Only big leverage will lift digitally connected care past the tipping point

Recent reviews and government strategy announcements have kicked off a new, and welcome, cycle of interest in the future of Telecare. The Housing LIN were right to suggest, in their recent white paper, that things could be ‘at a tipping point’. But we have been here before and I’m concerned that if we don’t do things very differently this time, we will just duplicate the same kind of activities that have so far failed to deliver the expected breakthrough. There have been a number of excellent initiatives, but none has satisfied wide enough interests to offer any clear direction for the care sectors to rally around.

Along with many others, I firmly believe correct application of digital technology has tremendous potential to reduce the increasingly unaffordable overload on the formal health and social care sectors while also increasing the productivity and quality of activity within them.

Digital technology has tremendous potential to reduce the overload on the health and social care sectors and to improve productivity and quality of delivery.I say this not as a Technologist, but as a Service Designer. My role is to tailor technology to people, not the other way around, which is all too common. I’ve been doing this in tech for 35 years, quite successfully, across many application sectors.

My work in Inclusive Design for older consumers and technology goes as far back as the early 90’s. In 2011 I chaired the ‘Lifestyle Task Force’ which created the human experience metrics for the Innovate UK d.a.l.l.a.s. project (opens new window): the widely referenced ‘6C’s. I was then the ‘user experience’ lead on the d.a.l.l.a.s. i-focus project which created the benchmark stakeholder map for elderly care and mapped many care scenarios to scope the technical challenge of interoperability from human and organisational perspectives.

Between 2010 and 2016 I was also the user experience design lead on a sequence of 3 large European projects tasked with understanding and overcoming the many human barriers to adoption of care technologies by older consumers, informal carers and managed care organisations. My team and I spent hundreds of hours in user research and co-creation sessions with all the key stakeholders in individual’s life journeys in and out of Informal, Social and Health care regimes. The outcome was a Service Design strategy called WellTogether.

The key learning from all this experience can be summed up in 7 points below. These are a useful benchmark for what needs to happen to create common interests strong enough to leverage digital innovation in the care sector beyond the tipping point.

• The sector needs a beacon for change: a clear, well defined, new tool. A single ‘something’ for care stakeholders across the nation to judge, adopt, criticize, improve and expand. We have Gov.uk, why not ‘Care.uk’? 
• The ‘something’ needs a clear focus on enabling the 4 digital information communication pillars that will drive gains to prevention and productivity: sensor data collection (from door openings to blood pressure) , peer to peer communications (text/audio/video), status sharing (alerts, diaries, presence) and content distribution (personal & institutional care records, trusted links to helpful patient information etc..).
• The ‘something’ needs to be big enough to convince all the stakeholders across the country that ‘this is the one’ that can help them, from individuals self-managing their own wellness to NHS hospital trusts and every form of care in between.
• The ‘something’ needs a solid, lasting, foundation: a highly trustworthy, scalable, data storage and communication architecture. One that is secure enough for the NHS combined with sophisticated privacy controls simple enough to be customised by individual consumers.
• The ‘something’ also needs to be open to extensive customisation by individuals, housing and care organisations and to permanent disruption from open partnerships in fast moving areas like sensor technology and AI.
• The ‘something’ needs a consistent, intuitive interface and terminology that can be picked up easily and used for many tasks over a long period on different kinds of device. In true inclusive fashion this applies equally to users of all ages (including older people), informal carers, and stressed out health-care workers.
• This ‘something’ isn’t a chimera, it’s a man-made artefact called a digital service platform. Well known examples are Facebook, E-bay and AirBNB. Digital platform innovation is the ‘the new normal’ that is driving massive disruptive innovation in everything from agriculture to banking.

Organisations built to deliver services based on digital platforms have grown very fast from start-up to huge scale because they are just that: unified, operationally integrated organisations, without legacies to distort management thinking, well-funded from the outset to grow fast and dominate by enabling large numbers of people to do familiar everyday things better, for less.

They are not ‘standards committees’, ‘coalitions of local best practices’, or ‘pilots’ Each platform satisfies a huge variety of needs using a tightly managed data coordination framework. Content is user-led across multiple individuals and interest groups. Interoperability is coded and owned. Management is lean and focused.

But the compelling power of digital platforms also comes with a health warning: the funding drives the agenda. Do we really want to outsource the solution to our national care challenge to multi-national organisations with their own, commercial agendas, no matter how totally justifiable these may be?

So my call to action is simple: let’s get enough stakeholders together to fund a national, cross sector, digital service platform to offer seamless connected care across all our communities.