Brain injury research study: progress is ‘ordered, predictable’

This past week, brain injury once again has made sad headlines in the US this weekend with the public suicide of an NFL linebacker, following his murder of the mother of his child. Reportedly, Jovan Belcher of the Kansas City Chiefs had been recently concussed, was on painkillers and had been drinking the prior evening. Thus the release of an academic research study on chronic traumatic encephalopathy (CTE), a progressive disorder that occurs as a consequence of repetitive mild traumatic brain injury such as experienced by contact sport athletes and soldiers, could not be more timely. Published in this month’s Brain: A Journal of Neurology (Oxford Journals), a research team drawn from the Boston VA, Boston University and the Mayo Clinic details the four progressive stages of CTE with symptoms progressing from headache and loss of concentration to dementia, depression, and aggression. This was based on (post-mortem) analysis of 85 brains — 64 athletes and 21 military veterans with a history of repetitive concussions. 68 had CTE and the group also had other neurological diseases. The study was funded by seven organizations, including the VA, the National Institute on Aging–and the NFL. Certainly this will be a key reference in the NFL-funded research being started by the FNIH and the US Army-NFL helmet sensor program to help detect cumulative injury [TA 7 Sept] CTE a Progressive Condition, Brain Study Shows (MedPageToday) The spectrum of disease in chronic traumatic encephalopathy (Brain): Abstract and full study (PDF)

Telecare Soapbox: Why using PIR detectors to check on residents’ well being is profoundly dangerous and misguided

In response to yesterday’s item that included a reference to Contour Housing using a Tunstall PIR system to give an ‘I’m OK’ service, James Batchelor, Chief Executive of Alertacall, sets out why he believes that such a development is a bad move. Just because he has a commercial interest to defend – his company provides well being checks – this does not invalidate his points. If Tunstall, or any other supplier, would like to come back with a response, it will be published.

If you use passive infrared detectors (PIRs) to check on residents’ well being, then be prepared for them to passively kill someone.

With cutbacks to Supporting People funding housing providers are finding themselves in the predicament that they have fewer staff hours available to look after the needs of their sheltered residents. This risks eroding the life-saving daily contact of the ‘traditional’ warden-based morning call, which is time consuming for both the housing provider and its residents.

For decades this daily contact was the backbone of sheltered accommodation, real people checking on other real people. It provided an insight into individual resident’s care needs as they developed.

However, you cannot blame housing providers for (more…)

Who, What, When? The History Project

What Who Designed It Who Did It First Date Evidence Source
First telephonic diagnosis (See comment below) 1879 The Lancet 29 Nov 1879, Page 819
Pendant alarm
Fridge monitor
GPS tracker for people with dementia
Device for asking health questions remotely

Founding of Association of Social Alarm Providers (ASAP) in the UK

1989? TA comment
‘Button and box’ Andrew Dibner Lifeline Inc in the States TA comment
opening of the first 24 hour call monitoring centre Stockport? 1979 TA comment
Alarm protocols from security industry adopted into social alarm systems TA comment
Publication of the ‘Three Generations of Telecare’ model 1996 Journal of Telemedicine and Telecare (JTT)
EXTRA (EXtended Telecare Remote Alarms) Technology in Healthcare (a spin-out from Bangor University) Licensed to Tunstall 1997- 2001 Products granted Millennium Product status in 2000 TA comment
FRED, a smart fall detector Gareth Williams (See EXTRA entry) TA comment
Successful telecare trials for frail older people and for people with dementia Anglesey, Cheshire, County Durham, Northern Ireland and Northamptonshir e 1998 -2001 TA comment
Large scale Opening Doors for Older People trial and roll-out Tunstall-led consortium including Technology in Healthcare, Possum and Motion Media West Lothian 2001-2004 TA comment
Activity monitoring that could be used to detect dangerous behaviour or patterns of activity for assessment purpose Technology in Healthcare’s MIDAS system (subsequently redeveloped by Tunstall as ADLife) Cheshire, County Durham and Londonderry 2001 TA comment
Remote vital signs monitoring (telehealth) RGB systems by Tunstall Carlisle, West Yorkshire and Medway? TA comment
Mobile-phoned based telecare medical alarm Vodafone  2001 TA comment
Safety Confirmation ‘I’m OK Button’ and Pellonia monitoring software. James Batchelor Alertacall 2005  Waybackmachine website sceenshot
ASAP becomes TSA
Telecare Code of Practice published Telecare Services Association (TSA)
Wire-free sleep monitor  University College Dublin  Omron, Japan  May 2012  Press release

KF Congress 2012: reflections on third day, 8 March

the poster session presenters. There were 17 over two days, each constrained to a 3 minute presentation. They therefore made their main points concisely. I observed that having identified themselves in this way there were plenty of people following up with them after the sessions. I had the impression that the other presenters in the parallel breakout sessions, who had 20 minutes to present did slightly less well but that is based on the small sample I attended.

There must be a version of Parkinson’s Law that states that ‘Presentations expand to fill the time allotted to them (and then some)’.

Poster sessions that got a special mention from Nick Goodwin, the Congress Chair (who also gets a thumbs up for his hard work), were the session on the Israel-wide EHR system by Orit Jacobson, the ‘TalkMeHome’ service for people with early dementia (Netherlands) and ‘Memory and Memories’ (Digital PhotoFrame Therapy, UK).

Keeping the best for last kept most of the attendees at the conference to the end: Magdalene Rosenmöller from IESE Business School, Barcelona and Adam Darkins, from the UD Dept. of Veterans Affairs (VA); the whole topped with a ringing speech from Jeremy Hughes of the UK’s Alzheimer’s Society.

Dr Rosenmöller gave a fast helicopter flight over much of the telehealth (in its broadest sense) landscape, while Dr Darkins showed why he has done so well since joining the VA: his style is visionary but clear, broad in scope but illustrated with relevant detail. Most refreshingly amongst the tidal wave of research data presented these past three days, his data are drawn from the VA’s management reports. Oh, the credibility that gives! It is a session to watch again if you missed it.

Alzheimer’s telecare project interim evaluation results (video)

30 minute presentation by Sarah Delaney, of the Work Research Centre, delivered to the Technology and Dementia Seminar, School of Social Work and Social Policy, Trinity College Dublin in November 2010 – but just posted by the University on YouTube – about the results of the Alzheimer’s Society’s survey of carers. Telecare Project Interim Evaluation Results.

Content: 10/10. Unmissable if you are interested in telecare with people with dementia, especially the ‘Food for Thought’ section starting around 20 mins. General non-UK readers will be interested too in the definition of ‘telecare’ around the 2 min mark.
Presentation: 1/10. Well organised and good to listen to, but the bullet-ridden, text-heavy slides are the kind that have (unfairly) got PowerPoint its bad reputation.

TSA 2010: A request, and reflections on the conference

This report is brought to you with the support of the Telecare Services Association (accommodation) and Tynetec (travel)
By concentrating on reporting from the exhibition floor on Tuesday and Wednesday I [editor Steve Hards] had some interesting conversations in addition to the published snippets, and these will inform commentary on future developments – just as my observation about Bosch in the UK triggered further observations about Bosch in the US from N. Americas editor, Donna Cusano.

I hope that spending my time like that will turn out to be more useful to Telecare Aware readers than reporting from the plenary and workshop sessions that I was therefore unable to attend. However, to give a flavour of what those covered, there is a list below.

Request

My request is to any readers who attended any of the sessions listed and who thought that particular speakers or topics were significant. Please let me know by email and I will try to contact the speakers to ask if they will produce a short piece for Telecare Aware.

Alternatively, if you have notes you’d like to share, do send them over.

(I did attend one plenary session on Tuesday afternoon. It was the presentation given by ex-NHS North Yorkshire and Yorks and ex-strategic health authority Regional Telehealth Lead, Paul Rice. I went in the vain hope that as he holds a doctorate in law and medical ethics he might have addressed some of the matters raised on this site around the NHS NYY project commissioning. However, it was a totally predictable, totally bland presentation of the type that unfairly gets PowerPoint a bad name. If any readers have experienced one of those moments when you suddenly-focus-and-realise-that-you-had-drifted-off-with-your-thoughts-and-you-wonder-if-it-was-actually-the-sound-of-your-own-snoring-that-woke-you-up, then you will forgive me if I use this commentary to say ‘sorry’ if I disturbed people around me.)

Reflections

There are a few things I’d like to say after a day’s reflection. First, the very small TSA team that put this together are to be congratulated on another large but, as far as I could see, smoothly run event. Second, the choice of Roy Lilley as Conference Chair (moderator for all the plenary sessions) hit just the right note. His style is not to everyone’s taste, but he was approachable and you could never ignore what he was saying. In a year when one could have expected the attendees to lapse into a state of collective doom and gloom – and have forgiven them for it – he was surely part of the reason the event stayed so upbeat.

Last year, the TSA was signalling that telehealth is going to be a significant topic for its members. This year the content, which should be giving telecare services much to think about, was almost all telehealth oriented. Next year, if it wants to keep up the exhibitor numbers, the TSA needs to bring in an audience that has a much higher proportion of NHS staff of all kinds, to get the message across to them.

Did the event tell us something about the state of telecare and telehealth in the UK? Clearly, the supplier companies are ready and waiting for the anticipated boom in demand, but the timing of that depends on many factors – political, cultural and informational – that are outside their control. There were pleas from a number of quarters, including the conference chair, for suppliers to be more active in marketing directly to the public. However, companies that have tried it find it extremely difficult. The message is not the problem but the cost of acquiring a customer is so high that it kills the business model, whereas having health and social care professionals doing the ‘selling’ to clients is cost effective despite the other problems it brings.

It was great to see a number of newly designed pieces of equipment breaking out of the forms we have become used to. Chief amongst those was Tynetec’s Reach and Touch hub devices of which one frequently heard “I wouldn’t mind that in my own home!” One could write an essay on that response, which is significant on many levels. (See comment, too.) Smaller, lighter, sleeker, easier is clearly the way to go, but suppliers and customers are, of course, looking over their shoulder at the fast-approaching rise in the numbers of smartphones that will soon be in the hands of the end users and are considering how long a future standalone devices have.

The big companies with deep pockets can afford to play a waiting game until the market and the technology trends clarify, perhaps in a year or two. Will the smaller companies be able to survive? Or will we look back later and say they played a role of softening up the market and getting the learning done before they disappeared? That would be a pity, but their boards are surely thinking about merger or other exit strategies. Aren’t they?

List of presentations I missed (see ‘Request’ above)

  • Key issues driving change: Trevor Single
  • Fiona Philips talking about her family’s experience of dementia
  • Making change happen [in dementia care, presumably]: Prof. June Andrews
  • Strategic health authority plans for a telehealth service to support the QIPP agenda: Dr Paul Rice [See above]
  • Interoperability – the driver for consumer health in Europe: Dr Petra Wilson
  • The ethics of telecare: Jennifer Francis
  • Prevention is better than cure – a security perspective: Mick Reynolds
  • Guest motivational speaker: Dame Stella Rimington

List of workshops I missed (see ‘Request’ above)

  • Managing EU funded projects – Soprano Project
  • Lighting at home to help older people and others with sight loss
  • Supporting dignity, independence and well being through telecare technology
  • Can telecare predict recurrent urinary tract infection?
  • Multi award winning low cost telehealth innovation by the NHS for the NHS
  • How can a sceptical, busy GP be convinced?
  • What if? [Disaster recovery plans]
  • Pathway to TSA accreditation
  • Delivering on telehealth
  • Digital connectivity with IP technology
  • Sustainability and bringing healthcare closer to home
  • Telecare and the personalisation agenda
  • Listening to people with dementia getting out and about
  • Usability is not an option
  • Integrated working: Patients and partnerships in telehealth
  • Me’n’Him Teleheath
  • Developing and implementing a telehealth project – learning the lessons
  • Healthy Outlook health forecasting service for COPD
  • Telehealth services for patients with long term conditions
  • When the inspector calls!
  • Tone of voice: saying it like it is
  • Supporting independence – telecare for people with a learning disability
  • Ethics and telecare
  • Set them free – Impact m-Care

Telecare Services Association Conference Wed 18 Nov 2009

November 16-18, 2009

Hilton London Metropole, W2 1JU

The cost of providing you with these reports has been supported by the conference organisers and
Home Telehealth Limited (UK)

home telehealth limited

Quick links to workshop reports, below:
Developing a telehealth service
Tellycare – delivering telecare and telehealth via TV
Protocols – from vision to reality
Safe at Home: Mental Health Intermediate care
Telecare assessment

Wednesday 18 November

Today’s contrast: Motivation and Motivational

This morning’s programme was relatively lightweight, much to the relief of a number of attendees, I suspect. First there was a chance to catch another workshop, then some last-minute calls to exhibition stands, followed by the mystery ‘motivational speaker’.

Although the attendee numbers were down on the previous days, there was no discernible lack of motivation amongst the people thronging the workshops and the exhibition. The ‘motivational speaker’ turned out to be Sir Ranulph Fiennes who talked about the nature of personal motivation with many humourous examples from his personal life and then went on to give some insight into what went into a couple of his amazing expeditions. He charmed everyone by downplaying the awfulness of the situations he found himself in and by letting his photos hint at that aspect. [Notes to self: a) Never volunteer for an expedition anywhere cold – more agony than ecstasy! b) Donate to his charity efforts when the opportunities arise.]

And the winners are…

tynetec winners

Alyson Bell, TSA Director, averts her eyes as she pulls out the name of Tynetec’s 30th birthday draw winners, who are:

1. Lynda East (Enhanceable) Wii Fit
2. Loraine Simpson (New Progress HA) IPOD Nano
3. Helen Gillivan (London Borough of Bromley) Champagne
4. Charlotte Walton (Cheshire West & Chester Council) Red Wine
5. Allyson McLeod-Hardy (Your Homes Newcastle) White Wine
6. Lesley Thomas (Salford City Council) Chocolates


Workshop reports


Workshop: DEVELOPING A TELEHEALTH SERVICE

Tuesday afternoon. Reporter: PAUL MITCHELL, Independent Consultant

This mega-workshop built on the plenary session presentation earlier in the day from Dr Janice E Knoefel on Managing Chronic Medical Conditions by Telehealth amongst New Mexico veterans.

Professor Russell Jones of Brunel University chaired the workshop with considerable panache and vigour, but the star of the show was supposed to be the technology.

First up, Professor James Barlow of Imperial College, dealt with emerging evidence from pilots and research into the efficacy of telehealth, or what he termed ‘Remote Care’ in patients’ own homes. He lamented the huge volume of pilots worldwide (over 9,000) but the lack of mainstreaming of remote care. He acknowledged some small pockets of excellence, but observed that they tended not to spread into general practice. He diagnosed some barriers to progression into mainstream healthcare, which included:

  • A lack of integration between partners
  • The absence of obvious business cases for investment
  • Evaluations which were not sufficiently robust
  • PCTs which have switched resources away from special programmes to fund deficits elsewhere
  • Support for individual applications of telehealth but a lack of systemic adoption

He finished with a plea to change the system now to mainstream remote care.

Next up was Angela Single of Choose Independence consultancy, speaking about the nurse-led programme of health monitoring in South East Essex using community matrons in the absence of GPs’ willingness to get involved. In effect, the nurses decided to go it alone. They have so far achieved 80 cases of patient monitoring at home within four months of initial programme deployment. This involved developing robust systems and procedures for rapid procurement and deployment of telehealth equipment with full nurse support. Using a call centre setting to monitor health lifesigns data has forced the development of systems in ways for which they had not been designed. Most importantly, the programme has challenged traditional practices such as routine visiting and monitoring of patients. Patients are prioritised for attention, not necessarily involving physical visits, on the basis of triage. The procedures remain flexible to adapt to changing circumstances, such as accommodating delays by some patients in administering their medicine and measuring their personal health data in cold weather.

This was followed by Pam Bradbury and Dr Nicholas Robinson of NHS Direct. Their theme was telecoaching in Birmingham East and North PCT area by Pfizer Health Solutions, the PCT, and NHS Direct. Each partner has a well defined role to perform in this model of community-based health care, which has been integrated with the PCT’s model of delivery to patients with long term conditions. It includes a telephone-based care management process, with phone consultations that can last up to half an hour. There is a field team of 38 whole time equivalents composed of a mix of health coaches and nurses, supporting 4,800 patients.

The levels of discovery from this telehealth approach are said to be considerable. Results include a 48% reduction in hospital admissions and 53% fewer visits to A&E in this patient group.

Dr Mike Short, vice president of R&D at Telefonica Europe focused his presentation on challenging the trend of proliferating data hubs in the home. These could soon include dedicated hubs for telehealth, games consoles (e.g. Wii), broadband wi-fi, and smart utilities meters. He sketched a connected world in which, by 2013, there may be more mobile phones in the world than people; who have readily taken up new information and communications media such as Google, Facebook, and Twitter. He also reported a prediction that e-Health spend in Europe will double to 50 billion euros by 2010. Against this backdrop of exponential growth of information hubs in the home, he dangled the unspoken question of why we needed to introduce new dedicated health systems into the home when we already have all this other technology at our disposal which can be adapted for that purpose?

The final presentation was from Dr Justin M Whatling, Chief Clinical Officer for BT Health. He revisited the barriers to mainstreaming telehealth posited at the start by Professor James Barlow, and added some more:

  • A care model trapped in servicing high cost patients with existing conditions, rather than prevention
  • Silo budgets and services
  • Lack of organisational capacity and willingness
  • No clear agency to take the lead

He then observed a perception of less value for money as telehealth systems become more complex and costly. Customers for telehealth, he thought, are oriented to buying devices rather than services and outcomes. Suppliers are reinventing the wheel with competing systems which are not integrated into mainstream healthcare. He also noted the proliferation of closed systems and software, which leads to organisations being locked into particular devices and a lack of choice. This has particularly affected the ability of SMEs to compete in this market.

Would there be more take-up if costs were lower? Your correspondent pondered where all this was leading. The solution, it seems, is achieving economies of scale and re-using sunk costs in existing investments. These include existing IT systems under the NPfIT programme, out of hours services, and consumers/patients’ own investments in mobile phones, televisions, etc. Again, the unspoken question was being asked: are dedicated home health hubs necessary?

In conclusion, the presentations seemed to express confidence that some new models of service have got it right in establishing new ways of working in supporting patients at home, but doubted the wisdom of investments in dedicated health hub systems. These new models of patient support are up and working now, but the prospect of few or single multi-purpose information hubs in the home seem tantalisingly just out of reach in a possible future.


Workshop: TELLYCARE – DELIVERING TELECARE AND TELEHEALTH VIA TV

Tuesday afternoon, covering ‘Looking Local’ TV service from Kirklees Council. Reporter Steve Hards

Actually, it’s only ‘telecare and telehealth’ if you work with a very broad definition, i.e. giving localised health information via a dedicated channel on people’s TVs. However, the approach is interesting in that the channel can be delivered via a number of means: dedicated set top box; Sky box; Wii interface; Virgin cable.

The principle is simple. For a £12,000 annual licence (plus £3,000 content bureau cost if required) a provider council is set up with a basic ‘starter kit’ set up. There are various plugins that can be added, such as one that feeds local bus times; a jobs feed from JobCentrePlus; Council Tax payments; doctor appointments and repeat prescriptions.

More information: http://www.lookinglocal.gov.uk

There are 89 councils currently using the service. One workshop attendee made the point that many telecare customers are being discouraged by councils from taking up Sky and Virgin cable services owing to their incompatibility with their telecare equipment.


Workshop: PROTOCOLS – FROM VISION TO REALITY
Reporter Steve Hards

Mike Piggott, Project manager BT, started by talking about the 21CN rollout and refinements introduced as a result of their pilot experience and working with TSA. One key point is that there have been no issues for telecare providers where they have been prepared. BT expects the change to be complete in 2011. Some devices – mostly over 8 years old – do not work well owing to transmission delays. There are published results for 159 devices: http://www.switchedonuk.org. (Ambers = partial fails – talk to the manufacturers re the level of risk.) Lots of info re the migration on the site, additional queries can be sent to cpe21@bt.com.

Dave Foster, Commercial Director, Tynetec. The potential for system failure increases with complexity of the call routing, and telecare alarm calls are typically complex routes owing to the use of non-geographical (0800) numbers. Some non-BT digital network providers exclude reliable social operation on their networks… a user’s change of telecoms provider may put the operation of their system at risk.The new British standard BS8521 (pubished May 2009) defines the telecare protocols (the identifying signals generated by devices). The standard will facilitate interoperability between manufacturers and has some built in futureproofing. So any unit meeting this standard will communicate with the software of any monitoring centre that also complies. It’s an analogue protocol and a digital ‘IP’ protocol is in development.

Use of broadband opens up many greater possibilities for interactive monitoring communications but, of course, it will take quite some time to become universal.

Charles Henderson, consultant for TSA. Future consumers will demand telecare that is totally interoperable, flexible and cheap. UK providers have to work in the global context – Continua Alliance (not an open standards organisation), etc. And this has to be done in the context of providers’ delivery and installation processes. Who is going to arbitrate? The technology is the tip of the iceberg.

Conclusions

  • It’s not just about 21CN, but ‘Next Generation Networks’.
  • Manufacturers will not be able to cope to deliver new, standard-compliant devices if service providers wait until the last minute to update.
  • Current, IP-based systems may not comply with future IP protocols but standard-compliant analogue devices will continue to work over digital networks.

Workshop: SAFE AT HOME: Mental Health Intermediate Care, Herefordshire
Presenters: Andrew Morris, Integrated Commissioning; Cheryl Poole, Older People’s Mental Health Services; Jodie Thomas, Care Facilitator, Specialist Intermediate Care.
Reporter: PAUL MITCHELL, Independent Consultant

This joint initiative between the PCT and Council targeted people at home with dementia. Domiciliary care services in 2007 had lacked the skills to support people with dementia, and care packages were continually breaking down, resulting in admissions to institutional care. The solution was a partnership specialist intermediate care service which commissioned home support from specially trained domiciliary care staff (Sure Care).

The carer teams support individuals to regain or maintain their skills, but can intervene when risk levels rise to help prevent or manage a crisis. Using ‘Just Checking’ technology to track the patient’s movements around their home (motion sensors in rooms), roving night teams can access Just Checking reports on smart phones whilst on the move, and respond to alerts during a crisis. The presenters were keen to emphasise the collaborative approach with the care provider, whose staff are trained to help them to understand dementia and how to support individuals with such conditions.

A group of users were tracked for 12 months to dispel the myth, then prevalent amongst carers, that people with dementia cannot learn to manage their conditions.

  • 78% of the group were still living in the community after 6 months (57% at 12 months).
  • Only 5% needed 24 hours per week support at home
  • Over half received less than 7 hours support per week.
  • Costs of the service were £79k, with savings in excess of £100k over alternative services.

Lessons learnt included:

  • Partnership working is essential
  • Technology must be fully integrated with care processes
  • Care must be person-centred, individualised
  • All care staff must be equipped with specialist skills
  • Ethical approach: always act in the individual’s best interests where consent cannot be meaningfully given
  • Be flexible about the 6 weeks rule for intermediate care

Workshop: TELECARE ASSESSMENT
Reporter FREDERIC LIEVENS, Med-e-Tel

The workshop started off with a short overview of Telecare in Barnet, where Guy is part of the two-person telecare team. They provide coordination, support, advice, guidance and training.

In Barnet, telecare training is standardly provided right across the board throughout the NHS, PCT’s, acute hospitals, OTs, specialist nurses, etc. So the assessment process can actually be done by any of them and they can, of course, refer back to the telecare team for assistance.

The telecare catalogue in Barnet consist of only two providers of lifeline services and two providers of stand alone systems. It’s a limited, but tried and tested offer, which seems to cover most of the needs. And if the offer does not suit a person’s particular needs, they will go off-catalogue to source other solutions.

The workshop then split up in four smaller discussion groups around two questions:

  • What makes for a good telecare assessment?
  • What information needs to be determined in the assessment?

The following suggestions and reflections came out of the discussions:

  • look at needs, environment and abilities/limitations of the person
  • assessor needs to have sufficient knowledge about available technolgies, how they work (through training)
  • ongoing assessment/reviews are necessary (is once a year – as stated in the TSA COP – enough?)
  • importance of informed choice
  • look at eligibility criteria
  • take into account previous assessments (eventually also non-telecare-related assessments)
  • think about risk management
  • use robust protocols

Main information that needs to be obtained is:

  • what equipment is available to serve specific needs
  • capacity of a person to operate equipment
  • what person can and can’t do
  • what outcomes are expected

For more info, contact telecare@barnet.gov.uk and look at their website on http://www.barnet.gov.uk/telecare (incl. An introduction to Telecare Services that takes people through some telecare basics, eligibility criteria and assessment procedures – http://www.barnet.gov.uk/telecare-booklet-2008.pdf). Guy also has an interesting site at http://www.smartthinking.ukideas.com.


 


home telehealth limited

Telecare Services Association Conference Tue 17 Nov 2009

November 16-18, 2009

Hilton London Metropole, W2 1JU

The cost of providing you with these reports has been supported by the conference organisers and
Home Telehealth Limited (UK)

home telehealth limited

Your reporter from this conference is Steve Hards

Tuesday 17 November

Contrast for today: pebbles and gems

Today was structured with plenary sessions in the morning with a round of workshops in the afternoon, and time to view the exhibition over lunch and between sessions.

The day started well with an opening address by Malcolm Fisk, Chair of TSA who flagged up an issue of particular interest to this reporter. That is, terminology in this field. He talked about the labels applied to the range of assistive technologies from spectacles, etc. to remote patient monitoring (RPM) and he suggested that ‘telecare’ could be used in a superordinate way to encompass the electronic technologies from pendant alarms to RPM. Whilst to many in the audience, used to thinking of ‘telecare’ as defining ‘smarter emergency alarms’ this may seem aberrant, the approach holds some interesting possibilities. If possible, further information will be posted in the Terminology section of this site to expand on the theme. Gem? Well, semi-precious stone at least.

For me, the next two sessions were pebbles. Tim Ellis, the Whole System Demonstrator Programme Manager for the Department of Health followed by Janice E Knoefel, Geriatrician in the Extended Care System of the New Mexico Veteran Health Care System, Department of Veterans Affairs. Maybe they covered what the majority of the audience (comprising people from a non-health background) needed to hear about telehealth but I suspect that the majority of Telecare Aware readers, hoping for some enlightenment and deeper insights than previously published in various places, would have been equally disappointed.

Most of the content of Tim Ellis’s session will be familiar. (If not, search Telecare Aware for WSD or start with this recent update on the WSDAN site.) He covered the history of the project and its problems and said that early results have been ‘very promising’. He also said that the results of the programme will feed into business cases but, having a dig at the equipment suppliers, said “the business case is easier to make if the equipment is cheaper.”

At the end of his presentation Tim showed an insipational video of telehealth in Newham. It does not yet seem to be available on their website, but there is one which you may want to watch, plus some Tunstall video case studies. You may also want to watch a BBC video of Tim Ellis demonstrating various telecare/telehealth technologies.

Janice Knoefel’s session was disappointing simply because her presentation slides were her reading notes. Her undulating tones and succession of difficult-to-read white text on blue slides were sporific. You may as well read them yourself, so, if possible, I will post a link to them if/when they become available. From the occasional asides, there were snippets: The VA has lots of care standards, but is driven by the bottom line – the more cost effective they are, the more veterans they can treat. Also, because they recognise that they cannot be all things to all patients, they target patients where they can have greatest effect on their care costs.

So where were the gems?

I confess I missed the following two plenary sessions (Working Smartly with Assistive Technology and Telecare, Clive Evers of the Alzheimer’s Society, and Digital Britain – the opportunities for telecare and telehealth providers and users, Richard Foggie, Department for Business, Innovation and Skills). My apologies if I missed two gems, but as one attendee remarked to me, the conference within the conference was going on in the exhibition area. It was certainly where most exchange of information, news and ideas was happening, and that’s where I did find some gems.

In no particular order they were:

a) The CareIP home telecare/telehealth hub, produced by Swedish company CareTech and marketed exclusively in the UK by Cirrus communications. The completely broadband-based system can connect devices to any call centre – always on, secure, and with no call costs.

caretech

b) The Everon system. Fast-to-install, easy-to-scale, fantastically reliable (thanks to its built-in protocols) wireless person monitoring and tracking. In the first year on sale in its native Finland it became the biggest-selling system in the care home market.

c) React Technologies’ implementation of the eye-catchingly small but sophisicated Ekahau tracking/tagging/two-button communication device. It can not only be used as a panic alarm but can be integrated into a whole network of ‘intelligent alerts’. For example, the system can be programed to ‘know’ when the last staff member leaves a building and can remind them to take certain actions.

react

d) The Novalarm (Verklizan Group) UMO system which has the potential to remove the need for fixed call centres, taking out a considerable overhead cost.

e) One gem I can’t show you yet because it isn’t properly launched in the UK. All I can say for the moment is that while nothing is perfect in the telecare world, the user-accepability of this tracking device will come pretty close. Pshaw!

Workshops

Will post a section on the workshops tomorrow.

Putting a Fun point on it

The team from SupraUK, suppliers of key safes and other safe boxes to the UK’s telecare industry, and one of the main conference sponsors, always go out of their way to inform and entertain. This year they emphasised their theme of Saves Time, Saves Lives by decking out their stand with a Tardis, and themselves in Dr Who costumes. It’s a great marketing gimick in the best sense of the word, making what could be a pedestrian product into an instantly recognisable brand amongst the conference attendees.

suprauk

 

Telecare Soapbox: Can the ‘old old’ have best lives when the pressure is to isolate them?

Donna Cusano is currently a healthcare services, wellness and supportive technologies marketing consultant based in New York City. Previously she was Vice President, Marketing, for Living Independently Group (QuietCare Systems). The following Soapbox item was triggered by the How the ‘Old Old’ can have best lives item.

So much of our emphasis in the technology area has been to keep seniors active that we tend to ignore planning for and helping seniors (and their families) to manage their last and usually inevitable years of increasing frailty, and the role that technology in the service of care can play. I don’t know of many cultures that support the ‘old old’ and those that have (Asian Indian, Chinese, Japanese) are increasingly not. Here is a moral, right opportunity for both healthcare and technology. I will make a similar case for the disabled and the support telecare/telehealth can be for them as well.

Unfortunately I think the trend towards treating the ‘old old’ – or even the just old – INhumanely is on the rise, despite… (more…)