The UK’s phone infrastructure is changing: By 2025, telecom companies such as BT will have switched off their analogue telephone network and transferred all their customers to digital phonelines, “IP Voice”.
Many organisations are aware of the impact that this change will have on the reliability of their existing telecare services, and so are planning to move to digital telecare. This is a significant investment in technology; to make sure that the full benefit is obtained it is important that the move to digital telecare is seen as only the first step on a wider transformation of health and care.
Telecare providers are faced with the challenge of moving their systems and entire user base to digital technology in relatively short timescales. This is a significant undertaking and understandably providers are looking to minimise the degree of change by moving services to digital on a like-for-like basis. This approach is sensible as it reduces the risk and disruption associated with the digital upgrade, but it must be seen as the first step of a wider programme of digital transformation; this digital enablement will put in place the technology foundations which can then be used to deliver further service improvements.
Even a like-for-like shift of the service offers a number of benefits; the time to connect users’ is reduced dramatically ensuring that emergency calls can be received and responded to faster; and monitoring and reliability of the service is improved by telecare alarm receiving centres being provided with regular status messages (‘pings’ or ‘heartbeats’) from in-home devices to show that they are operating correctly.
This move to digital also brings challenges. Historically, telecare has been delivered with limited input from IT staff. The move to digital means that telecare becomes an IT service, which will increase the pace of technology change significantly from historical levels and requires a shift in the skills and operational procedures required to manage and deliver the service. Digital telecare is reliant on a range of systems, such as internet connectivity, telephony, security, and potentially cloud-based services, to operate correctly, and staff that understand these systems are required to assist with resolving system issues. Operational processes also need to change to take account of the additional information digital systems provide, for example what does the telecare provider do at 02:00 when the regular ping messages show that a user’s home device has failed?
Digital telecare is installed, new operational processes in place, users migrated, everything working as expected…. job done? An organisation getting this far has certainly achieved a lot and has the comfort in knowing that their service will continue to operate reliably when telecoms companies roll out digital phone lines; but they shouldn’t stop there.
The move to digital technology provides an opportunity for providers to review their telecare service and how it is delivered; improving services and efficiency, and ensuring they fully exploit the capabilities of their upgraded telecare solution.
As an example, digital technology provides telecare providers with a greater degree of flexibility in the routing of users’ calls, meaning that call handling arrangements can be improved, for example, sending calls to other providers for business continuity, or using home based call takers to assist for short periods of time during peaks in call volumes. Automation of some calls types is also possible, freeing up staff time to concentrate on tasks that require the ‘human touch’.
Telecare services are no longer dependent on using dedicated telecare devices. Calls can be taken from a range of equipment, including users’ own phones and other smart devices allowing the reach of telecare services to be widened, both in terms of delivering services outside the home, and to users who may historically have seen a stigma associated with using traditional telecare equipment.
In parallel with these telecare developments, an increasing range of telehealth services are also being developed. Combined with the drive to integrate health and care from an organisational perspective, this means that the longer term goal for digital transformation must be to integrate telehealth and telecare to provide a single person-centred service.
The benefits that will come from this combined service are significant; data on users, collected from a range of services and devices, will be accessible to clinicians and care staff from single location; analytics can be used to monitor users’ health and wellbeing, highlighting where preventative advice, care, or other interventions are required.
While telecare service improvements can be delivered using existing technology, these solutions are not well suited to supporting combined digital health and care services. This requires development in, amongst others, joint health and care records, data standards, and data sharing arrangements. This means that this phase of telecare evolution is likely to be something organisations implement in the medium to long term delivering further technology change in parallel with the wider organisational and operational changes required to support this level of service integration.
Examples of our previous work in Digital Telecare.
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