Table 1 Cambridgeshire Community Services (CCS) assistive telehealth and telecare service profiles

Electronic assistive technology

Standalone

Individual pieces of electronic equipment that enhance a service user’s independence by prompting and reminding. They do not send alerts to either a carer or monitoring centre. Items include medication reminders, task prompting and orientation devices.

Telecare

Telecare standalone

Standalone telecare is similar to connected telecare. The main difference is that the sensors and detectors are NOT connected to a monitoring call centre but are programmed to link to pagers or mobile phones carried by a carer. The variety of sensors and detectors is similar to that of connected telecare and includes for example, bed and chair leaving alarms, fall detectors, epilepsy or enuresis monitors, door contact, flood, gas and smoke detectors and temperature extreme sensors. There are also proximity alarms, GPS positioning/tracking and buddy systems. The standalone telecare solutions avoid the costs associated with monitoring call centres but do require an informal or formal carer who can provide a 24-hour response to the alerts.

Telecare connected

This equipment includes wired and wireless sensors and detectors that are programmed through a base unit telephone or call system to raise an alarm to the monitoring centre. The monitoring centre then tries to contact nominated key holders or emergency services and can provide advice and reassurance via the phone for the service user. The variety of sensors and detectors are similar to that of standalone telecare and includes for example, bed and chair leaving alarms, fall detectors, epilepsy or enuresis monitors, flood, gas and smoke detectors and temperature extremes. Activity monitoring is also possible via PIR and door monitors in the home environment or via watches or straps worn by the individual. There is normally a charge for the services of the monitoring call centre but this may be subsidised via the local authority housing services or can be subscribed to privately.

Telehealth

Telehealth connected

This involves a home telehealth monitor and peripherals for measuring vital signs that are connected via a telephone line/blue tooth and automatically transmits the data to a monitoring clinician via a secure and confidential website. The monitoring clinician reviews the trends of the readings and signs/symptoms to instigate a treatment plan to stabilise the long-term condition. The vital signs that are most frequently monitored are temperature, heart rate, blood pressure, SPO2, weight, blood glucose and the most common conditions are COPD, heart failure, hypertension and diabetes.

Telehealth standalone

Service users take their own readings using calibrated equipment, for example, weighing scales, thermometer, blood pressure cuff or blood glucometer. The service users then manually transmit this data via e-mail, telephone or text, to the monitoring centre who record this onto a clinical system and instigates appropriate responses according to the plan made in advance. The vital signs that are most frequently monitored are temperature, heart rate, blood pressure, SPO2, weight and blood glucose and the most common conditions are COPD, heart failure, hypertension and diabetes.