Meeting government objectives for telecare in moving from local implementation to mainstream services

Barlow, James; Bayer, Steffen; Castleton, Beverly; Curry, Richard

doi:10.1258/1357633054461723

Cited by 31 publications

(33 citation statements)

References 5 publications

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“…Promoting the independence of older people forms a key part of the government's health and social care agenda, and new care delivery models supported by information and communication technology (ICT) are being developed to assist in realising this goal [2,3].…”

Section: What Is Telecare?mentioning

confidence: 99%

“…Aligning differences between organisational cultures and values, particularly in relation to perceptions of risk between medical practitioners and community-based support services is also recognised as problematic. It has proved hard to demonstrate the efficacy of telecare through systematic cost/benefit analysis that includes quality of life outcomes as well as resource implications, or to build business models that link the different actors in the supply chain, such as community alarm providers, equipment supplies and health and social care organisations, in a way that allows them to make informed and accurate decisions on pricing the different components of telecare services [3]. Telecare also carries connotations of 'Big Brother' and concerns have been raised both about the ethics of monitoring older people's behaviour in the privacy of their own homes [16] and also the difficulty of ensuring that consent to be monitored by ICT is genuinely 'informed' when the recipient of the technology is frail or confused [21].…”

mentioning

confidence: 99%

See 1 more Smart Citation

Attitudes to telecare among older people, professional care workers and informal carers: a preventative strategy or crisis management?

Hanson

Percival

Aldred

et al. 2007

Univ Access Inf Soc

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This paper reports findings from an attitudinal survey towards telecare that emerged from twenty-two focus groups comprising ninety-two older people, fifty-five professional stakeholders and thirty-nine carers. These were convened in three different regions of England as a precursor to telecare service development. The results from this study suggest that informants' views were shaped by prior knowledge of conventional health and social care delivery in their locality and the implication is that expectations and requirements in respect of telecare services in general are likely to be informed by wider perceptions about the extent to which community care should operate as a preventative strategy or as a mechanism for crisis management. to 'mainstreaming' telecare services in the homes of older people.A major impetus for the formation of the consortium was the inclusion of three project partners where live telecare installations were planned to take place within the lifetime of the project. These provided field sites for action research that constituted three very different physical settings, each representing a major type of housing for older people.Barnsley's patients are living in mainstream housing stock, much of which comprises ageing terraced and semi-detached houses and post-war council flats that were not inclusively designed. The Anchor Trust is developing a technology-enabled retirement village in South Bucks, with houses and bungalows for sale to more affluent older people as well as affordable housing in the form of flats and bungalows for rent, whilst Thomas Pocklington Trust, a leading provider of housing for people with impaired vision, is currently upgrading its extra care housing scheme for older people in Plymouth. Before embarking on any telecare interventions in these varied physical settings, the consortium felt it was important to benchmark the opinions and attitudes to telecare held by older people, care professionals and informal carers in all three areas where the service would subsequently be introduced. What is Telecare?Promoting the independence of older people forms a key part of the government's health and social care agenda, and new care delivery models supported by information and communication technology (ICT) are being developed to assist in realising this goal [2,3].Telecare is one such model that uses ICT to bring health and social care directly to the end user by providing safety and security monitoring, physiological health and activity A typical telecare service involves a system connecting sensors of various kinds that are dispersed in the homes of (or worn by) an older person, to a call centre. The sensors are either activated directly by the user, or raise an alert passively by recognising and responding to a change in the user's status such as a fall. The alert goes to a call centre, which then triggers a response that may involve informal carers, resident or mobile support staff or an emergency service, as required [8]. In some ways, then, telecare is simply an e...

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Section: What Is Telecare?mentioning

confidence: 99%

mentioning

confidence: 99%

Attitudes to telecare among older people, professional care workers and informal carers: a preventative strategy or crisis management?

Hanson

Percival

Aldred

et al. 2007

Univ Access Inf Soc

View full text Add to dashboard Cite

show abstract

“…There is also a debate about appropriate research methodologies. For example, economic analysis of telemedicine has not yet met accepted standards [5]; there is a relative lack of exploration of the socio-economic impact of telemedicine [7]; evidence on factors promoting uptake of telemedicine is lacking [8]; there is relatively undeveloped use, at the time, of qualitative methods [9]; many studies have not been well-designed [4] [10]; and, considering perceived difficulties of building a robust evidence base for recent innovations, researchers have argued that simulation modelling needs further development [11].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of telemedicine: A systematic review of reviews

Ekeland¹,

Bowes²,

Flottorp³

2010

International Journal of Medical Informatics

915

643

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To conduct a review of reviews on the impacts and costs of telemedicine services. Methods: A review of systematic reviews of telemedicine interventions was conducted. Interventions included all e-health interventions, information and communication technologies for communication in health care, Internet-based interventions for diagnosis and treatments, and social care if important part of health care and in collaboration with health care for patients with chronic conditions were considered relevant. Each potentially relevant systematic review was assessed in full text by one member of an external expert team, using a revised check list from EPOC (Cochrane Effective Practice and Organisation of Care Group) to assess quality. Qualitative analysis of the included reviews was informed by principles of realist review. Results: In total 1593 titles/abstracts were identified. Following quality assessment, the review included 80 heterogeneous systematic reviews. Twenty one reviews concluded that telemedicine is effective, 18 found that evidence is promising but incomplete and others that evidence is limited and inconsistent. Emerging themes are the particularly problematic nature of economic analyses of telemedicine, the benefits of telemedicine for patients, and telemedicine as complex and ongoing collaborative achievements in unpredictable processes. Conclusions: The emergence of new topic areas in this dynamic field is notable and reviewers are starting to explore new questions beyond those of clinical and cost effectiveness. Reviewers point to a continuing need for larger studies of telemedicine as controlled interventions, and more focus on patients' perspectives, economic analyses and on telemedicine innovations as complex processes and ongoing collaborative achievements. Formative assessments are emerging as an area of interest.2 Introduction Previous reviews of telemedicine have concluded that irrefutable evidence regarding the positive impact of telemedicine on clinical outcomes still eludes us. One review [1] of more than 150 articles concluded that potential effectiveness could only be attributed to teleradiology, telepsychiatry, transmission of echocardiographic images and consultations between primary and secondary health providers. Another systematic review [2] that assessed more than 1300 papers making claims about telemedicine outcomes found only 46 publications that actually studied at least some clinical outcomes. A review that analyzed the suitability of telemedicine as an alternative to face-to-face care [3] concluded that establishing systems for patient care using telecommunications technologies is feasible; however, the studies provided inconclusive results regarding clinical benefits and outcomes. A report on peer-reviewed literature for telemedicine services that substituted face-to-face services with ICT based services at home and in offices or hospitals [4] identified 97 articles that met the inclusion criteria for analysis. The authors concluded that telemedicine is being used even if the use ...

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“…Examples include economic analysis of telemedicine which has not yet met accepted standards [7]; concerns about a relative lack of exploration of the socio-economic impact of telemedicine [9]; lack of evidence on factors promoting uptake of telemedicine [10]; a relatively undeveloped use of qualitative methods [11]; and claims that many existing studies have not been well-designed [3,5,8,12]. The need for simulation modelling has also been expressed, given perceived difficulties of building a robust evidence base for recent innovations [13]. Telemedicine research exists at the crossroads of medical, technological and social/organisational research communities.…”

Section: Introductionmentioning

confidence: 99%