Hear from: Nicky Parker (Manchester City Council), David Pearson CBE (Nottm & Notts Integrated Care System / TEC Quality) , Tim Barclay (Appello), Steve Sadler (TSA), Ann Williams (Liverpool City Council), Mick Ward (Leeds City Council), George Crooks (Digital Health and Care Institute), Andy Begley (Shropshire Council), Steve Smith (Doro).
Direction of travel for many Local Authorities will be about being data driven and person-centred. There will be a shift away from providing single use, reactive analogue alarms to providing a more holistic digital service where a number of devices in the home and wearables are connected together to provide a more rounded and individual view of the person. These will form multiple digital eco-systems based around new digital platforms. The data collected will be able to be used more and more to predict population health trends in geographical neighbourhoods and also across cohorts of conditions.
When mapped with people’s individual health and care records, TEC will provide a critical tool for population health systems to help support people to live longer at home. If we can add a digital workflow to the data, we will see more immediate, targeted dispatch of support from integrated neighbourhood team colleagues such as district nurses, reablement workers, GPs and homecare providers and less false alarms and ambulance call outs. TEC will become more of an early warning system - that’s got to give better personal outcomes than just waiting for a crisis to unfold.
The increase in the use of GPS technology will mean TEC will become much more personalised and the rise in digital wearables will enable people to get out and about more, less reliant on a home-based system. As people’s homes become smarter, we will be able to support people on issues such as fuel, poverty and hydration. Whilst managing falls will remain at the heart of the community effort, new devices will enable a shift in focus to managing dementia and loneliness. All of this will bring some new players into the market and the pilots in Liverpool and Manchester have indicated this will involve everyone from large space agencies to small digital entrepreneurs.
The development and utilisation of rapidly changing technology is a defining feature of our age. Social care and health is no exception. Part of the development we can expect is that technology enabled care will no longer be a series of standalone products, but part of a range of digital tools and services, utilising data to understand and respond to need, blended with new consumer technologies and other care and treatment sitting alongside. People who need these services will be have more control over their records care and treatment.
People providing care and treatment will remain very important, but technology will help to join up information about need and services, provide more “real time” responses and coordination as well as being another helping hand. Technology will also enhance quality and cost effectiveness.
Those are the opportunities. But like all advancements they need to be shaped and nurtured in order to realise the benefit and avoid unintended consequences.
There are a number of things that we will need to do:-
The opportunities are clear - today is when we need to start working towards those opportunities, not tomorrow.
We will see growing awareness of telecommunications network changes, in terms of the shift to digital fixed lines, but also mobile network changes. The impacts on TEC will become evident, reinforced by test programmes that examine the performance of existing alarm systems, and help with forward planning.
Digital TEC will emerge as a mainstream option in the UK, including an ‘internet of things’, and with new types of connectivity for the living environment, carers and service providers. There will be a shift to the ‘cloud’ for monitoring applications and associated information storage. This will come with a demand for guidance and quality assurance.
Data will take centre stage in relation to service integration, predictive and preventative care options, and the management of population health. This will drive scrutiny of data and cyber security within TEC services and their supporting technologies. Artificial Intelligence applications for health and care will emerge, perhaps limited initially to ‘chat-bots’ and process automation, but extending to smart data analytics and care insights. This will raise challenges to ethics and regulation. We will see growing demands to help the care workforce to navigate and derive benefits from technology enablement, through new education and training programmes.
Standards - 2020 could be the year that digital becomes the minimum standard for telecare. Will a regulatory body step up and provide clear guidance to providers in the UK to desist from ordering/supplying anything that isn’t digital? To provide commissioners with clarity and support in making the best long-term investment we think this would be a welcome step in the right direction and one that could/should happen in 2020.
The safety and wellbeing benefits to individuals are so transparent - and the advantages for housing providers, local authorities and care commissioners are so evident - that a level of authoritative benchmark would only aid service providers to ensure they are making the best decision for their customers safety and wellbeing.
Analytics will change everything - digital telecare has opened up large amounts of data that was historically unavailable and which can be amalgamated with other data sources and accessed on the go. Both housing providers and care organisations can use this insight so that staff can prioritise their time easily and as a consequence deliver a better experience for the residents and feed into true care needs.
We predict that the sector will see significant strides in 2020, as providers become more knowledgeable on how they can deploy digital equipment and use the data to benefit organisation and customers.
Interoperability- the move towards open protocols and the Internet of Things (IoT) is creating huge possibilities from integrated technology. Taking a best of breed approach allows telecare providers and their customers to create ecosystems which can be small or large, which can be personalised at a by-customer level, depending on their individuals particular requirements. This move to mix and match technology will provide affordable, flexible and future-proof environments to suit a huge variety of needs.
As a Social Care Commissioner and Contract Manager at Liverpool City Council I am facing the crisis in social care every day for all the reasons we know about - lack of funding etc. TEC can help, and in Liverpool we recognise the important part it can play to help people stay in their own home and live independently for longer.The main challenge we have with TEC is the soon to be digital switchover from analogue. With no apparent ‘silver bullet’ yet, commissioners must avoid investing further in legacy telecare.
In Liverpool we are trialling different communication/network methods using a LoRaWAN network and have been using the DCMS 5G test bed and trial for health and social care. We've found that with a council owned private network providing WiFi for health and social care devices, we can introduce game changing technology at a low cost with no ongoing data costs.
I believe that the next year will see more of the large multinational companies launching tech for monitoring services.These technologies will not be branded specifically for “disabled” or “frail” people but will become mainstream.The challenge will be how do monitoring centres monitor calls from these devices so they can provide TEC as well as stop emergency services responding to the false alarms?
Data from telecare services will also become hot property as more companies want AI algorithms to be developed to help predict decline and to be able to target preventative services.The new IoT devices produce huge amounts of data and I know we do not use the data effectively at the moment. I think 2020 will be an exciting start to the next phase of TEC as the clock starts to tick down to 2025 and the analogue lines replaced with digital.
The continued growth of ‘Internet of Things’ will start to be viewed as having real potential benefit for people with care and support needs, but with interesting tensions developing between specialised health and care provision and the use of adapted generic digital products. We will also see Local Authorities having to start resolving the balance between the direct provision (or commissioning) of digital solutions versus effective sign posting for self-purchase.
With the need to develop services that are not only safe and effective but also sustainable into the future, the movement from reactive to proactive services will come more to the fore in 2020. As we move through 2020 all organisations involved in digital health and care will have to develop an understanding on how the increasing availability of Internet of Things solutions and how AI and machine learning can be harnessed to deliver real benefit to service users, providers and commissioners alike. Those organisations that invest some time and effort in gaining these insights will find themselves best placed to address today’s challenges and create future opportunities to improve the quality of existing services and develop new service offerings.
Predictions for 2020 include the early stage use of AI platforms for health analytics and predicative analysis, early stage AI interactive voice based systems for use in telecare call centres (non-emergency calls e.g. door entry etc). We may well start to see the use of CCTV in care monitoring replacing some personal visits (as used in the Nordics as well as the growth of EU wide telecare organisations providing products and services.
The trend of Google, Apple and other big blue chips investing in healthcare platforms will continue. Increased functionality from products such as Amazon’s Eco will start to have an impact on the sector putting pressure on traditional suppliers. A continued move to outcomes-based commissioning; and a continuing consolidation of the sector driven by increased costs associated with digital call centre platform upgrades, the need to invest in field-based systems, and the letting or larger contracts which require larger organisations to support.
The challenges we will face is a lack of funding within social care to invest in technology care; a lack of funding within the housing sector to upgrade assisted living technology to bring it into the digital age; a “head in the sand” approach to the digitalisation of the telephone network; trouble moving the NHS digital team away from thinking digital only applies to patient records; getting the NHS to embrace the opportunities of using technology to support safe discharging will continue to be a challenge.
The future for Health and Social Care is clearly the ever-increasing closeness of ties between our separate organisations. Where technology was once a complication, it is now acting as a bridge between services and I predict that tools such as Microsoft Teams will provide a strong glue between historically disparate partners. This new glue should help to highlight efficiency savings, opportunities for closer collaboration and other potential improvements through the better use of data, leading us towards the holy grail of Health and Social Care wide predictive analytics to support our ambitions to deliver preventative services wherever possible.