TAINAN (Taiwan News) — As the issue of super-aging inevitably looms for the Taiwanese population, a leading hospital in Tainan is building the country's first geriatric facility aimed to mitigate the impact of the crisis while addressing the main challenges faced by the country's single-payer National Health Insurance system.
Construction of the hospital is underway, and services will commence in 2022. A meeting between the National Cheng Kung University (NCKUH) team involved with the project and the country's information and communications technology (ICT) service providers was held on Sunday (Dec. 20) to help foster innovative digital health solutions through win-win partnerships between health and ICT professionals.
To get the desired hardware and software for its cutting-edge healthcare service, the team is proactively seeking partnerships with ICT manufacturers, who will be kept apprised of demands from the health professionals.
"We hope the partnership can help our ICT service providers as well as yield profitable business ideas after they are successfully carried out at the hospital," said Dr. Tsai Yi-shan (蔡依珊), the director of the Clinical Innovation and Research Center at NCKUH.
"The technological change is very fast," Dr. Tsai continued. "We have to prepare for what it would look like two to three years from now when the construction is completed, and we cannot be satisfied with the present technologies."
If the project succeeds, the hospital is expected to change the country's healthcare landscape.
Dilemma of service levels versus costs
Taiwan has been lauded for its affordable, universal health coverage, though there are complaints about the way patients are served as well as waste and inefficiency in healthcare delivery.
In sharp contrast to the high-spending U.S. system, Taiwan's healthcare costs are so low that there are also unwanted results: medication waste, manpower overload, and general inefficiency abound, making patient-oriented care a difficult goal to attain.
Moreover, in Taiwan, the elderly spend a long time on hospital visits due to a complicated appointment scheduling and registration process.
To receive different services for multiple chronic conditions, they can spend an entire day in the hospital. That makes a trip to the doctor a journey filled with depression, anxiety, and exhaustion. It is even more painful for seniors who reside far from a hospital.
A legislator cited statistics that the average visit duration is 3.5 hours for the elderly, with a maximum of 10 hours in some cases. The legislator is calling for the establishment of a senior-focused outpatient healthcare unit in hospitals nationwide and the training of physicians who specialize in geriatric care to address these issues, which will only worsen with coming demographic changes.
Aware of the difficulties the elderly face under the current system, NCKUH Superintendent Shen Meng-ru (沈孟儒) felt an obligation to establish a hospital catering to seniors. The idea and mission began to be realized in 2018 after the government approved the plan.
"The geriatric hospital was developed out of our commitment to social values, despite the astronomical costs," Shen commented. "This new hospital is tasked not only with offering healthcare services with state-of-the-art technologies but with tackling the social impacts associated with the aging of the population," he said.
"Geriatric care is labor-intensive. We need to include different parties in combination with the latest smart technologies to get the service done effectively and accordingly with less manpower," he added.
NCKUH has made extensive use of smart technologies to improve the efficiency of the service. For example, the hospital leverages AI technology by merging big data with cloud computing to enable the immediate interpretation and reporting of chest x-rays and brain CT scans.
AI is there to help physicians quickly and accurately diagnose acute problems and allow them to act speedily. The new hospital for the seniors will keep up the momentum by integrating a wide range of smart technologies to realize Shen's vision.
NCKUH Superintendent Shen Meng-ru (Taiwan News photo)
Taiwan is projected to become a super-aged society where at least 20 percent of the population is 65 or older by 2025. This is due mainly to a falling birth rate, which outpaced the death rate for the first time in 2020, the National Development Council said. The call for a comprehensive reform of geriatric care and health services has never ended.
"We are proactively seeking partnerships with ICT manufacturers to develop hardware and software catering to elderly outpatients and medical professionals as well, making their hospital visits more comfortable and hospital operations less costly," Shen explained. In addition, the new elderly hospital is designed to be patient-oriented, and one major element of the reform is to get an interdisciplinary team at the front office.
Instead of visiting multiple units for treatments, seniors visiting outpatient facilities will first encounter a group of physicians from different fields — radiologists, nurses, pharmacists, and so on — who will work together to provide customized service. The seniors could then be directed to diagnostic, therapeutic, or support services for further care.
The new way it will work is expected to significantly reduce the pain and duration of hospital visits, making services of a kind previously only known to the rich available to the general public.
Service at the new geriatric hospital will not be limited to the facility but will also involve the local community as part of an effort to promote senior health through preventive care and other initiatives.
According to Shen's plan, local communities will be encouraged to connect to different groups to address the needs of the elderly, which include meaningful social life, healthcare, nutrition, and family support. Resources will be significantly invested to help the elderly build up a healthy lifestyle and a virtuous cycle from the hospital, resulting in fewer patients over the long term and better service for everyone.
Dr. Yang Yi-ching (楊宜青), who has been appointed to lead the new hospital, said that the 12-floor facility will have 350 beds and offer therapeutic and support services, including intensive care units, hospice (Anning Ward), and dementia care on the first through ninth floors. A senior care and education center will be set up on the top three floors.
Dr. Yang Yi-ching, superintendent of NCKUH's Geriatric Hospital, poses with the model of the facility. (Taiwan News photo)
Yang said the building was designed by an acclaimed architect and will be built with a sustainable, green design. The aesthetic choices will aim to bring patients hope, comfort, and peace throughout the duration of their visits.
He also talked about a plan to develop a unique healthcare app for the hospital, which will be multilingual to allow foreign caregivers to be involved in the service.
In Sunday's meeting, Su Huey-jen (蘇慧貞), president of National Cheng Kung University, summarized the vision of the hospital in her opening remarks: "We are tasked with the mission to create a new paradigm for geriatric care that channels stakeholders to make it work."