Category Archives: Assisted Living

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Digital Engagement and Collaboration

Public Service to be saved by digital engagement?

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Using the Devon Local Authority area and demographic as a model, an assessment of this authorities annual social and economic benefits potential for public service digital engagement with citizens has currently reached a staggering value in excess of £2.4billion.

Realisation of these benefits will require the digital solution implemented achieving a true transformation of the current service delivery model, certainly one that services a more pro-active and well-being orientated approach to health and care requirements.

As the NHS England – Five Year Forward View strategy states “we now want to accelerate this way of working to more of the country, through partnerships of care providers and commissioners in an area (Sustainability and Transformation Partnerships).”

The key opportunity is the education and empowerment of the population through digital engagement solutions, the strategy goes onto offer;

“Working together with patients and the public, NHS commissioners and providers, as well as local authorities and other providers of health and care services, they will gain new powers and freedoms to plan how best to provide care, while taking on new responsibilities for improving the health and wellbeing of the population they cover.”

Critically however, digital engagement cannot only be about the NHS and it’s services, these are in essence after the fact and only engaged when you have a problem, the focus needs to shift to social care, and the up-front engagement that occurs with people with the potential to develop health concerns, the primary deliverable has to be about pro-active engagement that services better and more timely interventions and thus delivery of a wellbeing orientated focus.

Carers and Cross Service Collaboration is Key

Aiming for a family / carer orientated engagement approach at the core of any solution, implemented in a way that facilitates much improved cross service collaboration between public service functions, the Devon social and economic benefits to be obtained across service functions presently assessed at: health and social care unsurprisingly achieving the most significant benefit of circa £2.1bn, followed by Education at £151m, Criminal Justice at £100m and Welfare currently coming in at around £74m. With benefits research still underway it is very likely these values will grown by as much again.

A good proportion of these benefits would involve the realisation of cost savings and efficiency gains within each of these service sectors, and potentially at a scale that would make for a significant contribution on top of current sustainability and transformation plans. Given the maturity that exists in digital engagement technologies widely available today, perhaps the timeframe for achieving delivery of these benefits need not be too far away!

Troubled Families a Key Enabler

Whilst the NHS inevitably addresses requirements for improving use of systems and flow of information through the “Global Digital Exemplar” and further exploration and development of the “New Care Models” working with vanguard organisations and initiatives across the country. The more significant opportunity for transformation to a wellbeing orientated digital engagement approach is perhaps better defined by the Department of Communities and Local Government (DCLG), “Troubled Families” initiative (now in a second phase of delivery).

The fundamental differences between the NHS and DCLG approaches, is that the NHS is mostly geared to addressing issues once they have materialised, whereas local authority Social Care service provision in particular is being guided to becoming more pro-active in its engagement, through aspects such as the “Early Help” services targeted in schools to identify children at early stages of need for support, through to supporting adults to live independently and well.

The case for local authorities being the focal point for digital engagement with citizens is strong when you take into account that it is responsible for other key services that affect an individual’s wellbeing, such as education, housing, inclusivity in forms of transportation and access to digital services and other investments in local infrastructure to improve access to employment, all very significant in terms of servicing positive outcomes for individuals.

When we acknowledge that the issues and challenges the public service faces in trying to meet our needs are seldom caused by one single event or distinct set of parameters. We already acknowledge that deprivation and poverty are key issues affecting health and wellbeing, that poverty is also linked to crime, that mental health issues in adults affects the health and wellbeing of children, but that there is also a growing awareness of a significant gap in mental health support for children directly.

There is in fact a large body of work out there that has looked at cause and effect of different social dynamics and more importantly the benefits potential to be obtained from tackling negative social and wellbeing issues. Whilst some of this work warrants updating the models employed as a means of qualifying social and economic costs and thus potential in benefits remains good for today’s purposes.

Focus for Digitisation Strategy and Plans

The key to the client side digital engagement is to consider what can be utilised quickly to deliver benefits early, essentially adopting an agile and incremental approach to delivery. For example, much focus is being given to making patient medical records available and accessible online, but many struggle to appreciate what value is access to medical records going to achieve?

For those in the population that have an issue or pre-existing condition that perhaps is not being coped with or managed very well, wouldn’t just access to information and guidance that was more focused and capable of empowering the individual, and more importantly their personal care circle of family and friends to care better be a start.

Presently, Carers UK has approximately 6.5million registered carers*, and NHS England have identified 1.4 million unpaired carers providing fifty or more hours of unpaid care per week that they wish to better reach out to with engagement solutions, but are they right, is there only that many that care?

There are in fact over 40 million people aged between 16 and 74 years, many of whom have older parents or children under the age of 16 they care about, isn’t it this whole group that the public service solutions need to be setting themselves up to engage digitally with? We all care don’t we?

Conclusion

There is massive potential for social and economic benefits to be obtained by improved public engagement using digital technologies and tools, from a health, care and wellbeing perspective where services are under immense resource and funding pressures, this engagement and delivery of benefits cannot come too soon.

Critically however, whilst there is investment being made, most of it is presently being targeted at addressing shortcomings in inter-organisation information workflows and operational systems integration, which beneficial and therefore worth doing, but by comparison very little investment is being made on the wider opportunity that is direct digital engagement with citizens.

The key to securing the massive benefits potential that exists can only be achieved with a true citizen centric focus on their needs, and the subsequent servicing of this need with a digital engagement solution that services collaboration between carers, regardless of who these individuals are, or how they are funded, or who they work for.

Equally there is no reason why the solution cannot delivery short to medium term efficiency and cost saving benefits arising from better engagement of those with pre-existing long-term chronic conditions, whilst also and at the same time provide the framework for longer-term benefits from early help and intervention on children and adults with emerging issues. To establish a wellbeing orientation that over time benefits society through pro-active engagement that helps people to maintain healthier lifestyles.

Critically, if we are going to truly transform health, care and wellbeing for all and maximise the benefits to be obtained from a pro-active and wellbeing orientated solution, then maybe we need to move the focus from after the fact NHS and health, to local authorities and social care and what should be a pro-active and universal focus on concerns that have the greatest effect on citizens wellbeing and health!

Then and only then, will we see a transformed service delivering social and economic benefits of the scale mentioned at the outset of this article, which when extended beyond Devon and across the rest of the country would quickly amount to £10’s of billions for the UK economy.

* https://www.carersuk.org/news-and-campaigns/press-releases/facts-and-figures

** https://www.england.nhs.uk/commissioning/comm-carers/carer-facts/


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Ted Talks

How a handful of tech companies control billions of minds every day

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A handful of people working at a handful of tech companies steer the thoughts of billions of people every day, says design thinker Tristan Harris. From Facebook notifications to Snapstreaks to YouTube autoplays, they’re all competing for one thing: your attention. Harris shares how these companies prey on our psychology for their own profit and calls for a design renaissance in which our tech instead encourages us to live out the timeline we want.

 


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Digital Patient Engagement

Digital Patient Engagement or Participation?

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By 2018 patients should have access to their medical records online. By 2020 this should have evolved into a digital patient engagement solution as health and social care achieves “paperless at the point of care” working practices. But is it just about engagement, or should we be preparing more for active participation and ownership of health concerns and issues.

Digital Transformation of Service Delivery

Most concern I have had shared with me is that the NHS 2020 Digital proposals are still not making adequate plans to exploit the opportunity provided by Internet of Things (IoT), Wearables and Assisted Living technologies at the earliest.

The current focus is being given to resolving internal data integration / flow issues which do need resolving. Acknowledging that there are clinical and information governance concerns as well as care benefits needing to be addressed. But whilst these in the main deliver service quality and improved workflow for people already in the system. Their support for delivery of a transformed and more sustainable service delivery model is limited.

Transformation of the service delivery model and improvement in future sustainability of any significance for health and social care, is largely dependent on the digital patient engagement (or better – participation) and capabilities delivered by technology innovation incorporated to support pro-active participation. The opportunity and benefits potential is significant, when the service delivery model evolves from one that is largely re-active and after the fact, to an alternative and more sustainable pro-active and well-being orientated model.

These benefits are only going to be enhanced by any ability to integrate and exploit technology innovations and automation delivered by IoT, wearables, assisted living and health and care / well-being monitoring innovations and solutions. Adoption of these technologies will increase as they become more capable and with this increase the range of proactive information and data supporting opportunities for further cost saving interventions and / or preventions will also increase.

Data Governance and Management

Consequently the long-term objective of any digital health and care engagement solution, should be about providing the means to help us to live well, and if we are unfortunate enough to have one or more long term chronic conditions or disability, to be empowered to manage our situation as much and as well as we can. It is never though just about us and individuals, we pretty much all care for or are cared by somebody else. So we should be able to gain access to others information too.

All of the above inevitably leads to an explosion of information becoming available, and of the most personal and sensitive kind! Consent, data ownership / management quickly become the most important considerations in any engagement solutions design that needs to be open to accommodate future technology innovations delivering on the pro-active health and well-being opportunity.

It is, however, widely acknowledged that local developments and deployments are not being guided by core common engagement and consent model or universal data flow / integration standards, of concern consequently, the progress to a better model of health and care continues to evolve with massive variations in capability delivered differently across regions.

Conclusion

Until the need for core common standards on data consent, governance and interoperability are fully addressed, then the participation of patients and citizens with the digital solutions will likely remain inhibited, subsequently the opportunity to achieve the £20b of universal benefits from a transformed service delivery model by 2020 will very likely remain an elusive and much less assured target that it could otherwise be.

References and Links

Article produced in response to news item Health wearables firm Fitbit holds talks with NHS published by Digital Health


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Cybathlon 2016

Cybathlon 2016

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Cybathlon, the first Olympic Games for bionic athletes was hosted on 8 October 2016, in Kloten, Switzerland. This world premiere saw 74 international disabled athletes – kitted out with bionic prostheses and brain-computer interfaces – compete with each other at the specially created events. These modern-day cyborgs from 25 different countries competed in 59 different teams from all over the world.

The initiative was launched by Robert Riener,  a professor of sensory-motor systems at ETHZ. “One of the goals of the cybathlon is to encourage researchers and developers to work on robotic technologies that can substantially improve daily life for people with disabilities.

ETH Zurich will host the next Cybathlon in May 2020 in Zurich, Switzerland!

The unique competition for people with disabilities will continue!

The six disciplines from 2016; Brain-Computer Interface Race, FES Bike Race, Powered Arm Prosthesis Race, Powered Leg Prosthesis Race, Powered Exoskeleton Race, Powered Wheelchair Race, will remain in the Cybathlon 2020 programme. The tasks will continue to be relevant to everyday life, but will reflect advances in research. The main goal of the Cybathlon 2020 is to push the development of assistive devices for people with disabilities.

Due to the very successful Cybathlon event in 2016 and the feedback received, the Organising Committee plans an even bigger event, breaking it up into two days. There will also be an attractive secondary programme, wherein the visitors can try out the disciplines for themselves (hands-on demos) and understand the issues surrounding disability in a practical way.

 

 


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Smart City

Smart Cities Around the World

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Smart City – Definition

A smart city (also smarter city) uses digital technologies or information and communication technologies (ICT) to enhance quality and performance of urban services, to reduce costs and resource consumption, and to engage more effectively and actively with its citizens. Sectors that have been developing smart city technology include government services, transport and traffic management, energy, health care, water and waste. Smart city applications are developed with the goal of improving the management of urban flows and allowing for real time responses to challenges. A smart city may therefore be more prepared to respond to challenges than one with a simple ‘transactional’ relationship with its citizens. Other terms that have been used for similar concepts include ‘cyberville, ‘digital city’’, ‘electronic communities’, ‘flexicity’, ‘information city’, ‘intelligent city’, ‘knowledge-based city, ‘MESH city’, ‘telecity, ‘teletopia’’, ‘Ubiquitous city’, ‘wired city’.

Source: http://en.wikipedia.org/wiki/Smart_city

Smart City Expo World Congress

The Smart City Expo World Congress is the only international event on the smart cities’ calendar bringing together over 400 cities around the world, more than 200 companies, 400 speakers and the leading institutions and experts in urban transformation.

Event details available here for 2015

You might be interested (and a little surprised) in knowing the extent to which cities around the world are collaborating with the Smart City Expo World Congress.

Its still early days as far as development of smart city innovations go, but if yours is not on the list, you might want to ask the powers that be why it is not? Because given the rate at which things change, now would likely be a good time to jump on board this initiative!

eCulture Observations

Spain and Israel seem to have a fervour to develop their Smart Cities in a very big way, with a great many of these countries cities taking part.

India and notably South American countries Argentina, Mexico and Brazil feature as close runner ups, with the USA and European countries making up others that have a good number of cities engaged, though in some case not as many as you might expect?

The UK seems to have only what might be considered a reasonable rather than exceptional number engaged on this initiative, with notably only one in Scotland and none in Wales or Northern Ireland. My home city of Exeter in Devon is not on the list either, so some lobbying to be done here!!!! Good luck to anybody else who takes up the cause for their home city (or even town).

Cities Involved in 2014

Source: Cities involved in 2014

Algeria Wilayah
Argentina

 

Bahía Blanca, Buenos Aires, Cañada De Gómez, Casilda, Chaco, Chanear Ladeado, Córdoba, Hughes, La Plata, La Rioja, Mendoza, Resistencia, Rosario, San Cristóbal, San Telmo, Santa Fe, Totoras, Tucumán, Vicente López, Villa Cañás
Australia Melbourne, Newcastle, Parkville, Sydney
Austria Grödig, Innsbruck, Vienna
Azerbaijan Baku
Belgium Aalst, Brasschaat, Brussels, Genk, Gent, Gial, Heverlee-Leuven, Knokke-Heist, Kortrijk, Lokeren. Mechelen. Mol
Benin Aguegues
Bosnia Herzegovina Mostar
Brazil Belo Horizonte, Brasilia, Cantagalo, Casimiro De Abreu, Curitiba, Divinopilis, Guaruja, Macaé, Porto Alegre, Resende, Rio Das Ostras, Rio De Janeiro, São Bernardo Do Campo, São João De Miriti, São Paulo, Sete Lagoas, Três Rios, Vitoria
Canada Chambly, Kingston, Montreal, Toronto, Wolfe Island
Chile Santiago De Chile, Villa Alemana
China Beijing, Chongqing, Nanjing, Hong Kong, Qinzhou, Shanghai, Shenzhen, Shijiazhuang
Colombia Barranquilla, Bogotá, Ibague, Manizales, Medellín, Pereira
Congo Kinshasa
Croacia Dubrovnik , Sesvete, Zagreb
Czech Republic Brno, Prague
Denmark Aarhus, Albertslund, Charlottenlund, Copenhagen, Gentofte
Ecuador Durán, Quito, San Gregorio De Portoviejo, Yachay
Equatorial Guinea Malabo
Estonia Tallin, Tartu
Finland Espoo, Helsinki, Mikkeli, Sipoo, Tampere
France Bordeaux, Issy-Les-Moulineaux, Lyon, Nantes, Paris, Perpignan, Roubaix, Toulouse,
Germany Berlin, Bremen, Cologne, Dortmund, Freiburg, Hamburg, Hannover, Oldenburg, Potsdam
Ghana Accra
Greece Igoumenitsa, Larissa, Patras
Guatemala Guatemala
India Ahmedabad, Ajmer, Allahabad, Amritsar, Bhopal, Chandigarh, Delhi, Hyderabad, Jaipur, Mumbai, New Delhi, Pimpri Chinchwad, Pondicherry, Ranchi, Thiruvananthapuram, Vijaywada, Visakhapatnam
Indonesia Banda Aceh City, Jakarta
Iran Bandar Abbas, Esfahan, Teheran
Ireland Dublin, Galway, Naas, Phibsborough, Portlaoise
Israel Alfei Menashe, Ariel, Ashdod, Ashkelon, Bat Yam, Beer Yakov, Bnei Ayish, Bnei Brak, Eilat, Eilot, Gedera, Geva Carmel, Gush Etzion, Haifa, Herzliya, Holon, Hurfeish, Jerusalem, Katzrin, Kfar Saba, Kiryat Arba, Kiryat Gat, Luzit, M- Yehuda, Ma’Ale Edumim, Mateh Yehuda, Modiin, Natanya, Ness Ziona, Netanya, Petach-Tikva, Raanana, Ramat Gan, Ramla, Rehovot, Rishon Lezion, Savyon, Shoham, South Hasharon, Tamar, Tel Aviv, Tel-Mond, Yakum
Italy Amaro, Turin, Gènova, Lecce, Milan, Pordenone, Povo, Rome
Ivory Coast Abidjan
Japan Fukuoka, Kumamoto, Kyoto, Tokyo, Yokohama
Jordania Amman

 

Kazakhstan Astana
Kenya Nairobi
Lebanon Beirut
Latvia Riga

 

Lithuania Kaunas, Vilnius

 

Luxembourg Luxembourg
Malaysia Kuala Lumpur
Malta Malta, Victoria
Mexico Álvaro Obregón, Colima, Guadalajara, México, Puebla, Toluca, Zapopan
Morocco Casablanca
Nepal Kathmandu
Netherlands Alblasserdam, Amersfoort, Amsterdam, Assen, Eindhoven, Eursing, Groningen, Rotterdam, Schiphol, The Hague, Tilburg, Utrecht, Zoetermeer, Zoeterwoude
New Zealand Auckland, Wellington
Nigeria Abeokuta, Isolo, Surulere/Lagos
Norway Asker, Oslo, Stavanger
Panama Panama
Peru Lima, Miraflores
Philippines Manila
Poland Krakow, Warsaw
Portugal Gondomar, Lagoa, Oeiras, Portimão, Porto
Qatar Doha
Romania Bucharest
Russian Federation Moscow, Saint Petersburg
Saudi Arabia Jeddah, Riyadh
Singapore Singapore
Slovenia Ljubljana
Solomon Islands Solomon Islands
South Africa Cape Town
South Korea Daejeon, Seoul, U-Sung
Spain A Coruña, Amposta, Artà, Artesa de Segre, Badalona, Barcelona, Begues, Berga, Cambrils, Castelldefels, Castellón, Cerdanyola Del Vallès, Cornellà De Llobregat, Dénia, Donostia-San Sebastián, Esplugues de lobregat, Figueres, Gavà, Gijón, Girona, Granollers, Jaén, L’Hospitalet de Llobregat, Lliçà d’Amunt, Logroño, Madrid, Málaga, Malgrat de Mar, Manresa, Mataró, Mollet del Vallès, Móstoles, Ordis, Palma de Mallorca, Pamplona, Reus, Rivas Vaciamadrid, Sabadell, Sant Adrià del Besós, Sant Climent de Llobregat, Sant Cugat del Vallès, Sant Esteve Sesrovires, Sant Feliu de Llobregat, Sant Just Desvern, Santander, Santiago De Compostela, Santpedor, Sevilla, Sitges, Tarragona, Terrassa, Valencia, Valladolid, Vic, Vigo, Viladecans, Vitoria-Gasteiz, Zaragoza
Sweden Gothenburg, Kista, Malmö, Lund, Stockholm
Switzerland Geneva, Wallisellen
Taiwan Taipei
Turkey Besiktas, Istanbul
Uganda Kampala
Ukraine Lviv
United Arab Emirates Abu Dhabi, Dubai, Zaabeel
United Kingdom Birmingham, Bristol, Clevedon, Edinburgh, Glasgow, Greenwich, Leeds, Liverpool, London, Manchester, Milton Keynes, Peterborough, Redruth, Southampton, Swindon
United States Boston, Boulder, Charlotte, Denver, Fort Lauderdale, New York, Orlando, Philadelphia, Portland, Raleigh, Redmond, San Francisco, Seattle, Washington, Wayland
Uruguay Montevideo
Venezuela Catia La Mar

 


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Wearable Technology Show

The Wearable Technology Show 2015

In case you missed it – a video on why this is the biggest event for wearable technology anywhere in the world. Filmed over two days in March 2015 at London’s Excel.


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Intelligent Prosthetics and Future Upgrades

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An astonishing story has recently surfaced of technological progress to overcome disability, about a man called Les Baugh who lost both arms in an electrical accident 40 years ago. That with the help of Johns Hopkins University’s Applied Physics Laboratory and DARPA (Defense Advanced Research Projects Agency), has today a significantly reduced level of disability thanks to the development of Modular Prosthetic Limbs

What is astounding in this story is the fact that the intelligent prosthetic arms are able to interpret muscle movement and nerve signals when Baugh thinks about moving his arms, enabling the arms as a result to respond and move accordingly.

“Baugh is the first bilateral shoulder-level amputee to wear two Modular Prosthetic Limbs at once, according to the researchers. He’s spending a lot of time practising different tasks.”

Man and Machine Co-joined

Technological developments in robotics is certainly starting to break down the human (biological) / machine boundaries and certainly, the early beginnings of a whole new dimension in respect of how disabilities may be overcome is opening up.

Maybe I’ll be able to — for once — be able to put change in a pop machine and get the pop out of it,” Baugh said in a video about the breakthrough. “Simple things like that that most people never think of.

Presently he can only use the arms in the lab for now, but someday he will have two of his own.

Looking Ahead

Mike McLoughlin, the program manager at Johns Hopkins

There’s just a tremendous amount of potential ahead of us, and we just started down this road. I think the next five, 10 years are going to bring some really phenomenal advancements.

These new developments in intelligent prosthetics capability offer hope to millions of people struggling with the disability of a missing limb, and this will likely be the focus of developments for this next 10 years that Mike McLoughlin is referring to.

But what about beyond this? It is likely increased capability and improvements in performance, will create the potential for the application of this technology to go further, some people will want upgrades to deficient limbs, and even perhaps will seek to replace perfectly capable limbs with solutions that offer enhancements and improvements, ones that biologically alone cannot be achieved.

This will likely arise from the perspective that those once inhibited by disability, not only have the disability overcome, but that their individual abilities returned, are perceived to have become artificially enhanced. Ironically, in this scenario the tables become turned, in that the able bodied are now perceived to be the disadvantaged.

In a much more simplistic sense we have already born witness to this notion in the great debate that surrounded the discussion following the decision to allow Oscar Pistorius, “the blade runner”, to compete against able bodied athletes at the London Olympics.

Whilst the decision was arguably a triumph for those living with disabilities, Ade Adepitan, who competed in wheelchair basketball and now presents Channel 4’s That Paralympic Show, had more conflicted views when he offered his thoughts to the Guardian Article, suggesting that Pistorius could be a radical role model for disabled athletes, saying:

If he gets into the final it’s going to send shock waves round the world, and if he wins a medal, wow,” picture a double-leg amputee on the podium at the Olympics. What doors would it open up?

What implications does it have? None of us will know until it happens, but that’s the great thing about what Oscar is doing: he’s asking questions.

 In the same article another, as the Guardian author Tim Lewis put it – reliable erudite Roger Black, the UK’s greatest 400m runner, was one of the first to speak out. No scientific consensus, he pointed out, had been reached on whether the blades provided Pistorius with a benefit and until that was clear we did not have the faintest idea whether he was:

an amazing athlete or a very good athlete with an advantage

Black also placed himself in the spikes of an athlete beaten – maybe even to a medal – by Pistorius. Would they think, perhaps even justifiably, that it was unfair?

Upgrade Anyone?

Given human nature being what it is, humans wanting upgrade to overcome limitation of the human condition are an inevitability. A fact already explored by Yuval Noah Harari a historian in his book Sapiens, within which the human race takes on the role as intelligent designer, to surmount evolution by provision of the ability to upgrade ourselves.

Robotics and Bionics

Bionics

The fundamental problem as Hatari sees it is that this upgrade ability will be restricted to the rich, leading in a relatively short space of time to a social inequality of great significance.

Best summed up by the Guardian article, what we are faced with is a revolution already in progress, borne of engineering and exploits mechanical, electronic, chemical and genetic,

In the 20th century, the main task of medicine was to bring everybody to a certain level of health and capability. It was by definition an egalitarian aim,” Harari told the Guardian. “In the 21st century medicine is moving onwards and trying to surpass the norm, to help people live longer, to have stronger memories, to have better control of their emotions. But upgrading like that is not an egalitarian project, it’s an elitist project. No matter what norm you reach, there is always another upgrade which is possible.

The question perhaps, is given the increasing rate of technological advancement, could this next stage of human evolution be a reality within the next 10 years?

Article Links

Man Successfully Controls 2 Prosthetic Arms With Just His Thoughts.

Is it fair for ‘Blade Runner’ Oscar Pistorius to run in London Olympics?

Body upgrades may be nearing reality, but only for the rich


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Health and Social Care Act 2012: fact sheets

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As the new health and social care bill comes to fruition the government has published a updated a series of useful fact sheets that help explain different elements of the reform bill for those interested.

Link to the very useful fact sheets…

 


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