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 |
Joanne Surridge
I worked for Help the Aged from 1987 in the ‘Lifeline Appeal’ department. We supplied telephone alarms to older people funded by various fundraising activities. Many of the local appeals were run by the local monitoring centres. We used to work with the monitoring centres to connect the alarms into their services and the contacts that developed over the years we worked led directly to the formation of ‘Calling for Help’ which was a group that started to explore the ideas of standards, ethics etc. This in turn led to the formation of ASAP – I think I was the first treasurer, and I remember organising the first annual conferences.
Just returned to the industry after 10 years away, and it is really interesting to see what has changed and what has not. I am pleased that the ideas we were all so passionate about back in the day are now the subject of such interest, and that the support that the services have given to so many people over the years is now receiving recognition on a bigger scale.
Kevin Doughty
We can all learn from history – and it may help us to avoid making the same mistakes again.
Whilst there is a need to provide evidence for all claims these days, there is also room for opinion – most successful innovations come from someone backing a hunch rather than working from a script. Therefore, I suggest that Steve develops his table to include what readers think are the most significant developments in telecare over the past 40 years. The button and box by Andrew Dibner of Lifeline Inc in the States may be the starting point, but there are many examples of genuine community alarms in sheltered schemes in the UK going back more than 60 years.
My list of other key events (not in chronological order) are:
1. The opening of the first 24 hour call monitoring centre which allowed people in dispersed housing to begin supported by social alarms as well as tenants in sheltered housing – this also accelerated the trend to remove resident wardens! (where was this? Perhaps Sockport circa 1979)
2. The adoption of alarm protocols that began in the security industry into social alarm systems, paving the way for first generation telecare
3. The publication of the “Three Generations of Telecare” model in 1996 (JTT) which not only proposed the social alarm system as a platform for telecare but also defined second and third generations (which included lifestyle monitoring, vital signs monitoring, and video-based interactions)
4. The development of the EXTRA (EXtended Telecare Remote Alarms) sensors by Technology in Healthcare (a spin-out from Bangor University) from 1997- 2001 which were granted Millennium Product status in 2000 – the list of sensors was headed by FRED, a smart fall detector which won a student design award for Gareth Williams, and which was subsequently licensed to Tunstall.
5. Successful telecare trials for frail older people and for those with dementia in Anglesey, Cheshire, County Durham, Northern Ireland and Northamptonshire between 1998 and 2001 which demonstrated efficacy and popularity.
6. The large scale Opening Doors for Older People trial and roll-out in West Lothian in partnership with a consortium headed by Tunstall but also including Technology in Healthcare, Possum and Motion Media (2001-2004)
7. The introduction of Activity Monitoring that could be used to detect dangerous behaviour or patterns of activity for assessment purposes. First system deployed was Technology in Healthcare’s MIDAS system (subsequently redeveloped by Tunstall as ADLife) in Cheshire, County Durham and Londonderry (2001) followed by ALTera and Just Checking.
8. Remote vital signs monitoring (subsequently renamed Telehealth by US companies) – RGB systems by Tunstall in Carlisle, West Yorkshire and Medway?
9. Mobile-phoned based telecare medical alarm – Vodafone with embedded devices in 2001/2
10. The development of a Code of Practice by the Telecare Services Association to help develop quality standards for the industry.
The fridge monitor doesn’t get onto my list I’m afraid.
Editor Steve
@ Joanne and Kevin
Thanks for those great examples to kick things off. I’ve transferred them to the table. Steve
James Barlow
Don’t forget the report on ‘telephonic diagnosis’ in The Lancet in 1879 as a key event:
“Practice by Telephone”
The Yankees are rapidly finding out the benefits of the telephone. A newly made grandmamma, we are told, was recently awakened by the bell at midnight, and told by her inexperienced daughter, “Baby has the croup. What shall I do with it?” Grandmamma replied she would call the family doctor, and would be there in a minute. Grandmamma woke the doctor, and told him the terrible news. He in turn asked to be put in telephonic communication with the anxious mamma. “Lift the child to the telephone, and let me hear it cough,” he commands. The child is lifted, and it coughs. “That’s not the croup,” he declares, and declines to leave his house on such small matters. He advises grandmamma also to stay in bed: and, all anxiety quieted, the trio settle down happy for the night
The Lancet 29 Nov 1879, Page 819
And where do antecedents of remote care such as the flying doctor service fit in the key events?
James Barlow
According to USTelemedicine.com it goes back even further: “Actually, Telemedicine has been around for thousands of years in Africa. Tribes would use smoke to warn others of disease in their community.” See https://www.ustelemedicine.com/telemedicine-defined/
Terry Brady
Check out the work of Willelm Einthoven (also Wilhelm) – first ECG in 1903
David Kutzik
A comment re. behavioral monitoring and trend analysis–this was patented in 1997 under Kutzik etc. al. (subsequent patents 2000, 2008, 2011) and was commercialized as QuietCare in 2005. This was acquired by Intel-GE in 2009. The inventors are myself David Kutzik, and Anthony Glascock. We are professors at Drexel University in the US.
Donna Cusano
David, thank you for adding. I didn’t realize the patent went back to 1997. You may remember I was at LIG 2006-9 in marketing. We will add.
Kevin Doughty
I am old enough to remember behaviour and trend analysis based on basic movement detectors being discussed openly at an IEEE Biomedical Engineering conference in Hawaii back in 1987. Branko Celler’s work in Queensland extended this to include other sensors in the early 1990s which led to BT Labs in Martlesham developing bespoke sensors for monitoring water flow and electricity usage in the early 1990s. Several projects in UK universities then studied domestic log datasets for trend analysis during that decade leading to new ways of visualisation that can be used for both assessment and trend applications.
The prior art is considerable and goes back more than 20 years, making it very difficult to establish an accurate and significant time-line for such applications. However, I suspect that MIDAS 1, and MIDAS 2 were both introduced commercially by Tunstall prior to 2005 while ADLife and Tynetec’s ALTera were introduced also around this time. Their significance was that they were compatible with the dispersed alarm units that formed the first generation of telecare.
These systems are only now beginning to make an impact in the UK, and this is the result of additional and sophisticated sensors, some of them worn but most embedded into furniture or appliances. Machine learning of activity signatures and data mining of enormous datasets will provide the level of reliability that will make lifestyle monitoring and alert systems usable. Furthermore, the data will be integrated into electronic health records and used with genetic information to support the development of individualised medicines.