‘What is telecare?’ is an interesting question! Telecare Aware

The question ‘What is Telecare?’ has several answers

About this page

This page explains the difference between the terms telecare, telemedicine and telehealth in the social and health service context. However, the definitions of these terms are still under debate in the telecare/telehealth community. ‘Telecare’ is not found in dictionaries and, if it were, the definitions would probably be out of date. To complicate matters, ‘telecare’ is used quite differently in other contexts (see panel on right) and some people also use other terms for telecare, such as ‘electronic assistive technology’ and ‘preventative technology’.

Part of the problem for anyone who wants to define telecare is that equipment devices are inseparable from the systems that provide appropriate and timely responses to information from them.

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Telecare Aware is a news service about telecare and telehealth developments (see main page). To save having to search the internet constantly yourself for such news, sign up for alerts emails using the ‘Keep Informed’ form, above right.

If you were looking for other meanings of ‘telecare’, such as the eTelecare telecoms company or the Catholic Telecare TV channel, click this link.

Telecare defined

Telecare is the continuous, automatic and remote monitoring of real time emergencies and lifestyle changes over time in order to manage the risks associated with independent living.’

This is a good definition. It has appeared in a number of publications, but its original source is unclear. To elaborate the meaning, devices range from those where the user presses a button that raises an alert at a control centre, to systems that monitor the person’s well-being and/or environment and which trigger (without, if necessary, conscious involvement) a warning that the person’s well-being has deteriorated, or that an untoward event has occurred.

Some systems give the person immediate feedback so that memory problems in particular can be accommodated and the person’s dignity and independence maintained.

In all cases except the latter, procedures for delivering an appropriate response from an external person (carer, neighbour or statutory service, etc.) are vital to the whole system.

Examples of telecare devices are:

Movement/non-movement sensors	Falls sensors
Fire/smoke alarms	Automatic lighting sensors
Food/water alarms	Fridge activity sensors
Window/door sensors	Carbon monoxide sensors
Bed/chair occupancy sensors	Temperature range sensors
Gas shut off devices	Medication reminder systems
Wrist-worn wellbeing monitors	Safety confirmation devices

Here are three examples. For more details of the particular products click on the picture to go to the supplier’s website.

1) Devices that predict problems

An example of a system that helps predict problems and alerts professional carers is the WristCare system that monitors a person’s activity and environment. Spotting early changes in these can help predict and prevent problems. The system can also raise an alarm if the person wishes.

2) Devices that prevent problems

Telecare Preventative Device: Bed sensor being put under a mattress

A bed sensor can help prevent falls by activating a light when someone gets out of bed. This helps because the person does not need to reach for the light switch or move around in the dark. It can also raise an alarm if the person does not return to bed within a predetermined time. By getting help quickly, problems do not escalate.

3) Devices that mitigate harm

These send alert a call centre after a pre-determined event so that help can arrive quickly.

	An extreme temperature device activates when the temperature rises rapidly or reaches a high or low point, indicating a risk of fire or hypothermia.
	With this phone-based device the owner presses a button before an agreed time each day to confirm to the call centre that they are alive and well.

Telemedicine

Telemedicine as a term has been in use for some time and is therefore better defined. The following, by the World Health Organisation, is simple and clear.

Telemedicine is the practice of medical care using interactive audio visual and data communications. This includes the delivery of medical care, diagnosis, consultation and treatment, as well as health education and the transfer of medical data.’

Telemedicine is therefore essentially doctor-to-doctor, with the patient somewhere in the system, and typically involves consultations with specialists at a distance. There are also other branches of medical ‘tele-s’ such as teleradiology and telepathology.

Telehealth

Here is the best definition of home-based telehealth monitoring to date. It is from Telecare: Using Information and Communication Technology to Support Independent Living by Older, Disabled and Vulnerable People July 2003 Curry RG, Trejo Tinoco M, Wardle D.

‘Telehealth monitoring is the remote exchange of physiological data between a patient at home and medical staff at hospital to assist in diagnosis and monitoring (this could include support for people with lung function problems, diabetes etc). It includes (amongst other things) a home unit to measure and monitor temperature, blood pressure and other vital signs for clinical review at a remote location (for example, a hospital site) using phone lines or wireless technology.’

Examples of telehealth devices are:
Blood pressure monitoring
Blood glucose monitoring
Cardiac arrhythmia monitoring
Asthma monitoring
Medication reminder systemsIt will be a pity if, as telehealth technology gains a firmer foothold, the term ‘telecare’ becomes further confused by its continued application in the telehealth arena.

Although it is easy to predict that telecare and telehealth technologies will merge, and although the clients and patients they benefit are often one and the same individuals, it is still useful — that is, less confusing in this stage of technological and linguistic evolution — to maintain a difference in the terms.

However, just as people want entertainment, not necessarily a TV, some people also need a service that helps them to stay independent, with dignity. The technology should only be one means to that end.

For a more in-depth consideration of these matters, look into the ‘Terminology Campaign’ section of the site and/or read this briefing paper which includes comments on the definition in the UK Government’s Department of Health document Building Telecare in England, and some examples of the use of the terminology in the United States.