Telehealth & Telecare Aware has largely moved on from individual reporting of incidents. However once in a while it is perhaps worth sitting back to review the recent past, and look to the future. In telecare, the world of environmental sensing has developed so fast recently that it takes an incident like that reported in Harlow last month where it appears as if no device was fitted to clear the line to ensure that alerts always get through to remind one that most people’s telecare is still fairly basic.
Perhaps even more concerning was the failure of a smoke detector to alert, as reported in by the Inverness Courier. Does any reader know if the investigation has been completed yet?
Thankfully there were also good news stories such as this one from Brighton and Hove City Council. Gloucestershire County Council clearly has confidence in telecare too: it has announced today it is looking to save £5m in social care costs by expanding its current service. Members’ approval for retendering is being sought tomorrow.
Telecare also found its way into the press this autumn as a vehicle for saying how much the carrier of the news supports ‘our boys’. One such was the story of Mr Lee, the ‘abandoned desert rat hero’. That prompted Dr Kevin Doughty, who kindly sent me the link to the story, to compare this situation with the one in the USA where ex service people like Mr Lee would have been described as veterans and would therefore have been offered the very best of telehealth and telecare support.
Kevin then went on to speculate about why, in the Dept of Veterans Affairs, compliance of their members with medication prescriptions, behavioural change and everything else associated with healthcare is incredibly high. Is this he wondered because they are used to military discipline, or is it because compliance is a requirement for continued support (or perhaps the programme is just very well designed)? A topic I’ll return to after a chat with Adam Darkins when he visits us for the RSM Conference on 25 & 26 November (where the early bird rates end 28/10).
As we pointed out in a previous post on medication adherence, many people don’t take medication for reasons other than forgetting. It will therefore be interesting to see how successful CyberDoctor’s app will be, that allows users to choose from a range of different games all aimed at improving adherence. “It’s a complete departure from adherence applications,” Akhila Satish, CEO and cofounder, told MobiHealthNews. “There are no reminders, there’s no connection to an electronic medical record.” In their first trial, very impressive improvements are claimed in adherence for those suffering from diabetes.
Another thought-provoking piece, on Nick Hunn’s Creative Connectivity site, was Smart Wrist Good. Smart Home Bad which suggested that all the clever money was now going to wrist-based devices and no longer to true environmental monitoring.
One must-see short piece is Sam’s Story produced by the Kings Fund which makes a compelling case, so simply, for joined-up care, in which both telecare and telehealth can play a key role.
As readers who attended the RSM’s Worlds in Collision event last summer will know, I’m a great believer in reuse of simple, open technologies. One such that seems to be crying out for wider reuse, as Tom Morton pointed out, is the smartphone app developed by Manchester police to locate victims of stalking quickly: surely all older people should be offered this in case of a fall from which they cannot get up?
Another technology which looks to be reusable for others, in this case older, occasionally-confused, grown-ups, is the Guardian waterproof Bluetooth Smart device. Aimed at children, it can be worn like a bracelet, a pendant or a buckle. Should the child wander away (or be taken) beyond a pre-determined safety perimeter, an alert sounds and appears on the parent’s phone. A clever touch is that the moment the child gets within range of anyone else with the same app on their phone, a notification is sent via that person’s phone to the child’s parent. So what, you may be saying: GPS devices already do all that and more. Do they though do it for a one-off payment of $24.95 with a four to twelve month battery life?
One of the problems when you run a telecare scheme that offers body-worn kit, be they pendants or fall detectors, is getting users to wear them. I was therefore particularly intrigued by the alternative approach reviewed recently by my colleague Toni Bunting of getting dogs to wear them instead, on the basis that the dog’s behaviour changes if something happens to their owner.
The Engineer carried a short item on the Discovering Startups 2013 competition, with a focus on Simpalarm which monitors activities of daily living (ADLs) wirelessly and is tamper-proof, so great for those with dementia who are prone to fiddle with technology. The key to successful ADL monitoring is of course separating the signal from the noise. The company’s website mentions “intelligent software” notifying carers of changes. However the ultimate test is when the grandchildren arrive with much running and fridge opening: will the system send out false alarms? The Cambridge Wireless website feature Simpalarm as a winner so clearly the product impressed the judges (as it has me).
Finally, with a fresh look at wearables, the WSJ explains in an excellent article how they are becoming an increasingly important part of the workplace by monitoring people to help improve productivity and reduce errors.
Echoing the reference to Airstrip One and 1984 in my recent piece on telehealth, it’s hard at times to avoid the sense of Big Brother increasingly watching our every move…
Apart from those already mentioned, hat tip to Prof Mike Short and Joel Cains.
I find all this activity fascinating, coming from a background building tech companies and researching the potential of Telecare and Telehealth for a future venture, I find that the core issue across the piste is the lack of momentum for adoption by the ‘real people’ of many of these wonderful technologies in their isolated forms.
The author, Geoffery Moore, covered the current life cycle brilliantly in his 90s bible Crossing the Chasm, where technology gets tremendous acceptance by the early adopters (because we think its cool) but most technologies do not get across the chasm to mainstream use. (Many techies have garages and sheds full of great technology that never made it, that prove this point)
Telecare/health will cross the chasm but not necessary in the way its being brought to market so far to date. First we have to get past the cultural, social and political barriers and that probably is the real role of many of the current wave of projects to educate and inspire and they need to understand this role and drive the education, education, education line.
I must admit to a little disappointment to the fact that for each person preaching Telecare/health is good, I am surprised by the number of existing establishments who are proactively pushing to diminish the potential of Telecare/Health, the wave of negative clouds that are growing around many demonstrators and trials is more than I have seen across other tech sectors. (This is one for the conspiracy theorists)
It will happen, of that I am certain, but only when the real user understands the needs that it fills and it becomes almost an unconscious decision to use pervasively.
In my view we need to create a easier path to acceptance because beyond the early (and interested) adopters the adoption curve is too steep, thus creating barriers.