Executive Summary: City of Côte Saint-Luc, Quebec

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In the face of a rapidly aging population, the City of Côte Saint-Luc will implement a connected framework, leveraging smart devices and related technologies that will empower seniors to: (1) live more safely and independently in their homes; (2) be better connected to their communities and city services; (3) be more socially engaged, improving the overall well-being and quality of life for older adults and reducing stress on families and caregivers, the healthcare system, and long-term care facilities.

THE RIGHT PLACE AT THE RIGHT TIME

Côte Saint-Luc is a city of approximately 34,000 people, of which a third are seniors (age 65+). According to Statistics Canada projections, that proportion represents where Canadian society is heading over the course of the next few decades. Our community, which has been committed to improving the health and well-being of older adults through a variety of programs and services, is therefore the ideal ground upon which to test new initiatives related to aging.

The demographic shift will place an unprecedented strain on the health care system, both in terms of cost and, also, resources. In an effort to adapt to future demographics and improve the continuum of care, new solutions are being explored by the health system that will break down compartmentalization and bring care to where the patient is. Digital health is the future, and the Smart Cities Challenge has presented an opportunity for Côte Saint-Luc to lay the foundation for a partnership that will deliver better patient care to the home. What we have before us is the perfect opportunity, at exactly the right time, in the ideal place.

OUR VISION

The VillAGE Initiative is the future of aging in community. It operates simultaneously in the domains of technology and social transformation, and uses a Design-Thinking approach that continuously engages people and enables us to create appropriate and relevant services that meet the needs of older adults. With a focus on prevention, the Village Initiative is positioned to support the health sector while leveraging the trust and relationships that exist between people and their community.

Participants will have a single entry point, where initial intake and onboarding is done. A professional will make an assessment of his or her need and propose solutions from a menu of interventions or services. These interventions include everything from the installation of technology for safety and convenience in their home, to social prescription, to participation in the VillAGE Community App. Privacy will be a core principle by which the VillAGE Initiative is designed and operated, as will scalability.

The long-term impacts of the VillAGE Initiative will be felt on multiple levels. Older adults will see an increase in their autonomy, and feel more secure living in their homes. Social isolation will be reduced. The families of older adults will gain peace of mind and experience reduced stress. Community capacity, connectedness and wellness will be improved. In the health and social services domain, the timeliness of care will be improved and placement delayed.

GOVERNANCE AND PARTNERSHIPS

In setting up the VillAGE Initiative, we will create a federal non-profit organization (NPO). The decision to establish a NPO with a Governing Board and its own staff, rather than run the program directly through the City was based on many considerations which include: the size of the project, reduced interference from electoral cycles, more flexibility in terms of procurement and labour, and the ability to apply for a variety of grants. The City will, however, maintain some governing   control, with two elected officials on the Governing Board, and approval rights over the budget.

The Governing Board, totalling nine people, will be made up of independent members from a diverse and relevant range of backgrounds. The NPO will be led by a CEO and a Management Team, who will set up and manage the entirety of the VillAGE Initiative. A Technology Partner will act as the CTO and be responsible for the whole of the technology domain, platform development, and related partnerships.

A rich ecosystem of partners, including all levels of government, researchers, health sector representatives, private industry, community groups, and residents will collaborate to address the complex and widespread challenges our society faces related to aging. Côte Saint-Luc will be the epicentre for innovation—a Living Lab where senior health and aging will be studied, and solutions tested with residents, in the real world.

• The City of Côte Saint-Luc will be intimately involved in the development and implementation of the VillAGE Initiative through such means as providing space and in-kind services, co-developing programs, and cross-promotion.
• Our research partners at the Institut universitaire de gériatrie de Montréal and at the Université de Sherbrooke have already helped develop the VillAGE Initiative, and they and other research groups will continue in this role.
• Our health partners at the Ministère de la Santé et des Services sociaux and the CIUSSS West-Central (Regional Health Board) fully support the Initiative and will leverage it to develop their technological roadmaps and further their goals.
• MEDTEQ will support the VillAGE Initiative through in-kind contributions of expertise and funding.
• Other partners will add expertise and collaborate with the VillAGE Initiative in their respective domains.

HOW IT WILL RUN

The VillAGE Initiative was distilled into five main projects, or project categories. Each of these contain several activities. The projects are:

1. Governance and Operations
2. Community Engagement & Social Transformation
3. Platform  Development
4. Service Delivery
5. Sustainability  and Transferability

The short-term outcomes associated with the VillAGE Initiative activities include:

• Awareness of the VillAGE Initiative—measured by the number of people informed about the project through communication efforts;
• Participation in Community Engagement— measured by the number of people who reach out and participate in community Engagement activities;
• Active involvement of community in service design—measured by the number of people engaged in the design and testing of products and services;
• Adoption of Products and Services—measured by the number of people onboarded and who have adopted at least one product or service;
• Participant satisfaction—measured by survey results from participants, stakeholders, and data from the platform.

Mid-term outcomes include:

• Improved digital literacy in older adults;
• Improved safety in the home;
• Improved function and autonomy;
• Improved perception of personal physical and mental well-being;
• Increased social connections;
• Better communications between seniors and their families;
• Reduced mechanical falls and increase in fall efficacy.

The VillAGE Initiative has an implementation plan that dictates the scheduling, sequencing, and dependencies for each activity, their outputs and deliverables, and those responsible for carrying them out. In the first year, a series of plans will be generated that set the foundation for the proper management of the Initiative.

THE TECHNOLOGY

Aging in place technology is the fastest growing sector in the longevity economy. The marketplace is filled with a dizzying array of options that seniors can choose from. During the finalist phase of our project, we consulted with residents to discover their needs, then researched and evaluated a number of solutions that could meet those needs. We created an evaluation criteria, and in the end selected the most suitable technologies to use in our pilot project.

The Pilot Project

The DOMUS (DOMotics at the Université de Sherbrooke) smart home solution was chosen as the main tech tool for the pilot project. Based on open technologies, it consists of small passive sensors, to which we added Amazon's Echo and a floor light path. The Sherbrooke team helped us install the sensors in the homes of pilot participants. We also used the Laipac Look Watch for safety on the go. Our pilot continues until May 2019, but so far, we have gleaned interesting data and will use what we learned to shape our future service delivery.

The VillAGE Platform

The VillAGE Platform will allow seniors to access resources in three categories for help when they need them: convenience, safety, and social connectedness and engagement. The vision and architecture for the Connected Technology Framework is based on the principles of open technologies, great experiences at home and on the go, smart automation, interoperability, and privacy and security.

LISTENING TO OUR COMMUNITY

Community engagement is at the heart of the VillAGE Initiative, and it has shaped every aspect of this Final Proposal. Our research partners at the Université de Montréal and the CIUSSS Centre-West helped us structure our community engagement, which consisted of focus groups, public consultations, and a senior advisory council that consulted the seniors themselves, caregivers, staff who work with seniors, future seniors and the general public.

A Community Engagement Plan set a strategy whereby residents were given opportunities for various levels of participation. We asked about the challenges to aging in place, perceptions of technology, what the City can leverage, and privacy concerns. We informed residents about what we were trying to do, consulted on their needs, consulted on their impression of proposal concepts, collaborated with them, and finally empowered them through inclusion in a pilot project.

For the next phase of the VillAGE Initiative, we will add four principles to our community engagement approach: outreach, participation, user-friendly material, and a Design-Thinking model, which will enable residents to co-design and test products and services. In laying the foundation for a VillAGE Community App, many community-building social innovations will be tested. Other community engagement activities include: pop-up workshops, listening sessions, showcases, interviews, thrivability sessions, and more.

DATA AND PRIVACY

The VillAGE Initiative is deeply committed to implementing the highest standard of privacy and data protection. Sharon Polsky, privacy expert and President of the Privacy and Access Council of Canada, worked with our team to develop measures that will ensure that we depart from a point of Privacy By Design, going beyond the baseline and allowing participants to maintain control over the information. A Data Governance and Privacy Protection Policy will be created at the very beginning of the project.

FINANCIALS

Our Projected Financial Plan reflects the planned funding strategy through which the VillAGE Initiative will be financed. This includes the $10 million start-up fund financed by Infrastructure Canada through 13 milestone payments, and revenue generated from number of sources to ensure sustainability and scalability in the long-term. These include:

• Partner support, most importantly from MEDTEQ and potentially from the Quebec Ministry of Health and Social Services;
• Subsidies, research grants, government grants, foundations;
• Smart device solution sales;
• Fundraising;
• Planned giving and endowment funds;
• Solution support services.

OTHER CONSIDERATIONS

In conjunction with our economic development partners, we will integrate diversity and inclusion into our future project team. We will also further consult with the Indigenous groups in our region and make a strong effort to contact our own local Indigenous population.

In addition, we will ask the provincial government to expand its home adaptation programs to include smart technology devices as part of the program.

CONCLUSION

We believe in the transformational power of the VillAGE Initiative, not just for older adults and their families, but for Canadian society at large. Through a strong governance model, important partnerships, community involvement, technology and social innovation, solid privacy policies and sound management, we will bring the project to life and change the future of aging in community.

Figure 0-1: We conducted more than 15 community engagement events with more than 1,000 residents from November 2018 to January 2019. We also sent letters to 14,000 households with information about the project and an invitation to participate in the public consultations.