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PurposeThe aim of this paper is to present a conceptual valuation framework to allow telecare service stakeholders to assess telecare devices in the home in terms of their social, psychological and practical effects. The framework enables telecare service operators to more effectively engage with the social and psychological issues resulting from telecare technology deployment in the home and to design and develop appropriate responses as a result.Design/methodology/approachThe paper provides a contextual background for the need for sociologically pitched tools that engage with the social and cultural feelings of telecare service users before presenting the valuation framework and how it could be used.FindingsA conceptual valuation framework is presented for potential development/use.Research limitations/implicationsThe valuation framework has yet to be extensively tested or verified.Practical implicationsThe valuation framework needs to be tested and deployed by a telecare service operator but the core messages of the paper are valid and interesting for readership.Social implicationsIn addressing the social and cultural perspectives of telecare service stakeholders, the paper makes a link between the technologies in the home, the feelings and orientations of service users (e.g. residents, emergency services, wardens, etc.) and the telecare service operator.Originality/valueThe paper is an original contribution to the field as it details how the sociological orientations of telecare technology service users should be valued and addressed by service operators. It has a value through the conceptual arguments made and through valuation framework presented.

Purpose
This paper asks how the introduction of "smart" digital technologies might affect the goals that can be attributed to telecare for older people, by those coordinating its provision.


Design/methodology/approach
A total of 29 in-depth, qualitative interviews were conducted with local authorities, housing associations and other organisations coordinating smart telecare provision, as well as telecare manufacturers and suppliers. Interviews were analysed by using qualitative thematic analysis.


Findings
The analysis reveals discrepancies between the goals and outcomes of smart telecare provision, according to those coordinating service delivery. This study concludes that the goal for smart telecare to be preventative and cost-efficient may be complicated by various organisational and operational challenges associated with coordinating provision.


Originality/value
New, "smart" telecare technology for older people stands apart from earlier, user-activated or automatic devices. It may have distinct and under-researched organisational and ethical implications.

ABSTRACTThis pilot study investigated the feasibility of delivering an individualized program of oral home telecare training using PC‐based, real‐time interactive videoconferencing via the Internet to meet the unique challenges of dental care for people with tetraplegia. A home‐based videoconferencing method was tested with two adults with tetraplegia and an occupational therapist (rehabilitation specialist). As part of the proposed rehabilitation training to improve independence in performing oral hygiene, adaptive devices (a rechargeable oscillating‐rotating power toothbrush and a cordless oral irrigator) were introduced to facilitate oral care performance with interactive, Web‐based instruction. Training was conducted once a week for 4 weeks. The oral home telecare experience was evaluated using a questionnaire and in‐depth interviews after the training. Both subjects were satisfied with the oral home telecare services and were enthusiastic about using the services without major difficulty after having previously experienced barriers to dental care. In addition to their positive perceptions about videoconferencing, the subjects suggested adaptations and identified unexpected potential uses for interactive videoconferencing. The use of interactive videoconferencing as a mode of oral hygiene training may lead to a change in oral hygiene service delivery methods, improving accessibility to geographically dispersed populations with tetraplegia. Oral home telecare offers strategies to decrease physical barriers and communication difficulties that correspond to recommendations to improve the quality of dental health services for people with tetraplegia.

Telecare services are now available across the UK but few have the technical expertise necessary to prescribe and provide the bespoke solutions that may be required to support more complex cases. This paper describes a range of innovative approaches to extending the application of existing telecare systems to cater for the needs of people facing different physical or cognitive challenges. They include new, easy‐to‐operate alarm switches, interfaces for bed/chair occupancy and property exit alarms, and a range of hybrid arrangements that can result in automatic alarms for the management of various environmental emergencies. Examples are provided for hypothermia, hyperthermia, poor air quality and noise alarms.

The development of telemedicine and telecare has been changed all over the world the recent decades as practitioners and health care managers reached better understanding of the use of information and communication technologies to offer urgent and qualified medical services at a distance. Governments and health care providers have shown a large initial interest in the benefits of telemedicine services to reduce costs mostly for patient's transfer to tertiary hospitals or for educational purposes but have been slow to provide strategic plans and procedures in order to proceed the projects into practice.

Portable equipments for remote monitoring of heart's activity is one of the most innovative sectors in telemedicine and teleassistency. Health departments of governments are interested in tele diagnostic systems to avoid collapses in hospital and urgency services. In this paper, we describe a portable electrocardiograph/holter equipment with telephony and GSM ansmission, using a surface mount technology with low voltage battery supply. This project has been developed in collaboration with Teleasistencia Cardiotest, S.L. This prototype is patent pending.

AbstractImplementing telecare requires experience and knowledge from different disciplines and sectors; business, technology and care. The uptake of telecare has been slow, which is assumed to be caused by difficulties in co‐operation within telecare partnerships. This article presents a new approach to improve understanding of telecare partnerships. The approach builds on theories of trust and partnership working and is informed by rational choice theory.Within this article the approach is applied to recent experiences from a telecare project in Norway, to demonstrate how different ways of interpreting the complex social interactions in telecare partnerships yield new insight and understanding. Examples from the Norwegian project illustrate how different understandings of actions and choices affected trust and caused either improved or deteriorated co‐operation in the partnership. The partners that were able to develop trust through a common evaluation of the problems co‐operated better. However, when partners lacked or had insufficient knowledge, either of each other or of the situation, this led to disparate understandings that threatened trust and affected further co‐operation. The new approach presented here is helpful in analyzing and understanding the actions of different partners within a telecare partnership and identifying why things worked well or went wrong. The approach may have wider relevance for other partnerships.

Dominant discourses on telecare technologies often celebrate the erasure of distance and place. This paper provides a critical intervention into these discourses by investigating how spaces still matter, despite the move from physical to virtual encounters between healthcare professionals and patients. I argue that science and technology studies (STS) research on telecare, as well as other technologies, can be enriched by including a focus on place to understand the dynamic interactions between people and things. Adopting insights of human geographers, I show how places in which technologies are used affect how technologies enable or constrain human actions and identities. Whereas some spaces may facilitate the incorporation of technologies, others may resist technologies. A focus on how places matter is important for understanding how telecare technologies reorder and redefine healthcare. Although other healthcare technologies are also important actors in transforming healthcare, telecare technologies do this in a very specific way: they redefine the spatial dimensions of healthcare. To capture and further explore this changing spatial configuration of healthcare, I introduce the notion of technogeography of care. This concept provides a useful heuristic to study how places matter in healthcare. Although telecare technologies introduce virtual encounters between healthcare providers and patients, the use of telecare devices still largely depends on locally grounded, situated care acts. Based on interviews with users of several cardiac telecare applications, including healthcare professionals and patients in Germany and the Netherlands, the paper shows how patients' homes and public spaces are important for shaping the implementation and use of telecare technologies, and vice versa. Last, but not least, telecare devices are implicated as well. The paper emphasizes the place-dependency of the use and meaning of technical devices by showing how the same technological device can do and mean different things in different places.