Telecare System Research Articles

User satisfaction with home telecare based on broadband communication.

Home telecare services based on broadband communication were established in five locations in Europe. Two different types of telecare unit were developed: one based on a PC or set-top box containing a videoconferencing codec and another on off-the-shelf videoconferencing units. The participants in the project were 13 medical staff, 135 patients and 88 people informally caring for the patients. Questionnaires were used to evaluate user satisfaction with eight telecare services. Almost all participants rated the usability of the system as good or excellent. A total of 105 telecare sessions were scored by the medical staff. Overall, the quality of audio and video communication was judged satisfactory. For the patients and carers, the perceived quality of communication was also satisfactory and did not vary significantly between sites. The medical staff were reasonably satisfied with how the service supported them in their work. Except for the item about being able to support patients in a critical situation, medical staff agreed that an improved quality of health services was offered through telecare. All participants agreed that personal information was treated confidentially and that there was little risk in using the telecare services. The medical staff trusted the assessments they could make remotely while using the telecare system. Although the findings cannot be generalized due to the small number of telecare sessions and the relatively short duration of the experiment, the results encourage further research.

Human action pattern monitor for telecare system utilizing magnetic thin film infrared sensor

The magnetic thin film infrared sensor (MFI) is an infrared sensing device utilizing a temperature-sensitive magnetic thin film with marked temperature dependence in the room temperature range. We propose a human action pattern monitor (HPM) constructed with the MFI, without a monitor camera to save the clients’ privacy, as a telecare system.

8B12 在宅酸素療法実施者のための遠隔看護支援システムの開発に関する研究

8B12 在宅酸素療法実施者のための遠隔看護支援システムの開発に関する研究

A knowledge-based multimedia telecare system to improve the provision of formal and informal care for the elderly and disabled

A knowledge-based multimedia telecare system to improve the provision of formal and informal care for the elderly and disabled

Practical solutions for the integration of community alarms, assistive technologies and telecare

The use of telecare with appropriate domiciliary care packages may provide the means to manage many of the risks associated with the increasing number of older people who wish to continue to live independently in their own homes. Those who become especially frail or disabled can retain their independence and quality of life if their homes are made ‘smart’. This paper discusses the range of services that are available, or under development, for the prototype ‘MIDAS’ (Modular Intelligent Domiciliary Alarm System) telecare system, which enable traditional community alarm, telecare and assistive technologies to be used in an integrated and intelligent fashion. A range of services that allow autonomous operation within the home (and hence increase the perceived independence of a client by decreasing the reliance on a response centre operator) known as ‘HAMISH’ may be used. It offers a wider range of cost‐effective services of relevance to both the individual, and to society, in different types of home environment including dispersed housing and new sheltered housing schemes.

An attributable cost model for a telecare system using advanced community alarms.

We have developed an attributable cost model for a city-based telecare scheme involving 11,618 community alarm users. The equipment was assumed to cost 500 Pounds-1000 Pounds per installation, compared with 175 Pounds for the current system. Because of the significant additional capital cost of the proposed system, it would be necessary to borrow to finance it. For example, if the home equipment cost 500 Pounds per unit, an additional 2.2 million Pounds would be required. Nonetheless, it would be possible to achieve a return on the investment after 10 years. The principal savings would arise from reduced hospital bed costs and reduced residential care. The model suggests that the financial benefits of the proposed system would occur in the ratio of 4% to the local authority housing department, 43% to the National Health Service and 53% to the residential care provider.

Telecare in practice: a telecare initiative focusing on carers of older people based on Action

There is a continual need to support and assist carers who play a central role in providing informal care for a relative. This approach to care provision must have a strong foundation based on liaison between the family carers, professional carers and the older or disabled person who is the focus of care. Services that enable effective communication using videoconferencing, interactive communication, tailored Web based programs and other specific resources configured for the needs of the individual can help carers carry out their role effectively. The initiative described in this paper uses a combination of telematic focused interventions to meet the needs of carers and provides an in-depth overview of the ACTION telecare project. The ACTION (Assisting Carers using Telematic Interventions to meet Older persons’ Needs) project was set up and funded because of the need to develop supportive methods for carers and older people. The initiative was designed to improve autonomy and maintain independence and quality of life for people in their own homes and therefore reduce the need for institutional care. This has an economic as well as a social dimension. The project has demonstrated that with the involvement of users at all levels it can fulfil this need. The role of the ACTION project was to develop a cost-effective telecare system for the provision of education, information and support and has been demonstrated with successful results.

A knowledge-based multimedia telecare system to improve the provision of formal and informal care for the elderly and disabled.

We have developed a knowledge-based multimedia telecare system, based on a multimedia PC connected by ISDN at 128 kbit/s. The user display is a television. Multimedia material is accessed through a browser-based interface. A remote-control handset is used as the main means of interaction, to ensure ease of use and overcome any initial reservations resulting from 'technophobia' on the part of the informal carer. The system was used in 13 family homes and four professional sites in Northern Ireland. The evaluations produced positive comments from the informal carers. There are plans to expand the use of the system.

磁気赤外線センサによる人間の行動パターン計測

A magnetic infrared sensor (MIS) is a device that converts radiated infrared rays into magnetic change by means of its energy. Photoelectrical sensors using photoconductive, photovoltaic, photoemissive and pyroelectric effects have hitherto been used as an infrared sensor. The MIS system constructed with a 1.0-μm-thickness ferrimagnetic Film (FMF) prepared by RF sputtering and a magnetoresistance element. When infrared rays are directed onto the FMF, it receives energy and the device’s temperature rises, causing magnetic change. After this minute change is read out by a magnetoresistance element, it is converted into voltage. This paper describes the structure of the MIS and its application to the measurements of human action patterns for a telecare system without a monitor camera that protects the privacy of old people living alone.

Safety and risk issues in using telecare

The increasing adoption of technology to support independent living at home through the extended use of community alarms and, ultimately, second-generation telecare systems poses some safety problems. The implications of any failure of the technology must be addressed in order to provide a safe and reliable care service. The risks of using home-based technology can be assessed by standard techniques under three categories: environmental factors; human factors; and technological factors. A safety classification system for telecare devices is proposed leading to a range of design guidelines which represent good practice. An example of the use of these design principles is a prototype second-generation telecare system, MIDAS, which is currently undergoing trials. In order to reduce the risks associated with device failure, the system incorporates distributed intelligence, built-in self-testing and redundancy. Potentially hazardous situations can therefore be controlled.

Do community alarm users want telecare?

Previous surveys have suggested that community alarm users are in general satisfied with the service provided. However, there is also evidence that users would like additional options that could be provided by a telecare system. Inner-city users of community alarms were consulted about their current systems and the extension of these to incorporate telecare options. The users lived in 160 homes in three multistorey apartment blocks. The average age of the 176 users surveyed was 76 years. Seventy-seven per cent of users were interested in automatic fall detection, 68% in lifestyle monitoring, 57% in telemedicine and 46% in videoconferencing. Nineteen of those interviewed (11%) did not want any of the suggested enhancements. The survey showed that elderly people are not technophobes, since 58% possessed either a microwave oven or a video-recorder, and also showed that the majority were prepared to accept new technologies that would support their independence.

Home telecare system using cable television plants--an experimental field trial.

To solve the inconvenience of routine transportation of chronically ill and handicapped patients, this paper proposes a platform based on a hybrid fiber coaxial (HFC) network in Taiwan designed to make a home telecare system feasible. The aim of this home telecare system is to combine biomedical data, including three-channel electrocardiogram (ECG) and blood pressure (BP), video, and audio into a National Television Standard Committee (NTSC) channel for communication between the patient and healthcare provider. Digitized biomedical data and output from medical devices can be further modulated to a second audio program (SAP) subchannel which can be used for second-language audio in NTSC television signals. For long-distance transmission, we translate the digital biomedical data into the frequency domain using frequency shift key (FSK) technology and insert this signal into an SAP band. The whole system has been implemented and tested. The results obtained using this system clearly demonstrated that real-time video, audio, and biomedical data transmission are very clear with a carrier-to-noise ratio up to 43 dB.

A home telecare system for the care of chronic respiratory patients

A home telecare system for the care of chronic respiratory patients

Future systems for remote health care.

As the number of elderly people in society increases, the use of technology to support the care system is being examined. However, there is no agreed model of a technology-based health-care system that fully integrates the technical and social aspects to meet the needs of both clients and care providers. This paper examines a possible model from the perspective of both the client and the service provider, and estimates the costs, and hence the potential savings, associated with the introduction of a health-care system based on this model. Cost data are presented in the context of an installation as might be anticipated within a city such as Birmingham, UK. Installation costs of an advanced telecare system would be higher than the set-up costs of conventional systems. Expected savings in control centre costs and emergency services costs would be small. However, a reduction in the average annual length of hospital stay by one day and a reduction in the proportion of elderly people being treated in hospital from 32.4% to 32.0%, directly as a result of the use of advanced telecare, would produce significant savings. A financing scheme with a 5-year or 10-year repayment period would then be financially viable for a 10,000-home advanced telecare system.

Home telecare.

Technology can be used to help the care of people at home in many ways and home health care is one of the fastest growing areas of health-care provision. Home-based technology has two main facets: passive monitoring and active measurement. Technical solutions must be acceptable to both the health-care staff and the assisted person, and should supplement not replace human carers. Other important aspects of technical solutions are: simplicity of operation and management, availability, reliability and affordability. The introduction of a home telecare system always requires changes in organization, since it is not enough simply to transmit data. The data must be received and interpreted, and advice for care must be provided. The most important aspects of home telecare are: organization and training; improving the quality of care; improving the quality of life; economy; and technology.

Nurse and patient reactions to a developmental home telecare system.

Pilot studies have suggested that telemedicine is a satisfactory means of delivering nursing services into the home. A home telecare programme in Kansas provided nursing services to homes in four towns in Kansas. The present study examined patients' and nurses' perceptions of a variety of issues related to home telecare. Data-collection methods included in-depth interviews, observation and analyses of archival data from patient records. Patients suffered an average of 4.6 concurrent illnesses. On the whole, patients perceived the system as a valuable resource that offered great potential, although many saw no immediate health benefits for themselves. Nurses were enthusiastic about the prospect of practising in this way, although they did have strong opinions about what types of nurses, patients and illnesses were suited to telemedicine.

Lifestyle monitoring - technology for supported independence

Demand for community care services continues to increase due to demographic changes and rising expectations of quality of life. New technology may be able to enhance the range of current care services while also increasing efficiency and reducing the operating costs of those agencies providing the care. This would assist human carers to deliver care to where it is most required and at the most appropriate time, thereby supporting the independence of vulnerable people living in the community. This article describes a telecare system, based on lifestyle monitoring, which has been developed as part of a research project between BT and Anchor Trust.

Telecare at home: factors influencing technology choices and user acceptance.

Acceptance of telecare technologies in the home is strongly influenced by factors that relate to dwelling design and the ways in which independent living is promoted. The experience to date of personal response systems (and services) provides some indication of the reasons why users may either resist their introduction or not use such technologies after they have been introduced. Telecare systems and services are poised to incorporate medical and other sensors, so that the manner of their provision, installation and control becomes an important consideration for service providers. A clear ethical framework is called for.

A systems approach to achieving CarerNet--an integrated and intelligent telecare system.

The system requirements for an integrated telecare system are presented by using a modification of the CORE methodology. The resulting system model uses viewpoint analysis to establish the needs and requirements of both the client and the care providers within a system context and discusses the implications for a user-centered, technology-based solution referred to as "CarerNet." The implementation of CarerNet is considered in terms of the enabling technologies required within the local environment of the client and identifies the monitoring, networking requirements, and system intelligence necessary to the provision of a comprehensive telecare service. A hypothetical case study based on patient aftercare following discharge from the hospital is presented to illustrate the points discussed.

Continuous assessment of the risk of falling using telecare.

The prevention of falls in the elderly could be based on risk assessment and the prediction of when an individual is likely to sustain an injury. A telecare system should allow the dynamic assessment of risk to be produced by a control centre computer, based on data transmitted from local sensors in the elderly person's home. A fall risk index could be calculated from mobility, activities of daily living and medication. However, substantial data-sets will be required before such fall risk indices attain statistical significance. As they are developed, fall prediction algorithms could be constantly reviewed and modified in order to reach the point where an acceptable level of accuracy is reached.