strategic approach is based on the users and identifies the objectives of coordination, information to be shared between professionals or with the users and of equal access to autonomy and cares. And this is carried out in order to improve the users care itinerary. This itinerary is defined for one person depending on their given specificity (medical, psychological, social, environmental, etc...), as being one of the possible paths which needs a coordinated action from each stakeholder: prevention, health and social care. The Gérontopole as well as CENTICH within the Mutualité Française Anjou Mayenne bring forward Lena and MRAL as new models of organization of care designed to optimize the care itineraries of elderly people likely to lose their independence in order to support their staying at home, limit their risk of being hospitalized, support and prepare their discharge from hospital and promote the seamless continuation of the various supports related to their healthcare and social care. The success of this best practice is to build a bridge between the needs of the users and the solutions developed by research and industry. More information: Good Practice: Hearing Impairments and Low Vision Regional Centre (GP2) Reference Site : Region Pays de la Loire, FR: CENTICH (Centre d'expertise National des Technologies de l'information et de la Communication pour l'autonomie / Information and Communication Technologies National Center of Expertise for Autonomy) Contact information: Jawad HAJJAM 51, rue du Vallon, Angers, France Jawad.hajjam@centich.fr Short description of your good practice: The centre offers a new approach that optimises the use of residual functional hearing or vision and the development of other possible substitution sensory capacities and promotes compensation techniques, with the aim of increasing patient s independence and quality of life. It has visits a year, which corresponds to about 600 patients. Partners in the coalition: The Centre is managed by CENTICH, which is managed by the Mutualité Française Anjou Mayenne. The centre brings together professionals from both fields of expertise as well as a wider network of stakeholders who complement the services of the Centre. Start date: 2003 Project duration: permanent initiative. How we did it: The project started in 2003 with the creation of the Centre Regional Low Vision in Angers, followed, in 2009, the Centre of Evaluation and rehabilitation of hearing impairment. It was initiated by the Mutualité Française Anjou Mayenne and the Regional Health Agency. Page 28 of 181 The Low Vision and Hearing Impairments Regional Center is fully compatible and coherent with the Pays de la Loire Region healthcare system. The Mutualité Française Anjou Mayenne MFAM, which manages CENTICH, is a forerunner in the creation and

5 development of Hearing Impairments Evaluation and Rehabilitation Centers. Along with its partners, it is a part of the national dissemination process of Regional Centers with a double evaluation and rehabilitation expertise for Low Vision and Hearing Impairments. Funded via an overall allocation from the Health Insurance, the project is based on the Multiannual Contract of Objectives and Means for about 3 million euros per year. The users of the Hearing Impairments and Low Vision Regional Centre are patients and all the costs are covered by the public health insurance. The Hearing Impairments and Low Vision Regional Centre carries out a continuous assessment of the patients quality of life during their rehabilitation process. Three assessment tools of the assistance are implemented: a first global patient-satisfaction questionnaire and two other questionnaires in order to measure the efficiency of the rehabilitation program. These questionnaires are used according to the specific program of each patient before and after the rehabilitation in order to objectively measure the progress: -For low vision: orthopty, Daily Life Independence (D.L.I), locomotion, social worker, psychologist -For hearing impairments: Orthophony/audiology, speech-language therapy and compensation strategy, learning of technical assistance use, social worker and psychologist. A questionnaire before and after the rehabilitation based on the patient s quality of life is carried out with the patient and the psychologist in order to assess the improvements. Two-thirds of patients experience important effects caused by the program they underwent at the Low Vision and Hearing Impairments Regional Center. Our results: The Centre covers more than 10% of the elderly population affected by loss of independence caused by low vision or hearing impairments. The Centre is open throughout the year. It registers more than 3000 visits corresponding to almost 600 patients. The Centre carries out a continuous assessment of the patients quality of life during their rehabilitation process. Two-thirds of the patients experience important effects thanks to the programme they underwent at the Centre. Funded via an overall allocation from the Health Insurance, the project is based on the Multiannual Contract of Objectives and Means. Long term care services and rehabilitation programs cannot exist alone. Indeed, they are part of a larger assistance process (geriatrics, addictions, burns, etc ). They are also part of a network of partners, sometimes a healthcare network, dedicated to guaranteeing patients access to the necessary skills and technical structures and making sure that they are assisted all the way through their usual social, domestic or professional environment. Finally, they carry out initiatives related to research and innovation within their territory in order to develop new technologies and services for the silver economy market. Added value: - There are 11 Low Vision Regional Centres in France, but only 3 regions combine low vision and hearing impairments skills. - A vast number of the elderly are suffering from a double sensory impairment. The Low Vision and Hearing Impairments Centre can provide its patients with the possibility of complementary evaluations and a combined rehabilitation. - Disabilities in both senses can limit the possibilities of using compensation strategies. Only such multidisciplinary team (vision and hearing) can design the most efficient and best adapted rehabilitation possible. Success factors: Sensorial deficiency is a real issue in terms of public health and it therefore seems essential to promote initiatives which give autonomy, quality of life and dignity for all people, and particularly the elderly. Indeed, the aim of the Evaluation and Rehabilitation Center for Hearing Impairments and of the Low Vision Rehabilitation Center is to ensure the autonomy of the persons and to act more efficiently against dependencies which might develop when visual and/or hearing impairments appear. The assessment of the visual and hearing impairments is based on the functional use of residual skills and on the measurement of these disabilities caused by the deficiencies. Only 4 such centers exist in France. The patient can benefit at the same time from the visual and the hearing deficiency expertise and the Low Vision and Hearing Impairments Centers can therefore provide supplementary assessments and an adapted rehabilitation. The rehabilitation project can then be discussed in between both teams of both Centers, thus providing the best adapted and most efficient rehabilitation possible. Both centers welcome more than 800 patients each year and deployment is planned in all the regions of France. Barriers to innovation: The most persistent barrier to innovation is bridging the gap between medico-social and sanitary actors. We first had to model what could be the functional rehabilitation of vision and hearing from a given state. We have complied with the obligation to define the protocols of care, technical platforms, the composition of the interdisciplinary team, to describe the factors of success. The first phase was then to transfer our models Page 29 of 181

6 in three other regions. Then, the intention grew to promote the opening of this type of institution at the national level by creating a transfer of experience, ranging from information and the mobilization of the health professionals and users associations from one territory to the assembling of administrative and technical records. Key data: Transferable elements: - The idea of combining the two disabilities in one centre is very beneficial to the patients. Currently this care is available only in three regions. The ambition is to have national coverage by Lesson learnt and recommendations for others: The development and promotion needs the creation of a Committee of evaluation and national monitoring for: Setting up a "Toolbox" to share between institutions and project leaders developing a sustainable economic model reflecting on a strategy for internal and external communication continuing the overall assessment and proceeding to the impact of the course in rehabilitation for the patient from a tool already developed by the MF Anjou Mayenne More information: Page 30 of 181