Portsmouth Telecare Initiative

Health Improvement and Development Service Portsmouth City Council

What Is Telecare?

Technology that enables the continuous, automatic and remote monitoring of real time emergencies, as well as lifestyle changes over time, in order to manage risks associated with independent living

Using a combination of sensors and information and communication technologies, telecare supports the delivery of health and social care services to people in their own homes

How Does It Work?

Sensors worn by user or placed in the environment around the user

Wireless sensors placed around home Link to control centre via Home Hub (Community

Alarm) and phone line Sensors can monitor: - the person - falls, inactivity, wandering,

epilepsy, night-time incontinence - the environment - extreme heat or cold, gas,

flood, smoke

How does it Work?

Client activated calls for assistance

Automatically activated calls for assistance. Passive system, doesn’t need the user to initiate the alarm call

Automatically reported activity level monitoring. Preventative as well as reactive

Benefits

Increases choice and independence for users Reduces strain on carers Contributes to care and support for people with Long Term

Conditions Reduces accidents and falls in the home Reduces acute hospital admissions Reduces the need for residential care Supports hospital discharge & community rehab Enables those who wish to die at home to do so with dignity Unlock resources, re-direct elsewhere in the system

Telecare will contribute to a number of important agendas:

National Service Framework For Older people, DoH, 2001

The White Paper ‘Our health, our care, our say’ DoH, 2006

A ‘Recipe for Care’ Prof Ian Philp, National Director for Older People, 2007

‘Putting People First’ A shared vision and commitment to the transformation of adult social care. Chief Executive NHS, Secretary of State for Health, Secretary of State for Work and Pensions, National Care Association et al. 2008

Vision

An integrated service across health, housing and social services that supports people to stay in the community longer or return more quickly after hospital stays.

Funding

The project was initiated through the Preventative Technologies Grant (PTG) from the Department of Health (DoH) which was “to bring about a change in the way that services are delivered to support people living in the community”, The grant was for £80million over two years. Portsmouth’s allocated grant was £283,783

Approach

Started with pilots and was therefore developed from a solid base.

Two pilot schemes were implemented:

Falls Pilot – Falls detection monitors supplied to participants identified as ‘at risk of falling’

Medication Pilot – Medication Carousel to prompt / remind early dementia patients to take medication

Portsmouth’s Smart House

‘SmartHouse’ - working with Community Housing to convert suitable, accessible property

Display of safety and security equipment, telecare, teleheath and environmental control systems

Live link to control centre Demonstration/assessment centre for users, carers Training facility for staff Dispel myths about technology Market the service to the public

Entry

(Re) assessment of need

Care package development

Home survey

Telecare prescription&response protocol

Equipment provisionInstallation and

maintenance

Monitoring

Call handling

Response

Review

Telecare service integration

Source: Barlow & Curry 2006

Social services

Primary care

Housing services

Equipment suppliers

Telecare service providers

Acute care

Social Housing landlords

Fall detectorBed exit monitorChair exit monitorMedication reminder/dispenserWandering person alertNight time incontinence alertEpilepsy alertLow temperature

Activity/InactivityIntruder alarmBogus callerNatural gas Carbon monoxideFlood detectorSmoke

Extreme heat

After assessment, the most appropriate sensors are provided for each situation. There

are many sensors available, e.g.

Response

Call Centre currently in Southampton. Staffed 24 / 7

Record call and contact most appropriate response service

New First Line Response Service developed in Portsmouth

Entry

(Re) assessment of need

Care package development

Home survey

Telecare prescription&response protocol

Equipment provisionInstallation and

maintenance

Monitoring

Call handling

Response

Review

Telecare service integration

Source: Barlow & Curry 2006

Social services

Primary care

Housing services

Equipment suppliers

Telecare service providers

Acute care

Social Housing landlords

Review Process

Questionnaire / interviews conducted with ≈ 36 subjects

All have had telecare items for 6 months +

Review Questions Questions aimed to identify the following:

Fitness for Purpose Portability Comfort Timeliness Utility Responsiveness

Trustworthiness Reliability Safety Maintainability

Acceptability Usability Learnability Compatibility

Review Aims

Does the provision of telecare need to be re-evaluated?

Evaluation Tool-Kit for Social Services Systematic method for continuing

evaluation Justification of telecare

People not Gadgets

The technical aspects of telecare are relatively straightforward, it is the service integration which requires a high level of co-ordination to achieve success.

What Else Is There?

New Technology Is Being Developed Rapidly:

Lifestyle monitoring (e.g. activity, bathroom use, use of kettle and fridge) builds up picture of user’s normal behaviour patterns, available to carer/family or professional.Unusual behaviour triggers alerts that enable early intervention

Long Term Condition monitoring (e.g. in heart and lung conditions, diabetes, asthma) enables user to check own heart, blood pressure, breathing, weight, blood sugar levels, blood oxygen saturation. Results go to Community Matron or GP.

Advice and help can be provided by phone around the clock Results in increased confidence in managing condition at home Can enable timely medical intervention to avoid a crisis arising Reduced emergency admissions to hospital