Features: May 2nd, 2008

By Steve Sadler

Half a century of telecare has brought unimaginable developments in the support of people in their own homes and successfully improved the lives of millions. Older people and those with long term needs are able to continue to live at home well beyond past expectations. The author describes how smarter sensors and new ways of processing information mean that care teams are able to respond more proactively and effectively. He looks at the economic benefits to the NHS and local councils and glimpses the future for the next half century.

Since it was first aired in 1965, BBC’s iconic programme Tomorrow’s World informed, instructed and entertained viewers with glimpses of how we would be living in decades to come. The cream of UK scientists, engineers and inventors would proudly show how technology was to change our lives for the better, but many ideas never made it further than the studio walls. However, one concept which has successfully made it from a 1957 Yorkshire drawing board to being a truly widespread, life-saving piece of technology is telecare, used by over 1.6 million people in the UK alone.

So, more than 50 years on, what contribution has telecare made to health and social care delivery, and what developments can we expect to see in the coming years and decades?

Telecare Today

Today, telecare is about effectively monitoring and managing risks through a set of sensors placed discreetly around the home. Older people and those with long-term needs may be at a higher risk from potential environmental problems such as fire or flooding, or at a greater risk of falling.

Telecare addresses these risks by raising an alert if assistance is required, ensuring more timely care and giving people the confidence and ability to remain independent in their own home for longer.

Local authorities are using telecare to radically transform health and social care delivery. For example, falls account for over half of the A & E admissions to hospital for older people – deploying telecare solutions to manage the risks associated with falling reduces some of the burden on acute care providers and ensures healthcare resources are used more effectively.

To put this into context one Scottish council has successfully reduced the response time to falls to just over 22 minutes, compared with a four hour national average, by deploying telecare in the homes of all people with long-term needs to support a more timely and proactive model of care provision.

Building an intelligent home

Developing smarter sensors and new ways of processing information means care teams are able to respond more proactively and effectively to people’s needs. In the next few years we will see a wider implementation of more advanced home telecare units, which, by supporting a far wider range of smart sensors and combining them intelligently, will enable more complex risks to be managed. Activities of Daily Living (ADL) sensors unobtrusively monitor daily activities to provide indications of an individual’s well-being and their ability to consistently perform the fundamental activities of daily life.

This is done by using information from sensors to create a range of indicators relating to a person’s behaviour. These may relate to mobility level, nutrition and daily activities such as using the TV, kettle or fridge. In principle, such ADL monitoring systems can help assess needs, and identify potential risks before they become emergencies.

As we look five to 10 years into the future, advancements in technology will mean a move towards open interfaces between products, where different kinds of assistive technology will cooperate to provide consistent views of a person’s needs, and automated support around the home. These developments should also lead to the emergence of smaller, cheaper, ubiquitous sensors around the home.

The notion of intelligent living will continue to develop. Existing forms of assistive technology will become smarter, and as it converges with high street electronics there is no doubt that the technology will be delivered through friendlier user interfaces. In some homes this may extend as far as a ‘robotic’ environment, where the supporting devices exhibit behaviour that is personalised to the needs of the user.

A glimpse into the distant future

If we wind the clock forward again and leap further into the future we should expect to see some real progress in terms of preventative technologies. Implantable devices, which continuously monitor vital signs to help make certain chronic diseases manageable. Maybe gene therapy, to help with the prevention of genetic disorders, will have been further developed to the point where it is available as an integral part of healthcare models.

However, it’s important to bear in mind that this sort of technology would give care providers the ability to heavily influence an individual’s health and life span. This is a controversial subject where we are still some way from society being agreed on the ethics. Maybe these technologies will be restricted to early stage detection, rather than prevention until this ethical debate is resolved.

Moving forward with widespread telecare

The UK Government has consistently shown it believes that telecare is an integral part of the future of health and social care. This strong public commitment includes £80m funding of ‘preventative technologies’, along with the deployment of three Whole System Demonstrator (WSD) sites in Kent, Newham and Cornwall, to support over 7,500 people with long-term care needs over the next two years.

The WSD sites will hopefully confirm the outcome of other large-scale trials, which have demonstrated that providing assistive technology at home along with home care support, as an alternative to residential care, can more than halve the average stay in residential care for many people. This not only brings great benefits in terms of people’s choice and independence but also has a hugely positive budgetary impact on the local authority care providers. These levels of savings allow valuable resources to be deployed more effectively in other areas of social care provision.

In the last 50 years huge technological advancements have brought about radical changes in lifestyle for millions of people – and telecare is one development that has had a major impact on the way we provide care today. The next 50 years will bring even bigger and bolder changes to science, and one thing is clear – telecare looks set to radically enhance the way we deliver care, improving the lives of millions of more people.

Steve Sadler is the Chief Technical Officer at Tunstall