It has been some
time since I wrote about terminology (http://thetelecareblog.blogspot.com/2010/01/language-of-telecare.html)
but it’s funny that in the time since that piece was written things have moved
on and new services have developed. I do not intend to repeat that blog entry
but I think we need to have some common sense when it comes to the terms and
their usage. Maybe the discussion on
terminology is old hat and not of great worth at this time. Maybe the time is right to open the chest and
peek inside....
I have already
pointed out (in various papers) that the term ‘assistive technology’ has a
range of meanings depending on where you live in the world. In the USA, assistive technology is focused
on the technologies that can be used to assist children in schools and with
their education in general. The UK
meaning is very different. Similarly,
telecare in the USA is known as ‘Personal Emergency Response System’ (PERS) or ‘medical
alerts’, whereas the actual term ‘telecare’ refers to a range of technologies
relating to medical/health at a distance (which in the UK is defined as telemedicine
and telehealth).
Telecare seems
to be a catchall term. Breaking the word down, there is tele (distant) and care (the
act of caring, providing care, providing a caring service, providing care for a
person, caring for a person, showing you care). This can be contrasted with the
word ecare, which has the same second
half but the ‘e’ stands for
electronic. To contrast these two words,
telecare and ecare we need to see the
differences as one is care at a distance and the other is care provided through
electronic means. Similarly, ehealth and mhealth differ by health being provided electronically (e) or via mobile services (m).
A key feature of
telecare is remote monitoring, this involves people and technology (i.e. people
who monitor the alerts and call the person generating the alert). I consider a simple automated telephone service
that has a set of predetermined responses is not telecare; this is ecare. Strictly speaking, it should not
even count as ecare, but emonitoring as much of telecare and ecare is concerned with monitoring.
The public need
to be assured that what they are purchasing provides value for money and does what
they expect. In ecare systems there
are potentially no human interventions, whereas in telecare systems there are.
Does the system have call centres where people speak to the person who has
triggered the alert? Do the call centres
operatives also make decision on the best course of action (response unit, friends,
family, emergency services, doctor, etc)?
The way that a service is described needs to be clear for the customer as
their purchases result in a long-term commitments and cash outlays.
Current
regulations do not cover the differing types of service and legislation fails
to differentiate between the differing aspects of monitoring available.
I can see the
benefits of all the differing types of monitoring on the market and strongly
believe they each have a place and a level of merit. What I am concerned about is that the
language that is used does not allow for the differentiation that there is
between these services.
Personally, I am
not bothered what category a service fits under rather I am more concerned
about the service they provide. Where I do get concerned is when services are
portrayed as belonging to something they do not belong to, as this is a
misrepresentation to the public. The
people purchasing a telecare service are expecting care at a distance, whereas when
people are purchasing ecare they should be aware it is all
electronic.
I understand why
the name telecare was derived, but I also think that this name should be
changed to emonitoring or
telemonitoring. This way it says what
it does on the packet. I can also accept
that if a telecare service has a full response unit that will be attending
people in their home as part of the package then it might deserve the term
telecare, but many services currently fail to even offer this basic service.
As a potential
purchaser of telecare, for my mother, I suspect that when I look for the
company that will be providing the monitoring and technology, one of the first
questions I will be asking is does the services do what it says on the packet? Is this a real telecare service?
I know the currently
the UK Government is endorsing telecare through the Whole Systems Demonstrators
and the 3millionlives initiative has spent considerably large amounts of money
on developing and deploying telecare in the UK and there are now over 1 million
people with the service, I suspect that if we redefined telecare to make it
more realistic we will find the figures are very different.
