“Every conceivable device exists to enable home care – it just needs to be bundled together to a single destination” (Stuart Hope in 2013 in Aged Care Insite).
As with all aspects of modern society, technology is playing a part in home care and should (if we get it right) play a greater role in years to come. To date, the uptake of technology in home care situations has only been limited, where some progressive care providers have lead the way.
Two key questions for successful integration are: What is trying to be achieved with technology? What are the barriers to adoption?
Technology to engage and assist.
I think all would agree that best quality of life is achieved by living healthy and safely in one's own community for as long as possible, and not be isolated from the family and the community. There are some great technology solutions available to help in many home care areas.
From the ones that support the quality ageing need of health & wellness they enable the management of care goals and treatment plans and communicate with the care team. The goal is to educate and share detailed available information for clinical decision making. They use smart device integration to easily record vitals like weight, glucose or blood pressure. These solutions typically work through a tablet/mobile phone that collects the information and connects to the internet.
Monitoring services can also be provided that trigger alerts based on rules when set health parameters are breached, to ensure medications are taken, exercises from the care plan are done, or when the user indicates that their pain level is higher than normal. Additionally there are other devices for monitoring and assisting with safety & security, ranging from (in)activity sensors, extreme room temperatures, through to fall detectors and GPS watches.
These systems can be integrated with other care systems supporting the care consumers so the total picture of care is available and the care team can be informed. A home health care system such as the Engage solution acts as the lynchpin for the care information and can interfaces with other existing care systems to ensure all members of the care team can participate in acting on and providing information through mobile apps or a browser.
Voice, the new interface.
One example of the technology that is proven to be very useful is Voice software. Voice recognition has been around for decades and is now becoming more pervasive in eg. cars and smartphones. Voice software coupled with other voice assistant solutions like the Amazon Echo or Google Home can enable control and communication, very useful for people who have limited cognitive (like dementia) or physical capabilities, as many in aged care do.
Voice is the third wave of user experience. Internet was the first, mobile devices represented the second, and voice, in the form of conversational user experiences, is the third. The main advantage of voice is that it offers less friction as a technology interface. Users can use voice-enabled technology in a natural way, without having to learn how to navigate through a device or to use apps and tools. Users speak to their voice assistants just as they would to other people. This natural, human approach makes voice revolutionary.
The intersection of voice with Internet of Things (IoT) is where things get really interesting. IoT gives context (e.g., measured health indicators) to the information that users provide through voice assistants. Healthcare is an obvious area where voice assistants can make an immediate impact. Various healthcare applications, e.g., care coordination, post-discharge compliance, patient/family education, or remote patient monitoring are all areas where voice can improve patient experience and outcomes dramatically.
There are many issues with the adoption of technology in home care, and I think the two major barriers are:
Technology adoption culture: Although the elderly are often mentioned as the reason for low technology adoption, the inevitable hurdle seem to be the acceptance of technology by the carers and care organisations. The traditional culture within these organisations often inhibits transformation or responding to technological disruption. Even though elderly are less likely to embrace technology, the acceptance rate among seniors is getting higher, and solutions can be hidden, non-invasive and preventative as well as supporting elderly people to stay healthy & safely at home. Many solutions work without requiring the senior to learn or change anything, eg. no pendants as the embedded intelligence identifies anomalies and raises alerts automatically.
Affordability: Many people needing home care are on a minimal budget, and cannot afford the cost of new technology. Who is going to pay for the initial outlay, support, maintenance and repair? It is not only funding the initial outlays of devices, but their associated software will need maintaining – fixing and upgrading. Aged care providers generally do not have the budget, scale and skills to fund, integrate and maintain technology and therefore will have to find strategic technology partnerships and lease the technology solutions.
To improve affordability two of the keys to technology adoption in home care are commoditisation and familiarity. When the technology is an “off the shelf” item, it becomes more affordable, acceptable within peer groups, many people possess it, you can readily obtain assistance and, more importantly, people can make businesses supplying, installing and servicing.
That is why case managers and care coordinators in a care plan should standard direct a percentage (eg. 5-7% of the Home Care Package funding) into technology to support care consumers, with the possibility to opt-out, instead of the current approach to opt-in. To keep the technology services affordable the care organisation should also adopt a key principle: “Adopt before Adapt”, to avoid customisations.
Good examples at the moment are the ability of the monitoring devices mentioned above to integrate biometric devices like Nokia and iHealth - a good example of a readily accessible commodity device that rapidly gained acceptance.
Hubert van Dalen is Managing Director of eHomeCare, who supply technology solutions for the aged care sector.