Digital opportunities in Technology-Enabled Care STEve Sadler – TSA Sept 2017

Telecomms Digital Shift & Telecare Over the next few years (by 2025 latest?), analogue telephone services in the UK will be switched-off and replaced by packet- switched solutions (“ALL-IP”) Analogue systems (using ‘voice-band data’) are all affected to some degree, including: Security systems Fire alarm systems Cash-payment terminals TELECARE Migration is already underway, service providers experiencing data-transmission failures

Telecomms Digital Shift & Telecare Over 1.5 million telecare users in the UK employ analogue-connected systems Many analogue telecare systems will need upgrade or replacement – potential cost £150-300m over 5-7yrs Age of telecare users averages 75+ Limiting Long-Term Conditions 4x higher for 75+ than ages 25-44 An opportunity for better management of Long-Term Conditions?

Digital Shift & TSA Consultation ‘Think Tank’ (24 May 2017): 45 attendees, multiple stakeholder groups Input from international projects already underway, including Sweden Scotland (NHS Scotland A2DT programme) Participants examined multiple viewpoints: Users of health and care technology Care Service providers Infrastructure – providers & regulators Commissioners of health and care services Manufacturers of health and care technology Identified challenges, opportunities and proposed actions White Paper (October 2017) A Digital Future for TEC: Connecting People and Improving Lives

Digital Connectivity Challenges 100101110001100111100000110100011101010111010000101111001 Digital Connectivity Challenges Which care services and how connected? alarms, health data, voice, video? - what data-exchange is needed? 3G VoIP poor performance? - what connectivity performance is needed? 4G, 5G coverage & cost? - broadband or cellular or both? Who pays?

Digital Connectivity Challenges 100101110001100111100000110100011101010111010000101111001 Digital Connectivity Challenges Service Availability & life-critical systems New failure modes - reliance on single-channel not adequate Need ‘availability on demand’ - diversity, redundancy…. Scope of IP connectivity End-to-end? - body-word devices, voice? range? battery? IP-connectivity not always available What if IP-connections fail? - switch connection type? Information Governance, inc protection against cyber-threats Losing protective ‘analogue barrier’ Data security in IP-connected world? - design for security, penetration test

Digital Connectivity Challenges Geographic coverage Scheduling timing of telecoms switchover? co-existence of analogue & digital? Guidance & Regulatory Environment older regulations & standards may not apply role for guidelines - Standards development takes time Integration and Interoperability enable integrated and coordinated care - interoperability with community services & systems new and multiple suppliers - end-to-end reliability, and liability

Digital TEC Opportunities New, proactive service opportunities How to define and evidence benefits? How to exploit richer datasets? Voice of the consumer Increasing awareness of new technology Expectations increasing UK Telecare (85% inbound calls) Spain – Barcelona (70% outbound)

Digital TEC Opportunities Do we target ‘like for like’ digital TECS? OR One-time opportunity to include new technologies? Capture new technology expectations of users/buyers. Target a mixed-economy (co-pay) model. WHICH Needs evolution of systems design guidelines and service standards.

Key Issues Establish extent of the digital impact on telecare, and the timelines? Like-for-like digital TECS, or a one-time opportunity to include new technology and new health and care solutions? Identifying and evidencing new, data-driven health & care service opportunities? Will emergent technology and services disrupt economic models for TECS? (e.g. co-pay, personal budgets) Evolution of guidance & standards for systems and data design, to ensure dependability in life-critical applications Bringing TECS into core health & care delivery, via platforms that support integrated and coordinated care