This conference was held in a very salubrious conference facility at the LSE on March 24th & 25th. The organiser – Maggie Ellis – delivered her customary eclectic selection of contributors: there was a very broad range, from telecare and telehealth stalwarts through to insurers specialising in the financial issues of older people, management gurus and broadcasters advising on how best to get a story on radio or TV. In short it is like no other, and so has a faithful following among a certain group of assistive technology professionals, many of whom travel from continental Europe and beyond to be there.
Almost no-one talked about proving benefits of assistive technology; the focus was on how best to deliver those benefits that no one doubted were achievable. The highlight for me was a debate I had with Peter Saraga about how quickly technology was likely to be introduced wholesale to assist care delivery in the UK. From his Philips background, he drew the parallel with HDTV for which he said there was a much less compelling business case and more uncertainty of market size than for remote patient monitoring where the cost was reducing rapidly, whilst the cost of the alternative – manual monitoring – was rising as demographic projections became reality.
The consequence he suggested was that there was far more certainty in the transition than there had been for HDTV, and the longer the transition was delayed, the steeper the S-curve would be. This latter led back to a previous TTA post about the choices open to the medical profession, of whether to engage actively in the transition, reducing the slope of the S-curve, or continue believing in the RCGP’s vision of general practice in 2022 where the boldest technological change foreseen is remote delivery of test results. If the latter, then clearly the transition when it happens will be very rapid and turbulent, with the potential for much harm.
(In fairness to the RCGP, it seems that remote delivery of test results is still in the future for some practices – as my local surgery had emailed me recently, I asked them also please to email me the summary results of my recent NHS Health Check, to avoid my spending an afternoon calling the surgery. This was met with a flat refusal with no explanation, however “what i can do is print off these results and leave them in reception for you to collet”. Words fail.)
Another feature of the conference was the comment made by a number of contributors, most notably Professor Heinz Wolff (still wowing us all at the age, he told us, of 86) that care is delivered by hands, not electronics. This is of course true, however, when the technology can assess a patient physically and chemically (and, increasingly, genetically), can access a vast database to diagnose their state of health and determine the best evidence-based care plan, can monitor progress, and can focus care when it is most needed, that will leave those engaged in doing many of these tasks at present with far more time to deliver personal care, and to concentrate on the times when it is most needed. It will also enable mutual care among fellow sufferers too, along the lines of patientslikeme. Except for the very brightest in their fields, it will of course disappoint those for whom practising medicine is more about using their intellect than their bedside manner.
Another point picked up by many presenters was that stigmatisation is still a big issue. People do not want to use products that badge them as old or frail. As the range of products and services available to help older people increases, that they are therefore often unwilling to use, this is becoming a more serious problem. There is an urgent need for a national (or perhaps wider than that) drive to create a more positive image of ageing.
All presentations were of the usual high standard. A few points made by presenters that especially appealed to me were:
- Professor Anne Power from the LSE talked about the importance of a concentrating a high density of older people close to shops and transport links, common in many other EU countries though less so in the UK – under these circumstances it was far easier to support older people remaining happily in the community. The very worse situation was where children had moved out and a spouse had died, leaving one older person alone in a large house.
- Alex Wyke gave a most interesting presentation on My Health Apps. This now covers 375 apps which, though not strictly comparable of course, is nevertheless twice what NHS Choices Apps Library currently covers.
- Gill Whitney from Middlesex University, who has been looking at digital inclusion issues, pointed out that for those who struggle with spelling and grammar are unable to pick up the errors that are the telltale signs of spam and phishing.
- Kevin Doughty reported on an audit of telecare installations that showed that only 30% were correctly assessed – some errors, such as CO detectors installed in houses heated/cooking by electricity only were inexcusable. He explained how local authorities using the Telecare Equipment Prescription Guide (EPG) had reduced average cost by 22% compared to those using the far more restricted listing from a single supplier whose costs had only reduced by 9%. The EPG now covers 66o items. Kevin’s latest acronym in response to Which? reports is the WHAT report, which covers a person’s Wellbeing, Health & Assistive Technology.
- Professor Heinz Wolff made the point that many ‘nearly new’ stairlifts are available on eBay for a small fraction of their original cost because they were installed too late. People should be encouraged to plan for their old age and get used to using kit so they know how to use it and it is there when they need it. He also had a seemingly-ingenious idea for dealing with pills: printing drugs on rice paper with a description. Apparently older people struggle with swallowing many pills and often get confused which to take. Printed drugs would be easier to swallow, and to recognise.
Overall another great EKTG event with plenty to think on.