The Sociotechnical Challenge of Integrating Telehealth and Telecare into Health and Social Care for the Elderly

The Sociotechnical Challenge of Integrating Telehealth and Telecare into Health and Social Care for the Elderly

Ken Eason, Patrick Waterson, Priya Davda
DOI: 10.4018/978-1-4666-6339-8.ch063
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Telehealth and telecare have been heralded as major mechanisms by which frail elderly people can continue to live at home but numerous pilot studies have not led to the adoption of these technologies as mainstream contributors to the health and social care of people in the community. This paper reviews why dissemination has proved difficult and concludes that one problem is that these technologies require considerable organisational changes if they are to be effective: successful implementation is not just a technical design issue but is a sociotechnical design challenge. The paper reviews the plans of 25 health communities in England to introduce integrated health and social care for the elderly. It concludes that these plans when implemented will produce organisational environments conducive to the mainstream deployment of telehealth and telecare. However, the plans focus on different kinds of integrated care and each makes different demands on telehealth and telecare. Progress on getting mainstream benefits from telehealth and telecare will therefore depend on building a number of different sociotechnical systems geared to different forms of integrated care and incorporating different forms of telehealth and telecare.
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2. The Promise And Disappointment Of Telehealth And Telecare

There is widespread belief that telehealth and telecare applications can be used to help people live independent lives at home even when they are suffering from multiple conditions that are severely disabling. In England the Department of Health has launched the 3 million lives programme ( to encourage their widespread deployment in community care. There are a variety of names given to technologies that support the health and social care of people in their own homes and in care homes. Telecare applications, often associated with social care, typically provide monitors and alarms in the home or on the person that can alert external agencies, e.g. in a call centre, when the person has a fall or another kind of emergency so that help can be sent. Telehealth and telemedicine are tools for health practitioners to deploy which, for example, enable test results to be collected at home and monitored by healthcare agencies or, in the case of telemedicine, enable remote real-time conversations between a patient and a medical specialist. These applications may also enable the person themselves to monitor their own health and achieve a higher level of self-management of their long-term conditions.

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