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

2. 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

3. 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 £ m 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?

4. 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

5. Digital Connectivity Challenges
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?

6. Digital Connectivity Challenges
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

7. 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

8. 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)

9. 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.

10. 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