adass spring seminar telecare & assistive technologies in … doughty... · 2013-04-16 ·...

ADASS SPRING SEMINAR

Telecare & Assistive Technologies in Social Care

– Impact and QualityKevin Doughty

JRF Centre for Usable Home TechnologiesUniversity of York

SELSDON PARK HOTEL, SANDERSTEADThursday, 23 rd. April 2009

Assistive Technologies• Fixed Systems

– Individual to property– Can be expensive to buy,

install & maintain– Lengthy planning– Wasted when user moves on

• Portable Systems– Low-cost & readily available– Little or no maintenance– Ideal for “retail model”– Goes with the user

• Electronic Systems– Remote controllers– Communication aids– Smart homes & appliances– Telecare

© KD 2009

REACTIVEEMERGENCY

ALARM SYSTEM1st. Generation

PROACTIVELIFE & HEALTHMONITORING

(2nd. Generation)

STAND-ALONE ELECTRONIC ASSISTIVE

TECHNOLOGIESGeneration Zero

ADVICE,INFORMATION,

ENTERTAINMENTAND

COMMUNICATIONSYSTEMS

(3rd. Generation)

t

Telecare

Devices and systemsto help overcome sensory or functional problems in performing activities of daily living

FUNCTIONALCOMPENSATION

© KD 2009

Practical Digital Assistants• Smart bed

– Monitors breathing & sleep disturbance– Turns occupant to avoid pressure sores– Gets you up in the morning

• Dynamic zimmer frame– Helps people to move about– Guides user to destination– Offers supportive comments

• Clever coffee table– Has holes to hold drink containers– Contains compartments for medication– Issues reminders for food, drink &

tablets• Wizard wardrobe

– Helps with dressing– Steams shirts, blouses & trousers– Sends dirty clothes down laundry shoot

© KD 2009

Amplifying the Body’s MusclesExoskeletons

© KD 2009

REACTIVEEMERGENCY

ALARM SYSTEM


ENVIRONMENTALSENSING & CONTROL

TECHNOLOGIES

ADVICE,INFORMATION,

ENTERTAINMENTAND


t

Overcome anxiety, increase

confidence, manage risks to independence

RISKCONTROL

© KD 2009

Response TeamTelecareContact Centre

Wireless alarm

Telecarers+

Emergencyservices

Components of a Social Alarm Telecare System

SMART Sensors

© KD 2009

AdvancedLifeline Unit

Emergency Response Team

Rapid ResponseTeam

Liftingservice

Emergency Treatment

Team

24 hr. Home Care

Relatives, Friends, & Carers

Floating SupportSocial Worker - EDT

TelecareMonitoring

Centre

Out-of-hoursGP

Fireservice Ambulance

Police

Emergency plumber

24 hour Gas fitter

Paramedic Home Treatment Team

Individual protocols -- for each service user- for every time of day- for every alarm

+ escalation procedure

© KD 2009

Integrated Care TeamCare & Support

Coordination & Telecare Centre

Osteoporosischeck

Memoryclinic

Sittingservice

Strengthtraining Dietician Healthy

living centre

Energyadviser

Electricblanket

checks

Balancetraining

Optician

Meals onwheels

A.T.Installer

Keep warmKeep well

Safetychecks

Tai Chi

Medicationreview

O.T.Medicalassessment

TherapyDay centre

Continence advice

Bobbyvan

© KD 2009

REACTIVEEMERGENCY

ALARM SYSTEM



TECHNOLOGIES

ADVICE,INFORMATION,

ENTERTAINMENTAND


t

Detect changes in habit, activities and vital signs to predict

and prevent problems escalating

PREVENTIONAGENDA

© KD 2009

Telehealth Hardware & Software

© KD 2009

Applying Lifestyle MonitoringApplying Lifestyle Monitoring

© KD 2009

REACTIVEEMERGENCY

ALARM SYSTEM



TECHNOLOGIES

ADVICE,INFORMATION,

ENTERTAINMENTAND


t

Technology systems to provide advice,

news, entertainment and new on-line

services

HEALTHPROMOTION

© KD 2009

Integrated Telecare Services

Telecare Centre

PSTN(BT

21CN)

Service User’s Home

Activity Sensors & ActuatorsSmart Home Automation

Vital SignsMonitoring

User display

Home HubSet Top Box

ehealth Records

CommunityResponse& SupportServices

1st Generation Alarms

© KD 2009

Impact of Telecare ServicesHealth

EconomyHousing

ProvidersSocial

ServicesCarersService

Users

Reduction in overall care costs

Increased independence

Improved Quality of Life

More responsive approach

Increased choice in managing risk

Opportunities for respite

Increased independence

Improved Quality of Life

Reduced Stress

Improved peace of mind

Reduced demand for other services

Increased capacity of care system

Fewer delayed transfers of care

Improved assessments of needs & risks

Reduced admissions to care homes

Improved security of properties

New roles for wardens and support staff

Fewer incidents of accidental damage

Increased demand for special housing

Reduced voids in sheltered housing

Shorter hospital stays and rapid discharge

More patients able to perform self care at home

Fewer ambulance call outs and A&E presentations

Improved medication compliance

Reduced hospital admissions and readmissions

© KD 2009

Impact and Estimated Benefits of Scottish Telecare Programme 2007-8

518 admissions £3.42mDelayed or avoided admissions to care homes

York Health Economics Consortium at York University /Scottish Government Final Evaluation Report, Jan 0 9

SavingsBenefitsOutcomes

£3.34m1220 patientsReduced unplanned hospital admissions - bed days saved

£1.79mAvoidance of check visits

Reduction in Home care visits

£1.70m517 dischargesReduced delayed transfer of care (speedier hospital discharge)

£0.85mMore independenceReduced overnight support (Learning Disability)

£11.1mTOTAL VALUE OF SAVINGS

Winning the Telecare RacesRACE 1: Medication MedleyRACE 2: EMH Nursing Home CupRACE 3: The Fire & Flood DerbyRACE 4: Frail Elderly Care Home ChaseRACE 5: The Falls HandicapRACE 6: A&E Presentation StakesRACE 7: The DeToCs NationalRACE 8: Supported Discharge SpecialRACE 9: The Home Care SprintRACE 10: Carers HurdlesRACE 11: Learning Disability CupRACE 12: Long Term Conditions PlateRACE 13: Extra Care SpecialRACE 14: Mental Health Derby

© KD 2009

BUT WHAT ABOUT THE QUALITY OF THE RUNNERS?

Care PlanCare Plan MonitoringMonitoring

MaintenanceMaintenance

AssessmentAssessment

Components of a Telecare Service

TelecareStrategy

TelecareStrategy

TelecareService

Specification

TelecareService

Specification

TelecareProcesses &

Implementation

TelecareProcesses &

Implementation

Vision &High-levelObjectives


Target UserGroups &

Needs

Target UserGroups &

Needs

ServiceEligibility &Charging


TechnologyTechnology

SupportServices

SupportServices

Monitoring& Response


Performance& Quality


ResponseServices

ResponseServices

Installation &Programming


‘Prescription’Guidelines


ResponseResponse

TRAINING

TRAINING

Reporting& Review

Reporting& Review

ReferralsReferrals

Stock Control& Recycling


SERVICE

PROMOTION

SERVICE

PROMOTION

ONıGOING

REVIEW

ONıGOING

REVIEW

SERVICE EVALUATION© KD 2009

Care PlanCare Plan MonitoringMonitoring

MaintenanceMaintenance

AssessmentAssessment

Telecare Service Audit (A real one)

TelecareStrategy

TelecareStrategy

TelecareService

Specification

TelecareService

Specification

TelecareProcesses &

Implementation

TelecareProcesses &

Implementation



Target UserGroups &

Needs

Target UserGroups &

Needs



TechnologyTechnology

SupportServices

SupportServices





ResponseServices

ResponseServices





ResponseResponse

TRAINING

TRAINING

Reporting& Review

Reporting& Review

ReferralsReferrals



SERVICE

PROMOTION

SERVICE

PROMOTION

ONıGOING

REVIEW

ONıGOING

REVIEW

SERVICE EVALUATION© KD 2009

Raising the Quality Bar• Value for Money - understand

costs and willingness of public to pay

• Training - specialist prescribers with knowledge of local inventory and evidence

• Extended inventory – use of new devices to satisfy identified needs

• First responders – audit the suitability and availability of family and friends to respond 24/7

• System removal – analysis of how long system is used

• Audit access arrangements –manage key-safe numbers

© KD 2009

Conclusions• Assistive Technologies and Telecare have the

potential to benefit all stake-holders• There is considerable evidence of success with

many user groups across the UK• Services only give good Value for Money if:

– They offer the right equipment– To the right people– At the right time, and include– Highly trained & experienced monitoring staff, oper ating – Personalised call handling protocols, and– Appropriate response mechanisms

• Best practice needs to be established by Social Services Departments quickly so that they can commission the highest quality services

© KD 2009

THANK YOU FOR YOUR ATTENTION

For copies of papers and articles on which this presentation has

been based, please e-mail: [email protected]

Tel.: 01286 678648

adass spring seminar telecare & assistive technologies in … doughty... · 2013-04-16 ·...

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