Q1. What is Assisted Living?

A1. Assisted Living involves the application of sensor based condition monitoring which combined with a response service provides the additional degree of support needed to help people with particular health or mobility needs to continue to lead an active and independent life in their homes. A very simple but well understood example would be the "call buttons" that the frail elderly or those with needs that require an immediate response may have fitted in their homes or carry with them and which are linked to a call centre. The range of sensor based support services is expanding rapidly including into the area of monitoring of medical conditions.

 

Q2. This project is one of a number approved by the Technology Strategy Board to support the development of services for those with chronic conditions. Why is this important?

A2. An increasing number of people - of all ages - are suffering from chronic conditions. Often these conditions can not be cured but they can be managed. The challenge for society and the individuals themselves is to develop innovative arrangements for the monitoring and management of these conditions. To harness modern sensor and communication technologies to support assisted living in radically new ways.

Traditionally the management of chronic conditions would have been achieved through regular visits to GPs and Out Patients Departments and also regular home visits by Community and Specialist Nurses. However, with the development of new sensor technology, new means of data exchange including in particular the internet plus new working practices within the NHS and closer collaboration between social services and other agencies it is now possible for patients to take a more active part in the (real time) management of their own conditions and to do this in the comfort of their own home. The potential for data monitoring to take place in real time also offers the opportunity for the individual and their health service suppliers to make earlier interventions and so avoid the patient's health deteriorating to the point where emergency hospital admission becomes necessary.  The outcome should be improved services for users, better health outcomes and reduced demand on the emergency services.

 

Q3. Why is there a need for research in this area?

A3.  Current practice is for individual sensors to monitor a particular condition or characteristic relating to medical and other factors affecting the user in their home. Monitoring can cover a wide range of medical and other matters such as blood glucose levels, movement of the user within their home, overflowing baths or sinks, room temperature and so on. Data is sent by phone (usually a fixed land line) to a call centre which actions the required response if any.

Typically the sensors will have been produced by manufacturers to their own technical and software standards. Sensors produced by different manufacturers are unlikely to be compatible - so ruling out any prospect of a market place based on flexible plug and play capability regardless of the manufacturer with consequential  difficulties in getting sensors to work together. Call Centres will handle only certain streams of data. Sharing data across a network of service providers who may need to communicate with each other to deliver coordinated support to meet the needs of users is unlikely. Data transfer across different media such as fibre to mobile and vice versa may not be straightforward.

There is a pressing need to find solutions to issues relating to the establishment of an open access communication infrastructure including in particular finding a solution to technical and software incompatibility and the need for seamless data flow across communications media. We need to make substantive progress in these areas if we are going to remove impediments to stimulating competition and increased consumer choice for assisted living products and also to stimulate the development of more effective services which follow the user wherever they might be - in or out of their home.

Our project will begin to address a number of these issues.  What we will not be addressing in this project is anything to do with the quality and scope of services delivered in response to data transfer.  

 

Q4. Describe the project in broad terms.

A4. Our 3 year project comprises 6 major elements:

 

• Developing for demonstration purposes a "model" of a software tool that will enable better informed decision making on assisted living products to meet the individual needs of those suffering from chronic conditions given their specific circumstances and the needs of their family and carers.
• Identifying the impediments and standardisation issues necessary to achieve connection and inter-operability of sensors regardless of the particular manufacturer and seamless data transfer between the user, their carers and family and those involved in the delivery of assisted living services.
• Determining the role and function of a "Health Hub" that will enable the unrestricted transfer of data. This may or may not involve a specific piece of equipment.
• Developing Guidance on the installation of the communication infrastructure into the built environment alongside physical adaptations to support the user to remain in their home for as long as possible.
• Scoping out the requirements for large scale National Testing Facilities for the assessment and certification of new sensor and communication solutions. Ensuring that products will deliver appropriate technical performance, durability and confidentiality need to be assured.
• Identifying opportunities for trialling new sensor based assisted living services to support those with chronic conditions in large scale real world demonstration projects

Our job is to identify and deal with impediments to achieving seamless communications and in supporting market development based on inter-operable products. Making progress on these matters is essential if new models for assisted living are to be realised.

 

Q5.  Is the use of sensor based technology simply a way to save money in the delivery of services to those with chronic conditions?

A5. The cost of treating chronic conditions or providing additional care is growing rapidly in response to an increasing population, an ageing population and a major increase in the numbers of those suffering with chronic conditions. The use of sensor based technology has the potential to expand the range of services that can be provided and also increase the quality of services to the user and to the users family, friends and carers.  It is not clear if any savings will arise as a direct result of the enabled services since in many cases there will be no existing comparator against which to make an assessment. However, it is entirely likely that the use of sensors to monitor the condition of patients and to involve users more fully in managing their own health will reduce the incidence of emergency admissions to hospital as well as improving long term monitoring as a stimulus to better diagnosis and better management of medical conditions.  In the absence of this technology it is certain that the cost of maintaining current models of care will impose increasing strain on health budgets.

 

Q6. How fundamental is the assisted living programme to future of the NHS and to health services globally?

A6 There seems little doubt that harnessing the potential of inter-operable sensor based technologies with a seamless communication infrastructure has the potential to support step-change in the delivery of health services. In particular the technology has the potential to enable all of us to become much more involved in taking care of our health as a matter of routine not simply when a problem arises. The potential of the technology ranges much wider than just assisted living - although this is the strategic priority at this point in time. It is anticipated that the fundamental challenge will not be in achieving seamless communications and technical compatibility but rather the extent to which service providers will refresh their offerings and working methods to deliver models of service response that will maximise the health and assisted living outcomes opportunities that the technology will enable.     

 

Q7. What do you mean by the "Health Hub"?

A7. The Health Hub is the term used to describe the mechanism which manages the two way flow of information from and to the user. It may or may not be a distinct piece of new equipment. It is entirely likely that the flow of data can be managed by software embedded into new sensor products and/or provided within communication or display devices such as mobile phones or TVs. This needs serious attention in order to clearly capture what we mean by the Hub. The graphic shows two Hubs - this can't be right can it?  

 

Q8. Why is it important to develop interoperable "plug and play" services to link together various sensors and to enable data to flow through a range of IT media?

A8. In order to grow the market and increase choice for users and other decision takers and to stimulate competitiveness within the space it is essential that artificial barriers to entry are minimised. For the market to develop we need to remove technical restrictions which currently serve to frustrate the free flow of data and in effect give rise to restricted services.

 

Q9. Why should manufacturers support measures that will open up their markets to competitors?

A9. We are looking at addressing the impediments to creating a much larger EU and Global market for products and services in which manufacturers will be able to compete for market share. Increased consumer involvement in the choice of product can be expected to drive design and functionality enhancements. In turn economies of scale arising from this larger market should serve to reduce the cost of the products.

 

Q10. What do the project partners bring to the project?

A10. This project is led by the Digital Access Forum which is a consortium of leading technology providers, clients, assisted living equipment suppliers, user representatives, construction interests, local authorities and others. Our consortium includes the full range of interests needed to deliver the project objectives.

 

Q11. Does this project have application outside of the UK?

A11. Support for assisted living is a policy priority for many advanced economies. The pressures resulting from an ageing population and the need to help people to remain longer in their homes has international recognition. Many of the members of our Consortium operate internationally. Since our work programme is focusing on the delivery of a seamless flow of information and is entirely agnostic on the financial arrangements for health and social service delivery we believe that our project outcomes will provide commercial benefits for the UK in seeking overseas opportunities in the market for assisted living. In addition to commercial opportunities arising from new technology the development of a seamless communication platform will open up substantial opportunities for the UK suppliers to seek commercial service supply contracts based on this common platform.

 

Q12.  How will your project advance the development of services for those with chronic conditions in the UK?

A12. Our project will advance knowledge and will identify on a trial basis new technologies to deliver enhanced services in support of assisted living which are developed and delivered with the user at the heart of the process. Our project will not however deliver technical solutions that will be capable of immediate introduction onto the market place. However, in order to get to the point where there are no technical impediments to the connection of devices produced by different manufacturers and where data can travel seamlessly across various media (which were of course developed for an entirely separate purpose) it is essential that this enabling work is carried out. Our project will take us a lot closer to the point where large trialling of an integrated approach to the delivery of assisted living technology can take place.

 

Q13. Why is the BRE involved in this project?

A13. BRE is recognised for its impartiality and authority within the built environment. BRE is not competing for market share in the delivery of assisted living services and because of this has been able to connect the various competing and supply chain partners. BRE will provide specialist advice to inform the integration of assisted living technologies and infrastructure within the built environment and to communicate with built environment clients on the trialling and widespread application of the new technology.

 

Supplementary Q&A

Q.  What is Tele-Care?

A.  Tele-Care is the name given to the application of sensors to enable external real time monitoring of the "environmental" conditions and the movement of the users of the Technology. Examples include flood detection, falling out of bed and gas leakage. Typically these individual sensors will be linked by a phone line to a call centre where monitoring takes place.

 

Q. What is Tele-Medecine?

A.  Tele-Medecine involves the use of sensors to obtain real time information relevant to certain clinical conditions affecting the user. Often the sensors will be remotely monitored by a Community Matron or another health practitioner. The data received may in extreme cases generate an immediate medical response but generally it will provide a record of the patient's  condition without the need for the user to undergo the stress and inconvenience of  attending clinics or out-patients for regular testing.

 

Q.  So is your project about Tele-Care or Tele-Medecine?

A.  The focus for our project is on the provision of assisted living support for those suffering from chronic conditions. It is entirely likely that users will need support both in connection with Care and also the monitoring of clinical conditions. In any event our programme is looking at the development of data transfer methods and therefore we are agnostic on the end use application.