“the 7 waves of teccs” - telecare, telehealth and tecs hub...02/11/2016 7 understanding the...

02/11/2016

1

“The 7 Waves of Community Care Technology

– Is Your Service Ready”

1st. UK Telehealthcare Annual Integrated Meeting 2016

South Thames College, Merton Campus, MordenWednesday, 2nd. November, 2016

Dr. Kevin Doughty

Director

The Three Eras of Care

Institutional focus (1st Era)

Geriatric hospitals replacing the

Workhouse and Public Assistance

Institutions

1st

© KD 2016

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Community focus (2nd Era)

Sheltered housing, residential care

homes, home helps and domiciliary

care in the home, and personal

assistants

1st

2nd

© KD 2016


Person focussed (3rd Era)

Use of technology to support health,

well-being and independence, and to

avoid the need for long-term care

(self-care)

1st

2nd

3rdThis is a transition – ALWAYS difficult to

achieve – it involves a change in culture

© KD 2016

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Person-Centred Care

Abilities

Interests

FamilyValues

Goals

© KD 2016

Person-Centred Care

InterestsGoals

is not…

Practitioner-based

Problem-based

Deficit focus

Professional dominance

Acute treatment

Cure/improvement

Facility based

Dependence

Episodic

Reactive

is…

Person-centred

Strengths-based

Skill acquisition

Collaboration

Community integration

Quality of life

Community-based

Empowerment/choices

Least restrictive

Preventive

© KD 2016

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Which Technologies Support Person Centred Care?

Medtech

PPharmaceuticalsHealthInformatics

AssistiveTechnology

TECHNOLOGYENABLED

CARE

© KD 2016

Significance of MedTech

Medtech

PharmaceuticalsHealthInformatics

AssistiveTechnology

TECHNOLOGYENABLED

CARE

Scanners, diagnostic devices, keyhole surgery, ultrasound, radiotherapy

HOSPITALS AND TREATMENT

CENTRES

© KD 2016

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Significance of Pharmaceuticals

Medtech

PharmaceuticalsHealthInformatics

AssistiveTechnology

TECHNOLOGYENABLED

CARE

DEVELOPMENT IN THE LAB – BUT USED EVERYWHERE

Chemotherapy, antidepressants, oral medicines, statins, etc.

© KD 2016

Significance of Health Informatics

Medtech


AssistiveTechnology

TECHNOLOGYENABLED

CARE

Electronic health records, digital healthcare, hospital

administration systems

ESSENTIAL PART OF HEALTH AND SOCIAL CARE – BUT SYSTEM RATHER THAN

PERSON BASED

© KD 2016

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What About Assistive Technology?

Medtech


AssistiveTechnology

TECHNOLOGYENABLED

CARE

Smart devices & conventional aids to daily living that help people to

be more independent

A FOCUS OF CARE AND SUPPORT IN THE COMMUNITY

– PERSON-CENTERED

© KD 2016

Telemedicine

Telehealthcare

Assistive

Technologies

Integrated Personal Care & Well-being

eHealthcare

Technologies Enabled Care (TEC)

© KD 2016

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Understanding the Terms

Telemedicine• Technologies for ill-health

& acute conditions

• Clinician and nurse led

• Institutional context

• Focus on patients

• Monitoring and control of patient

• Treatment may promote dependency

Telehealthcare

• Technologies for well-being

• Service or user led

• Home or community context

• Focus on people

• Self-management by user

• Empowerment supports independence

© KD 2016

Telemedicine(Technology Enabled

Hospital & Healthcare Systems)

Integrated Personal Care & Well-being

eHealthcare

There Are 2 Types of TECs

© KD 2016

Telehealthcare

Assistive Technologies

Technology Enabled Care in the Community

Technology Enabled Community Care (TECC)= Community Telehealthcare

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20011980s

20182020 TECC

Timeline

2006

2012

Broadband

IP, Fibre-TTC

ADSL

3G mobile networks

GSM

4G

1990s

ISDN

Fibre-TTP

G.fast

© KD 2016

20165G

Unidirectional wireless remote control

Smart smoke sensors

Activity sensors

Smartphones and apps

Low-cost vital signs sensors

Retailed wearable self-care devices

Low cost linked cameras

Internet of All Things

Health prediction & prevention

Trusted robotic software Ubiquitous cloud

storage & connectivity

Big data analysis

Analogue PSTN

switch-off

The TECCs Journey

INCREASING UNCERTAINTY

2000 2004 2008 2012 2016 2020 2024

1st

wave2nd.

wave3rd.

wave4th.

wave5th.

wave6th.

wave

7th. wave

Community alarm systems

© KD 2016

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Community Alarm Systems

Sometimes known as a ‘button & a box’ approach

Active devices - press

or pull in emergency

Unworn pendant

38%

Denial28%

Not wanting

to disturb

operator17%

Unaware of a

problem12%

Too timid5%

© KD 2016


2000 2004 2008 2012 2016 2020 2024

1st

wave2nd.

wave3rd.

wave4th.

wave5th.

wave6th.

wave

7th. wave


Telecare alarm services

The TECCs Journey

© KD 2016

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3. Call handler talks to service

user to work out what help is

needed

4. Call handler follows protocol

and arranges appropriate

response

1. Sensor automatically raises

alarm to dispersed unit

How alarm-based telecare works

service user id, alarm type

& location info

Response

Telecare

Monitoring

Centre (TMC)

Individual’s

home

Help!

2. Alarm call raised

Ouch!

Example: Fall detection

Telecare hub /

Dispersed Alarm Unit

© KD 2016


2000 2004 2008 2012 2016 2020 2024

1st

wave2nd.

wave3rd.

wave4th.

wave5th.

wave6th.

wave

7th. wave



Vital signs & activity monitoring

The TECCs Journey

© KD 2016

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Telemonitoring of Vital Signs

© KD 2016

Activity Monitoring Systems

• Systems such as Just Checking and Canary can be installed in minutes to enable room and door activities to be recorded and viewed remotely over the Internet.

• Other systems use smaller sensors that can detect specific actions enabling alerts to be generated if routine tasks are not performed on time.

© KD 2016

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2000 2004 2008 2012 2016 2020 2024

1st

wave2nd.

wave3rd.

wave4th.

wave5th.

wave6th.

wave

7th. wave




Mobile devices, apps & wearable alarms

The TECCs Journey

© KD 2016

Smartphones – We will all have one!

Features

Powerful processors

Large touch-screen colour display

Large memory and storage capacity

Telephone and text-messaging

Versatile apps

In-App notifications and messaging

Familiar interface options

Lightweight and always available

Battery life improving

Contactless and touch ID

Sensors, actuators and connectivity

Microphone

High quality audio

Accelerometers

GPS and GSM location

Magnetometer

Temperature

Camera(s)

Vibration unit

Bluetooth and Wi-Fi for connectivity

NFC and proximity sensor

Ideal platform for mCare and mHealth applications

© KD 2016

Vulnerable people can now go out and feel protected!

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2000 2004 2008 2012 2016 2020 2024

1st

wave2nd.

wave3rd.

wave4th.

wave5th.

wave6th.

wave

7th. wave





Home video services

The TECCs Journey

© KD 2016

The 5th wave – Video-based Services

Systems can overcome social isolation by linking people with their families many miles away

• TV set-top boxes or tablet devices for people living alone or in care homes

Teleconference technology can help avoid visits to A&E, to GP surgeries and to specialist consultations

• Teleconferencing allows scheduled and on-demand services to improve efficiency and reduce the need to travel for staff and patients

Providing security and access to properties

• New teleconcierge services will provide allow monitoring centres to provide remote access and to screen potential bogus callers

Offering enhanced welfare checks, lifestyle advice and service reviews

• Identifying changing support needs at an early stage

© KD 2016

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Home & Virtual Therapy Services

© KD 2016

They open up opportunities for people who need physiotherapy,

occupational or speech & language therapy to perform exercises

and participate in observed competitions in their own homes

Gaming

platforms

such as

Microsoft

Xbox &

Kinect,

Nintendo

Wii and

Playstation


2000 2004 2008 2012 2016 2020 2024

1st

wave2nd.

wave3rd.

wave4th.

wave5th.

wave6th.

wave

7th. wave





Home video services

Personal care technologies

The TECCs Journey

© KD 2016

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Collecting Health & Well-being Data

© KD 2016

Personal Assistants & Chatbots

Amelia works for Enfield Council, answering telephone questions.She can answers many calls at the same time – so no capacity issues.

© KD 2016

Name Siri Google Now

Cortana Alexa M

Company Apple Google Microsoft Amazon Facebook

Communication Voice Voice & typing

Voice Voice Typing

Capability Answer question,place calls

Getting directions, reminders

Manage calendar, PC file finding

Streams music, cooking assistance

Supports complexinteractions

http://kaden.watch.impress.co.jp/img/kdw/docs/359/435/html/24.JPG.html

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2000 2004 2008 2012 2016 2020 2024

1st

wave2nd.

wave3rd.

wave4th.

wave5th.

wave6th.

wave

7th. wave





Home video services

Personal care technologies

Social robotics & advanced prediction

The TECCs Journey

© KD 2016

Robotic Devices - From Companions to Butlers!

© KD 2016

02/11/2016

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Where Are We on the Journey?


2000 2004 2008 2012 2016 2020 2024

1st

wave2nd.

wave3rd.

wave4th.

wave5th.

wave6th.

wave

7th. wave

Many smaller service providers –(and some big ones!)

Only a handful of forward-thinking services

HOUSING

© KD 2016

Smart assistive technologies

can make a home WISER:Watchful – able to monitor activities

& well-being of individual

Intelligent (and Informed) – able to recognise problems & take action

Safe (and Secure) – able to prevent accidents and crime

Empowering – support individual to participate in events & tasks

Responsive – quick to react sympathetically to changing circumstances or need.

WISER Homes All properties for older or disabled people could become WISER Homes

(but when?)

© KD 2016

Is this the big IoTapplication?

02/11/2016

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2000 2004 2008 2012 2016 2020 2024

1st

wave2nd.

wave3rd.

wave4th.

wave5th.

wave6th.

wave

7th. wave



HOUSINGSOCIAL CARE

© KD 2016

Social Care and Maslow

© KD 2016

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Risks for Community TECs to Help Manage

Environmental

safety

Personal

Safety/Security

Social Well-

being

Personal

CareHealth

Fire

Floods

Extreme

Temperatures

Noise

Air quality

Frozen pipes

Radiation

Power loss

Reduced

lighting

Intruders

Bogus callers

Insecure doors

Going out alone

Falls at home

Gas hazards

Dangerous use

of oven or hob

Physical abuse

Falls outside

Becoming lost

Door entry

Incontinence

Pressure sores

Medication errors

Nocturnal seizures

LTCs

Daytime seizures

Stroke rehab

Hypoglycaemia

Sleep apnoea

Asthma attacks

Depression

Cardiac arrhythmia

Anxiety

Fear of crime

Mood swings

Social isolation

Depression

Challenging

behaviour

Loneliness

Boredom

Speech issues

Fear of going

out

Reduced cold

sensitivity

Forgetfulness

Reduced

mobility

Lack of

exercise

Hygiene

Nutrition

Hearing loss

Poor vision

Confidence

Reduced

dexterity

Increasing Complexity

© KD 2016

Risks for Community TECs to Help Manage Environmental

safety

Personal

Safety/Security

Social Well-

being

Personal

CareHealth

1st wave 2nd wave 3rd wave 4th wave 5th wave 6th wave

© KD 2016

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2000 2004 2008 2012 2016 2020 2024

1st

wave2nd.

wave3rd.

wave4th.

wave5th.

wave6th.

wave

7th. wave



HOUSINGSOCIAL CARE

HEALTHCARE

© KD 2016

The Better Care Fund, and the TECCs Savings Clock – Avoidance Objectives

Short-term admission to a care home

Long-term care services

More use of primary care

Delayed transfers of care

Unnecessary hospital admissionHospital readmission (for same cause)

Ambulance presentation to A&E

Police/Fire services for emergencies

Personal accidents such as falls

Need for mental health services

Stressed family carers

Long-term admission to a care home

© KD 2016

02/11/2016

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2000 2004 2008 2012 2016 2020 2024

1st

wave2nd.

wave3rd.

wave4th.

wave5th.

wave6th.

wave

7th. wave



HOUSINGSOCIAL CARE

HEALTHCARE

DIY CARE – Self Management

– 3rd Era of Care

How do you sell to this market?

© KD 2016

*

The DIY Care & Support Market – Personal Budgets

© KD 2016

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The DIY Care & Support Market – Personal Budgets

© KD 2016

Independent TECC Information• The Vivo Guide from

the Liverpool dallasproject supports users to find their own TECC solutions (and services)

• Vivo Pro helps health & social care staff to find tried and test products to advise patients to buy and use, sharing opinions of solutions

© KD 2016

• It provides the basis of self-assessment using the principles of the New Care Act

• It is limited by content and sustainability

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i–CUHTec Bridge Model

DISTRIBUTORSINDIVIDUALS &

THEIR FAMILIES

PRODUCERS

DESIGNERS &

INNOVATORS

RESEARCHERS

& INVENTORS

SERVICE

PROVIDERS

COMMISSIONERS

ASSESSORS

• Training• Evaluation• Strategies• Discovery• Assessment• Information• Reviews• Comparisons• Quality measures• The future

The FREE membership organisation

© KD 2016

i-CUHTec Regional TECC Forums Half day informal

meetings in each of 5 regions 3 times a year.

Free to attend for members.

Agendas set by those planning to attend.

Focus on operational issues, training needs, & general service improvement.

Open discussions on new products & models.

NORTH WALES & NORTH WEST ENGLAND

SOUTH WALES & SOUTH WEST ENGLAND

LONDON & SOUTH EAST ENGLAND

SOUTH SCOTLAND & NORTH EAST ENGLAND

THE MIDLANDS

© KD 2016

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iCUHTec for New Ideas & ProductsProduct or

service idea developed

Bring concept to Regional TECC Forum for Opinion &

Short Co-design Session

Improve product/service

specification

Produce Working Prototype

Enter i-CUHTecNew Product

Process

Submit for formal product evaluation

Managed trials by iCUHTec members

Seek iCUHTecendorsement

© KD 2016

Product Testing & Endorsement Process

© KD 2016

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Product Testing & Endorsement Process

© KD 2016

Product Testing & EndorsementTesting & evaluation reports are sub-contracted to T-Cubed who act as the professional independent test-house.

Features

Design

Ease of Use

Performance

Value for Money

A score of 3 stars of more is required to allow a product to be recommended for an i-CUHTec group trial. Products scoring well may be accredited.Those successful in group trials may be “Endorsed by i-CUHTec”

© KD 2016

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The Challenges for All of Us• Declining public funding will lead to more people trying a

DIY strategy to support their health and well-being –they will need independent information and advice to avoid making dangerous (and costly) mistakes

• Products are only as good as the services that surround them – new emphasis on assessment, installation, support, maintenance, response – how much of this will Argos be able to provide?

• Services to the public will be limited unless they adopt flexible “good practice” principles – and are available to individuals privately as well as through commissioners

• People want complete TECC solutions – both connected and standalone Assistive Technologies – not 5 different products and services from 3 or 4 different organisations

© KD 2016

Those who deliver quality at every level

Service quality"We have some pretty strong beliefs about things like who is responsible for service, - and it's every member of this organisation.“

Jayne Parker,

Director of Disney University

© KD 2016

Who Will Survive in the TECCs Industry, and Who Will Thrive?

Staff training is key!

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i-CU Tec

i-Centre for Usable Home Technology

Thank you for your attention

How can i-CUHTec help you?

Join i-CUHTec for free at http://icuhtec.org

Contact me at: [email protected]: 07810797971

http://icuhtec.org/

mailto:[email protected]

“the 7 waves of teccs” - telecare, telehealth and tecs hub...02/11/2016 7 understanding the...

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