adass spring seminar telecare & assistive technologies in … doughty... · 2013-04-16 ·...
TRANSCRIPT
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
PROACTIVELIFE & HEALTHMONITORING
ENVIRONMENTALSENSING & CONTROL
TECHNOLOGIES
ADVICE,INFORMATION,
ENTERTAINMENTAND
COMMUNICATIONSYSTEMS
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
PROACTIVELIFE & HEALTHMONITORING
ENVIRONMENTALSENSING & CONTROL
TECHNOLOGIES
ADVICE,INFORMATION,
ENTERTAINMENTAND
COMMUNICATIONSYSTEMS
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
PROACTIVELIFE & HEALTHMONITORING
ENVIRONMENTALSENSING & CONTROL
TECHNOLOGIES
ADVICE,INFORMATION,
ENTERTAINMENTAND
COMMUNICATIONSYSTEMS
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
Vision &High-levelObjectives
Target UserGroups &
Needs
Target UserGroups &
Needs
ServiceEligibility &Charging
ServiceEligibility &Charging
TechnologyTechnology
SupportServices
SupportServices
Monitoring& Response
Monitoring& Response
Performance& Quality
Performance& Quality
ResponseServices
ResponseServices
Installation &Programming
Installation &Programming
‘Prescription’Guidelines
‘Prescription’Guidelines
ResponseResponse
TRAINING
TRAINING
Reporting& Review
Reporting& Review
ReferralsReferrals
Stock Control& Recycling
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
Vision &High-levelObjectives
Vision &High-levelObjectives
Target UserGroups &
Needs
Target UserGroups &
Needs
ServiceEligibility &Charging
ServiceEligibility &Charging
TechnologyTechnology
SupportServices
SupportServices
Monitoring& Response
Monitoring& Response
Performance& Quality
Performance& Quality
ResponseServices
ResponseServices
Installation &Programming
Installation &Programming
‘Prescription’Guidelines
‘Prescription’Guidelines
ResponseResponse
TRAINING
TRAINING
Reporting& Review
Reporting& Review
ReferralsReferrals
Stock Control& Recycling
Stock Control& Recycling
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