The nurse is with the patient in her home and she needs physical advice. She hooks up with the physiotherapist on videoconference. This is how a house call to a recently discharged patient can be carried out especially if the patient is referred to the patient-centered health care team at the University Hospital of North Norway.

– Good morning, Erna, it is nice to see you again! How is your shoulder? Can you show me how far you can stretch your arm? Could the nurse lift the iPad a bit so I can see you better?

This unique, interdisciplinary team is responsible for following up patients with chronic and/or complex conditions that are discharged from the hospital.

An entire team in your pocket

The patient-centered team is testing the iPad as a communication tool within the frames of the European project RemoAge.
– Initially, we planned for the iPad to be in the patient’s home, and that she should use it to call us. In the end, this was not how it happened. Many of the patients in this group are both cognitively and physically impaired thus the iPad was too complicated for them. That is why the iPad has become a communication tool mostly between health professionals, says Hege Mathisen, nurse in the patient-centered team.

– I have faced situations alone on house calls where I needed advice from a nurse or maybe the patient needed to talk to a doctor. In these situations, it is brilliant to have the iPad available so that help is just a keystroke away, says Monika Eriksen, physiotherapist of the team.

Invents new uses

The use of iPad has evolved naturally in the team, and the team members have figured out new ways to use it. For example by filming a situation in the patient’s home in order to get advice from colleagues when back in the office.
– This one time, for example, we needed physical advice so we filmed the patient while she walked up the stairs, but did not frame her head so that we would ensure patient privacy.
The physiotherapist made a video explaining how the patient should move not to get hurt, and the nurse who went on house call could show the film.

Elin Breivik, project leader for RemoAge at the Norwegian Centre for E-health Research praises the members of the patient-centered health care team:
– This enthusiastic bunch have found ways to use the iPad that we had not thought of when the project began. The aim of the project is to improve the flow of information and interaction within the team, with external healthcare professionals and patients, and we can already see that this is happening.

The research project Ethical reasoning and considerations in connection with the implementation of digital services in the health and social care in municipalities is conducted within the framework of RemoAge.

Two qualitative studies on health care with digital services are planned in five municipalities participating in RemoAge in northern Sweden.

One study is focusing on the staff perspectives and the other study on care receivers and their family member´s perspective.
Data collection is planned through semistructured diaries, focus group interviews and individual interviews. During week 5, 2016, the first diaries are assigned to local project managers in municipalities for the documentation of ethical reasoning and considerations made in connection with the digital services offered in health care.

Lecturer Britt-Marie Välivaara at Luleå University of Technology is responsible för data collection.

During the Autumn 2015, the project former leader Ingela Johansson has been working as a quality strategist at Luleå municipality, Sweden, but from January 1, 2016, she returns to the Norrbotten County Council.

Her new role at the County Council is business developer and it allows her to work again in the regional RemoAge project in Norrbotten with her colleague Marja-Leena Komulainen at the local authority associations of Norrbotten. They are responsible for leading and coordinating RemoAge in Norrbotten.
– I eagerly look forward to lead the regional RemoAge project and in the future take part of the experience that the introduction of welfare technology provides, says Ingela Johansson.
The Current project leader, Gustav Söderlund, will continue to work in the role of lead partner with the responsibility to lead and coordinate the entire RemoAge project.


Starting October 1st, Gustav Söderlund will take over as the lead partner Project Director from Ingela Johansson, who will move on to a new job in the Luleå Municipality, Norrbotten. Gustav Söderlund works as the E-health Strategic Officer at the Norrbotten County Council, Sweden. He has a background in product design, developing consumer electronic products in Europe and Asia, and holds an MSc in Ergonomic Design Engineering from Luleå University of Technology.

Gustav Söderlund will be responsible for coordination and project management of RemoAges transnational activities and collaboration.

– Even though I have not had an active part in the planning and startup phase of the RemoAge project I have had the opportunity to follow the progress from the inside. Thanks to Ingela and all the other project partners from Norway, Scotland, Shetland Isles, Sweden and Western Isles the project is very well prepared.  I am very excited for this opportunity to be part of this transnational group of specialists that has joined forces to find smart ways of using technology that enable frail older people to live independent and vibrant lives for a longer time.

Gustav Söderberg believes that the situation all our respective regions face today, with aging demographics and limited resources, is not only a problem, but also a fantastic opportunity.

– In the RemoAge project we can take advantage of our collective knowledge and different cultural perspectives, and utilize our creativity, dare ourselves to test unorthodox ideas and in the end, find innovative ways of using technology to enable us to provide quality health care no matter if you live in urban or rural areas.

Northern Europe's rural population is aging. To be able to stay in their homes as long as possible, the healthcare practices has to change. Now a three-year EU project takes on the challenge of finding new working methods supported by technology.

– This is an important project for us, because we have been involved in the process of developing the project. These are areas that are important for the research we conduct, and we have high hopes for the development of knowledge about ethical issues, says Stefan Sävenstedt, professor of nursing at Luleå University of Technology.

Find solutions

The project includes Sweden, Norway, Scotland, the Western Isles and the Shetland Islands. Common to all countries is a population i rural areas that is aging, and together they will find durable solutions for patients, relatives and staff. The focus is multi ill elderly and people with dementia.

– It's easy to get caught up in our own way of working and now we have the opportunity to see how countries with the same problem work and think. Everyone is really committed and there is a lot of knowledge and experience gathered here, says Elaine Mackay from Wester Isle.

All parties met for two intense days in Luleå to get the project running and benefit from each other's experiences. The parties have approached the issue in different ways, thus complementing each other.

Saves social costs

During the project period, personalized tests will be carried out. The expected result is to develop methods to be able to use the technology in health and social care, such as supervision during the day and night, virtual meetings with relatives and doctors, alarm support with GPS function and digital medication management. Also working methods to strengthen the collaboration between municipalities and counties will be developed.

Elin Breivik, Norway, has in previous projects seen similar services save time and travel expenses for medical staff, patient and family members. Also, the meetings tend to be shorter because everyone is better prepared.
– We hope that services in the project can make the patient stay at home as long as possible, thereby delaying a move to nursing home. The society saves enormous costs.


Remoage started May 1, 2015 and will last until the end of April 2018. The project is funded by the European Union within the program for the Northern Periphery and Arctic Programme. The County Council of Norrbotten is the projectleader.

Photo: The RemoAge project consists of seven project partners from Sweden, Norway, Scotland, Western Isle and Shetland Islands. Photo: Erica Lang