SAPHE - policy and uptake SAPHE Steering Committee 15 September 2006

Discussion Pervasive healthcare policy development –Telecare vs. e-Health Market models –Public sector vs. Consumer driven SAPHE exploitation & communication plans

Policy background Over 20 government reports since 1998 have called for telecare Targets in Delivering C21 NHS IT Support (reiterated by ODPM in Nov 2005) £80m+ via Preventative Technology Grant (PTG) for telecare, plus equivalent programmes in Wales and Scotland Partnerships for Older People Projects (POPP): 9 out of 19 projects in first wave Whole system telecare demonstrator across a unitary authority, with telecare in c.9,000 homes, to start Jan 2007 (?) Telecare supports strategic health policy agenda: care outside hospitals, capacity management (bed blocking), chronic disease management & focus on prevention and self care

Government and other official reports mentioning telecare published annually Royal Commission on Long Term Care National strategic programme for IT in the NHS Building Telecare in England

Business models Public provision Private consumer demand Designed system Internal regulation Tendency to lowest common denominator Oppressive requirement for evidence base before adoption Inertia Can meet objectives of NHS care provision Poorly defined or complex customer relationships Emergent systems Ad hoc standards Responsive to consumer demands Fragmented suppliers and systems Lack of integration No inherent equity Potential for emergence of non-optimal oligopoly supply chains

Public sector business model The telecare ‘supply chain’ involves several key stages: –Needs assessment –Care package development –Development of telecare prescription & response protocol –Home survey –Equipment provision –Installation and maintenance –Monitoring of the individual –Call handling –Response in the event of an exception / problem –Review and reassessment of needs Different public, private and voluntary sector partners will be responsible for different stages These will come together in different configurations depending on the telecare application (e.g. conditions specific vital signs monitoring v. general safety & security monitoring)

Entry (Re) assessment of need Care package development Home survey Telecare prescription & response protocol Equipment provision Installation and maintenance Monitoring Call handling Response Review Telecare supply chain – key stages Source: Barlow & Curry 2006

Entry (Re) assessment of need Care package development Home survey Telecare prescription & response protocol Equipment provision Installation and maintenance Monitoring Call handling Response Review Different agencies / companies involved in different stages in different configurations … PCT / Acute / Social Services? Source: Barlow & Curry 2006

Entry (Re) assessment of need Care package development Home survey Telecare prescription & response protocol Equipment provision Installation and maintenance Monitoring Call handling Response Review Telecare supply chain Telecare equipment supplier 1 Source: Barlow & Curry 2006

Entry (Re) assessment of need Care package development Home survey Telecare prescription & response protocol Equipment provision Installation and maintenance Monitoring Call handling Response Review Telecare equipment supplier 2 Source: Barlow & Curry 2006 Telecare supply chain

Entry (Re) assessment of need Care package development Home survey Telecare prescription & response protocol Equipment provision Installation and maintenance Monitoring Call handling Response Review Specialist call centre / NHS Direct etc 1 Source: Barlow & Curry 2006 Telecare supply chain

Entry (Re) assessment of need Care package development Home survey Telecare prescription & response protocol Equipment provision Installation and maintenance Monitoring Call handling Response Review Specialist call centre / NHS Direct etc 2 Source: Barlow & Curry 2006 Telecare supply chain

Entry (Re) assessment of need Care package development Home survey Telecare prescription & response protocol Equipment provision Installation and maintenance Monitoring Call handling Response Review Voluntary sector, relatives, neighbours Source: Barlow & Curry 2006 Telecare supply chain

Entry (Re) assessment of need Care package development Home survey Telecare prescription & response protocol Equipment provision Installation and maintenance Monitoring Call handling Response Review Voluntary sector, relatives, neighbours PCT / Acute / Social Services Source: Barlow & Curry 2006 Telecare supply chain

Private supply chain Individual consumer making purchasing decisions Supply routes: –Traditional alarm suppliers –High street retailers –Insurance –Health service providers –Direct sales to customers Issues –Trust and confidence: consumers and health professions –System integration –Emergence of monopoly suppliers eliminating innovations

Exploitation & Communication Plans Technical approach 1.Develop a novel telecare system based on experience from Care in the Community Centre and UbiCare Centre 2.Establish formal requirements for the specification and testing of such a system 3.Modelling the value to providers and users and the potential ways in which such novel telecare systems could be deployed 4.Running a trial to demonstrate effectiveness and validating the value and deployment models

Exploitation & Communication Plans Innovations 1.Intelligent ‘blob’ ambient motion sensor 2.Wireless sensing – low cost versatile nodes 3.Wireless sensing – low cost ambient installation 4.Wireless sensing – unobtrusive vital signs and context sensing 5.Data fusion and feature recognition 6.System value modelling 7.Trial of an integrated wireless sensing system for pervasive healthcare applications

Exploitation & Communication Plans Expected Deliverables From Project 1.Monitoring software 2.Wireless nodes 3.Ambient sensors, especially intelligent ‘blob’ sensor 4.Wearable physiological sensors 5.Trials results 6.Telecare business models 7.SAPHE prototype system How to exploit each of these?

SAPHE Potential market Target market: chronic disease management; also be applicable to care of the elderly Major diseases: CHD, Hyper- tension, COPD, Asthma, Diabetes, Stroke and Dementia. –total prevalence in UK is approximately 17M ( allowing for co- morbidities, approx 10M) Target users: seriously affected of these - 1.5M to 2M people in UK –£2.2bn UK market potential in UK (based on annual value of sales and services at around £1,200 each) –the world market potential of £40bn by 2020.

Project Dissemination Activities Detail planned publications. –D02 – Service and End User Requirement –D03 – Details of specification and service model scenarios –D06 – SAPHE Prototype architecture analysis –D07 – Service Requirement for large scale deployment –D11 – Pre-trial cost benefit deployment models –D16 – Post-trial analysis –D19 – Telecare deployment business models –Top level technical specification –Complete user and trial system specification, and outline trial design –Completed and verified system and trial approvals –Final Report

Stakeholders SAPHE Steering Committee Government: –Department of Health and NHS –Department of Social Security –DTI Healthcare Technologies KTN/Medilinks Commercial Customers Community Activities Research Community User Communities Pervasive Computing/Wireless/Healthcare Community Press