The UTOPIA Project evaluation of telecare in social care report published (UK)

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2018/02/Utopia-project-report-2018.jpg” thumb_width=”150″ /]An important and comprehensive evaluation of telecare in use in UK social care has been published this past week by King’s College London. The UTOPIA Project (Using Telecare for Older People In Adult social care) surveyed local authority telecare managers (114 valid responses or 75 percent of responders) November 2016-January 2017 to find out how telecare is being used by local authority adult social care departments in England to support older people.

This study springboards from the £80m Whole System Demonstrator (WSD) and its “curious neglect” by those engaged in UK telecare. The WSD’s findings contradicted earlier research in finding that telecare did not have long-term improvement of outcomes, gauged after only 12 months. It created, in the UTOPIA’s study’s terms, a ‘policy problem’ among major stakeholders. “The WSD remains an important study and its neglect is curious. The research team wondered why the findings had been overlooked and what, if any, consequences might have flowed from this.” The study thus looks at local authority aims, how local evidence is being collected, and how telecare is operationalized and delivered.

The areas surveyed and some highlights of the findings are:

  • Use of research: 33 percent were informed by research and 47 percent were aware of but did not agree with the WSD’s findings which were negative on the long-term value of telecare.
  • Where does telecare fit in?:  “Telecare ‘fitted’ best if it was provided alongside social care (77%), to support reablement (77%), for people eligible for and funded by the adult social care department (75%) as well as for people who pay for their own care (75%).” Only 24 percent collaborated with the NHS or other partners. There was full (100 percent) agreement that telecare helps to reduce risk and promote safety and 81 percent agreement that it supports unpaid carers. 
  • Achieving strategic aims and monitoring of progress: Over half (53 percent) of respondents said their local authority was accredited to the Telecare Services Association (TSA) Codes of Practice for Telecare and Telehealth. 
  • Barriers and facilitators: Barriers mentioned were skill deficits among professionals and installers, as well as contract inflexibility with suppliers. There was also concern about the reduction of face-to-face contact and care. Access to telecare and availability of advice and support were good for both users and family carers, but levels of awareness about it were only average.
  • Financial commitment: Not surprisingly, funding is scarce and usually cobbled together from several sources including local authorities, CCGs, and users. 24 percent felt it saved money but many found it difficult to provide hard evidence.
  • What’s considered in telecare assessments?:  Nearly all (92 percent) agreed that a key assessment included the user’s ability to move around, their memory status, the person’s ability to communicate, and their daily routines. Flipping the script, “40% of respondents said that their local authority’s telecare assessment focused on what it was hoped would be achieved through using telecare.”
  • Who are the assessors, and is assessment always required?(more…)

Robot-assisted ‘smart homes’ and AI: the boundary between supportive and intrusive?

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2016/06/Robot-Belgique-1.png” thumb_width=”200″ /]Something that has been bothersome to Deep Thinkers (and Not Such Deep Thinkers like this Editor) is the almost-forced loss of control inherent in discussion of AI-powered technology. There is a elitist Wagging of Fingers that generally accompanies the Inevitable Questions and Qualms.

  • If you don’t think 100 percent self-driving cars are an Unalloyed Wonder, like Elon Musk and Google tells you, you’re a Luddite
  • If you have concerns about nanny tech or smart homes which can spy on you, you’re paranoid
  • If you are concerned that robots will take the ‘social’ out of ‘social care’, likely replace human carers for people, or lose your neighbor their job, you are not with the program

I have likely led with the reason why: loss of control. Control does not motivate just Control Freaks. Think about the decisions you like versus the ones you don’t. Think about how helpless you felt as a child or teenager when big decisions were made without any of your input. It goes that deep.

In the smart home, robotic/AI world then, who has the control? Someone unknown, faceless, well meaning but with their own rationale? (Yes, those metrics–quality, cost, savings) Recall ‘Uninvited Guests’, the video which demonstrated that Dad Ain’t Gonna Take Nannying and is good at sabotage.

Let’s stop and consider: what are we doing? Where are we going? What fills the need for assistance and care, yet retains that person’s human autonomy and that old term…dignity? Maybe they might even like it? For your consideration:

How a robot could be grandma’s new carer (plastic dogs to the contrary in The Guardian)

AI Is Not out to Get Us (Scientific American)

Hat tip on both to reader Malcolm Fisk, Senior Research Fellow (CCSR) at De Montfort University via LinkedIn

North West Telecare event, 23 November

Wednesday 23rd November 2016, 9:15am – 4:30pm
Village Hotel Club Ashton Moss, Pamir Drive, Ashton-Under-Lyne UK (close to Ashton Moss Metrolink Station)

This is a free event for housing and healthcare professionals with a full day of workshops on telecare in supporting independent living, case studies of best practices and demonstrations of the latest products. There are four workshops which run both in the AM and PM sessions. There are also three guest speakers: Dr Malcolm Fisk, Director of the Telehealth Quality Group, De Montfort University, Leicester; Gill Drummond, Dementia Lead for Greater Manchester West Mental Health NHS Foundation Trust; Alyson Scurfield, Chief Executive of the TSA. More information and registration here. Hat tip to reader Dawn Thornber of Contour Homes. UPDATE If you have last minute difficulty booking, please contact directly Andrew.Townsend@contourhomes.co.uk

Telehealth Quality Group first conference Manchester 21 June 2016

The Telehealth Quality Group kicks off its campaign to stimulate new thinking around telehealth and telecare with a UK event in Manchester on June 21st. The focus of the event is on ‘Integrated Care’ – the route to which has been exercising strategists, policy-makers, commissioners and those tasked with delivery for some time.

The programme includes the likes of Malcolm Fisk, Kevin Doughty and this editor as well as Dr Laura Ryan of NHS24 … bringing news of the experience in Scotland, and Professor Andrew Sixsmith … bringing practice examples and insights from Canada.

Participants will also learn more about the TQG’s International Code of Practice for Telehealth Services – for which apparently three services are now seeking certification.

Other treats at the Manchester event include sessions that:

• look back and learn lessons from the Whole System Demonstrators;
• consider some of the technological developments and market trends around telehealth and telecare;
• check out developments in Rochdale as they pursue integrated care in the context of Manchester’s new devolved powers;
• draw on the telehealth experience of a West Yorkshire GP; and
• make sure the position of carers and service users is not overlooked.

A potpourri, maybe…and hopefully of interest to readers. Details are on the TQG website here

How technology can help fight elder abuse–ethically

The increasing awareness of abuse of older people by their caregivers, whether at home or in care homes/assisted living/nursing homes, invites discussion of the role that technology can play. This presentation by Malcolm J. Fisk, PhD, co-director of the Age Research Centre of Coventry University, in the BSG Ageing Bites series on YouTube looks at technologies viewed by level of control and intrusiveness:

  • Social alarms, which include pull cords (nurse call) and PERS–what we think of as ‘1st generation’ telecare: high level of control, low intrusiveness–but often useless if not reachable in emergency
  • Activity monitoring, which can be room sensor-based or wearable (the 2nd generation): less control, slightly more intrusive–also dependent on monitoring and subject to false positives/negatives
  • Audio and video monitoring, while achieving greater security, are largely uncontrolled by the older person and highly intrusive to the point of unacceptability. (In fact, some feedback on tablet-based telehealth devices indicates that a built-in camera, even if not activated, can be regarded with suspicion and trigger unwanted reactions.)

The issues of consent, and balancing the value of autonomy and privacy versus factors such as cognitive impairment, personal safety and, this Editor would add, detecting attacks by strangers and not caregivers, are explored here. How do we ethically observe yet respect individual privacy? This leads to a set of seven principles Dr Fisk has published on guiding the use of surveillance technologies within care homes in the latest issue of Emerald|Insight (unfortunately abstract access only) Video 11:03Hat tip to Malcolm Fisk via Twitter.

19th ISfTeH International Conference – 5th Carrefour de la Telesante

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2014/07/logo_catel-ISfTeH.png” thumb_width=”150″ /]16 – 17 October 2014. Cité des Sciences et de l’Industrie, Paris

The annual fall “Telesante” meeting’s theme this year is “Towards an international eHealth?” Sessions will center on success stories of eHealth applications, connected tools and services, methodologies, eHealth and economic development, and legal/regulatory frameworks. Organized by CATEL, the French Network for eHealth providers, and the ISfTeH, the International Society for Telemedicine and eHealth. Website and registration

Also: July ISfTeH newsletter Hat tip to Malcolm Fisk, CoDirector of Age Research Centre, Coventry University

Looking ahead with TeleSCoPE (EU)

Perhaps because we have covered the topic before, a cryptic email arrives from Malcolm Fisk, the driving force behind the development of the European Code for Telehealth Services, suggesting I consult the TeleSCoPE website and his Med-e-Tel presentation last week where “you’ll see a little announcement that indicates that things are moving forward”.

The website now includes a yellow box with the statement:

The framework for telehealth services to be assessed against the requirements of the European Code of Practice for Telehealth Services is being released on May 16th 2014. This follows collaborative work between the Telescope Partnership and DNV Healthcare. A four year cycle has been agreed that includes a Foundation Assessment followed by (mostly off-site) reviews and conformity checks. Accompanying the framework will be the new version of the Code by which the first tranche of services will become accredited.

…and the presentation includes, at the end, (more…)