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Patient Safety in Community Care: e-health systems and the Care of the Elderly at Home

Handbook of Research on Patient Safety and Quality Care through Health Informatics

This chapter reviews a number of technologies used for remote care: telecare, telehealth, telemedicine, electronic patient record systems, and technologies to support mobile working.

Abstract:

The increasing number of elderly people in need of health and social care is putting pressure on current services to develop better ways of providing integrated care in the community. It is a widely held belief that e-health technologies have great potential in enabling and achieving this goal. This chapter reviews a number of technologies used for this purpose: telecare, telehealth, telemedicine, electronic patient record systems, and technologies to support mobile working. In each case, technocentric-design approaches have led to problematic implementations and failures to achieve adoption into the routine of delivering healthcare. An examination of attempts to implement major changes in the service delivery of integrated care shows that e-health technologies can be successfully implemented when they are seen as an intrinsic part of the creation of a complete system. However, the design process required for successful delivery of these services is challenging; it requires sustained and integrated development work by clinical staff and technologists coordinating their work on process changes, organisational developments, and technology implementations.

Patient Safety in Community Care: e-health systems and the Care of the Elderly at Home Ken Eason

Link to IGI Global

Eason K. D. and Waterson P.E Patient Safety in Community Care: e-health systems and the care of the elderly at home In Michel V., Gulliver S., Rosenorn-Lang D. and Currie W. (eds) Patient Safety and Quality Dimensions of Health Informatics. IGI Global 198-213

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

Published in ‘Healthcare Administration: Concepts, Methodologies, Tools, and Applications’

Abstract:
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.

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.

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

IGI Chapter Link

Eason K. D., Waterson P. and Davda P. (2013) The Sociotechnical Challenge of Integrating Telehealth and Telecare into Health and Social Care for the Elderly International Journal of Sociotechnology and Knowledge Development 5(4) 14-26