In ICE-T, we define Telecare as ‘the use of information and communication and sensor technologies to deliver health and social support to people to help them live as independently as possible in the lowest intensity care setting consistent with their needs and wishes’. In our description health monitoring services (often referred to as telehealth) are a component of telecare, as the basic service being provided is one of care and support and the user does not distinguish between the two.
It is tempting when trying to write descriptions of the terms used in telecare to start from what is used i.e. the technology. In ICE-T, we prefer to start with a specification of what is required to be delivered and that is ‘support to help people live as independently as possible for as long as possible in the lowest intensity care setting, consistent with their needs and wishes’. This brings in all the concepts involved in telecare. People, and this doesn’t just include the elderly but those with other physical and mental impairments, are to be supported to live in their own homes either alone or with a carer, in sheltered accommodation, or care homes with professional carers. This reinforces that telecare is just a tool in the care professional’s armoury and it is their professional judgement as to how and when to use telecare.
There have been a number of studies identifying what support people want. People’s needs can be broadly divided into:
- social inclusion and connectivity
- mobility and choice
- support to achieve behavioural change
- easy access to therapies
The features of a comprehensive telecare service that would deliver on these needs are shown below in Fig. 1:
Providing information and communication will ensure that people remain socially included and have access to community services, particularly care services and services supporting behavioural change. Providing sensors in the home connected to a call centre that can initiate appropriate action will ensure that people’s safety and security is ensured and that they have rapid access to their carers. Additional devices connected to the same call centre will ensure that individuals can monitor and report their own vital signs and in the future, as devices become more sophisticated, have access to more sophisticated therapy services. Fig 1 also shows the existing service provision to the home through the assistive technology services. This has already been identified as one way of integrating telecare with mainstream services. Together assistive technology and information and communication improve a person’s functionality. The other features mitigate the risk of not transferring them to another care facility. Currently, the sensors and services are activated either by the individual or through a change e.g. a bath overflowing, and are reactive. In the future, the service will recognise changes in lifestyle and clinical condition and automatically initiate appropriate preventative services.
Telecare can be described as the delivery of health and social care services to an individual using a combination of information and communication technologies and sensor technologies. Telecare is an umbrella term. From Fig 1 it is clear where and how other terms which are in regular use such as telemonitoring, telehealth or telehealthcare, lifestyle monitoring and assistive technology contribute.
The Technology Strategy Board (TSB) has used the term Assisted Living in its Innovation Platform. This is an even wider term bringing in concepts in other important areas such as the environment and transport.
Telecare is about the delivery of care following an assessment. There is no diagnosis involved so the use of the term telemedicine in this context is inappropriate. Other terms commonly or traditionally used are described below:
- Telehealth
The remote exchange of physiological data between a patient at home and medical staff at hospital to assist in diagnosis and monitoring.
- Telemedicine
The use of medical information exchanged from one site to another via electronic communications to improve patients' health status. This typically involves remote consultations with specialists to support care delivery, as well as health education and the transfer of medical data.
- Telemonitoring
The provision of a monitoring service to an individual to enhance their safety and security and provide access to assistance.
- Telehealthcare
The provision of a monitoring service to an individual that allows them to report certain physiological measurements and provide access to assistance.
- Lifestyle monitoring
The provision of a monitoring service surrounding an individual to note any changes in daily routines and to alert carers.
- Assistive technology
Any device or system that allows an individual to perform a task that they would otherwise be unable to do, or increases the ease and safety with which the task can be performed.
