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Personalisation, prevention and the fourth generation of TEC




2​9 May 2023



Adrian Scaife, Access Health, Support and Care

Four years ago I wrote about a nascent third generation of technology enabled care.

A new generation of telecare that delivers proactive, preventative, consumer friendly services that build on strengths (of individuals and communities) and that utilises interoperable data to provide insight, acting as an enabler for wider transformation across health and social care .Source

A lot has changed since, including a Covid pandemic! On the positive side there has been widespread recognition of both the need for change, the outcomes required and the benefits that it could bring both to individuals, their families and friends, the wider health and care sector and society as a whole. The title and content of this year’s ITEC 2023 conference “Unlocking Personalised Outcomes” is further evidence of the desire for change.

However, the TEC Alliance paper Technology-Enabled Lives launched at the ITEC event flags a lack of progress with delivery.

“The paper highlights the lack of widespread adoption of digital social care services despite the public’s desire for technology to better support those who draw on social care and health services. The paper reveals that only a handful of councils, housing, and care organisations are delivering digital care in people’s homes at scale. This is despite evidence that using technology in social care keeps people safe, healthy, and happy at home.”

Just days after the conference the Department of Health and Social Care published their Next steps to put People at the Heart of Care policy paper. Tucked away in the Digital transformation in adult social care section I read this statement.

“AI-enabled sensor-based technologies, which identify changes in a person’s daily routine, can play an important role in supporting people to live more independently in their own homes and communities, alerting people’s care and support network to their needs”

It will seem self-explanatory to many but the words “alerting people’s care and support network to their needs”really resonated with me and challenged me to think about what this actually means in practice. Personalisation and preventative service delivery is by definition very personal, unique to the individual, and it requires people with a close relationship with the person drawing on care and support to be involved. It takes place close to people and their daily lives and feels quite different from traditional reactive alarm services where the service provider is remotely available 24/7 to respond to an infrequent, but significant, crisis event and where the consequences of the event are then effectively managed e.g. calling a responder or the emergency services.

Family and friends are the obvious people included within most people’s care and support network. However, there is a another stakeholder group that fits the requirements and who have not traditionally been involved with technology enabled care provision. The group I am referring to is Homecare providers. They have a trusted relationship with the individual, and often family too, they are frequently in the persons home and their objectives are closely aligned.

Proactive, personalised and preventative TEC can benefit homecare providers and their clients as the insights and evidence can support:

  • Personalise care and improve homecare outcomes through tailoring of care provision
  • Improve quality, safety, efficiency by using the insight to make better, more timely and evidence based decisions about care and better evidence CQC compliance.
  • Increase capacity by being able to prioritise care and ensuring just in case care plans which encourage dependency are moved to just enough care which supports greater independence.
  • A proactive and preventative approach and away from reactive, crisis driven models.
  • To create an ecosystem of stakeholders and provide positive reassurance to family and friends
  • Create new revenue streams and move their business up the value chain

Bringing care providers into the technology enabled care service mix will sound like an impossible task to many. However, I am reassured by the history of our sector and its propensity for change. Prior to 2005 first generation TEC was almost exclusively a housing orientated service and mainly delivering manual alarm activations through pendants and buttons. In 2005 Building Telecare in England was published by the then Department of Health. Not only did this launch second generation telecare but it also engaged, for the first time, Social Care in the commissioning and provision of TEC services.

I am going to be bold and strongly suggest that if we are truly serious about providing preventative and personalised services then involving people’s individual care and support network is essential. The third generation of TEC using insight derived from activity data will likely be driven by the involvement of the care provider sector, probably supported by the third sector, just in the same way that Social Care drove the adoption of the second generation resulting in over 500,000 new users over the ensuing years.

Back at the ITEC 2023 event I was delighted to see the home care sector being represented in the Homecare Reimaging session. The presentation from Jane Townsend, Chief Executive of the Homecare Association made the case for an increased use of integrated care tech and data by homecare providers.

Finally, a few thoughts about what I am going to describe as Fourth Generation TEC. Third generation TEC has been enabled by the underlying improvements in digital technology – always on connectivity, the cloud, Internet of Things sensors and data analytics turning raw data into meaningful and actionable insight. Its probably fair to say that these changes could not have been imaging back in 1996 when Kevin Doughty first described three generations of telecare .

I believe that the Fourth Generation of Technology Enabled Care will further take advantage of evolving technology. It will be about breaking down data silos, releasing value and efficiencies, and enabling collaboration across organisations and stakeholder groups with the ability to both focus on the individual and at a population level at the same time.

To loosely define this new hyperconnected generation I would describe it as a TEC system that is interoperable with any other system with a different primary purpose. Examples, would include a person’s TEC event history being available in a social care case management system, preventative alerts delivered into a homecare system used by front line carers or even a family member being able to ask Alexa is Mum up yet this morning?

You can hear more about this fourth generation in this short video clip from ITEC 2023 link

If this article resonates with you, you would like to find out more or join us on this journey please feel free to get in touch. You can find out more about the Access TEC service here or contact me via



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