Last month I spoke, on behalf of the Housing & Support Alliance, at Sitra’s Annual conference and agreed to blog my presentation, so here goes!
The title of the conference was Innovating for Efficiency. Although Telecare can and does bring efficiencies, the theme of my presentation was about the role of people in Telecare. I have seen and heard enough to know that if we want efficiencies (monetary or otherwise) from telecare then we have to pay special attention to the roles of people within that process. So, my emphasis was very much on practical issues; the realities of frontline practice, and the importance of the relationship between people and technology.
As this is a blog you don’t get the benefit of the anecdotes, but the presentation is available online, more about the conference can be accessed here, and you can, of course, contact me if you would like some training!
I spoke about a number of the keys barriers to Telecare working efficiently and being taken up more widely. These include:
- Pinpointing desired outcomes
- Ensuring assessments are relevant and personalised
- Lack of understanding about what equipment is available and how it can be used
- Fears around staff roles, responsibilities and changes to the way people are supported, including fear of social isolation
- Lack of training and ongoing support
Firstly we need to decide what it is that we actually want to achieve. That sounds obvious and simple, but so many people are given equipment because it is available or practitioners are being told to include equipment within assessments but with no clear idea about what they want to achieve.
So, some outcomes may be:
- create a safer environment
- protect the building / environment
- give someone greater control, independence and confidence
- (Self) manage conditions
- keep someone at home for longer (reduce hospital/care home stay/admission)
- assist carers to provide more reliable support or less intrusive support
Personalisation and assessments
In terms of personalisation, we are all now familiar with the concept and, for the most part, we are providing support which is personalised to the individual in terms of their needs, wants and aspirations. However, I’m not convinced that we are doing this when we think about telecare.
Assessors need to spend time understanding the person’s needs and way of living. Think about how the individual and their staff will use the equipment. We will not achieve any efficiencies or decent outcomes if equipment doesn’t fit someone’s needs and lifestyle. Equipment should work with care arrangements to enhance support rather than replace it.
What equipment is available?
Almost anything you need or want!
There are many pieces of equipment with the same name that work differently so it’s important to ask questions, source from the whole of the market and remember that one size does not fit all!
On the powerpoint presentation I showed examples of three flood detectors: the first needs to get wet before it signals that there is a flood, the second signals that the water has reached the overflow in a sink or bath and the third signals that the water has reached the overflow and shuts off the water supply.
So, this is just one example to demonstrate that if you limit your procurement to one supplier, or individuals/staff are expected to purchase from a tick list or a catalogue without much explanation, then they could end up with something they don’t want, that doesn’t work properly in the given scenario or environment and certainly doesn’t do anything to increase efficiencies, confidence or provide good support.
The same can be said for the system with which the equipment interfaces – panel, pager, mobile phone, website, call centre etc. If a carer needs to respond immediate (for example some is about to abscond and run into the middle of the road) then best to choose a system which provides an immediate response, such a pager for on-site staff, rather than a website based system that you are going to log into periodically! Sounds obvious, but again and again I have heard about or been asked to sort out systems which do not respond in a way which is appropriate to the circumstances. The biggest offenders are suppliers who insist that alerts need to be routed to the mobile phone of the carer in the same home! This costs the user money (mobile phone calls) when a system such as a DECT (cordless) phone or pager could do the same job with no on-going call costs.
Again, if we get this part of the assessment wrong at best we don’t make those efficiencies and at worst we could be putting people in danger.
Information and training
Technology should support the way people live or wish to live and be supported and not replace it, but clearly this isn’t happening in every case.
However, some change is inevitable, and change is scary. Individuals and staff will have to work with the equipment and become responsible for it in different ways. Processes will be needed to report activities, faults and for contingency arrangements in the case of equipment failure. So it will mean change and people need to be supported through that.
In many cases, people have been put off by the “failures” they have encountered. If the only encounter someone has with Telecare is not a good one then they are less likely to advocate for it or engage with it in the future. We need everyone in the process – individuals, their families and professionals to be confident about telecare and other equipment which assists otherwise we are not going to see efficiencies, good support or regular use of technology in the care sector. So, people need to:
- Understand the intended outcomes and benefits
- Understand how the equipment works – both its capabilities and limitation
- Know what to do if it doesn’t work – and the consequences
Resource constraints can lead to training being overlooked or not considered important. Had there been sufficient training for the people I talked about at the conference, then I don’t think I would have had those scenarios to mention, as all, in their different ways, arose due to a lack of understanding in one form or another. Training around technology definitely needs to be considered as an “invest to save” area.
I talked a lot about failure at the conference. In fact, the right technology in the right place for the right reasons can be very effective and I wholeheartedly support the use of technology in these circumstances. I love gadgets and am always excited by the possibilities they can bring! There are many reports and good news case studies available already, so I wanted to provide a slightly different perspective. No figures, hard facts, citations or specific references (which probably annoyed some people) but hopefully experience and commonsense which illustrates that people are the key to success when we start thinking about introducing technology for the people who need some support or reviewing systems which are in place already.
I have been working with colleagues to produce an online Telecare Assessment Tool, which should be ready within the next few weeks (spring 2013). It enables individuals or staff to be guided through an assessment process by asking a number of questions about the potential user. It then suggests a number of pieces of equipment which can then be considered by real human beings before being purchased! It works on all platforms – apple, android, blackberry and pc. There will be a blog about it at some point......