What can the COVID-19 pandemic teach us about how to commission Care Technology?

The adoption of video-calling technologies mushroomed during the COVID restrictions. As illustrated in BBC WORKLIFE, they enabled virtual contact and helped people feel less isolated. Many who had not previously used FaceTime or Zoom turned to their iPads or PCs to connect with family and friends in a more engaging way than by phone.

Some of those who have only recently adopted video-calling will continue to use this technology post-pandemic. For clinical consultations for example, which have also spiked, as explained here: Effect of COVID on telehealth usage. Their aim will be to save time or enhance communication, and they will be largely disinterested in the device or software they use. I’m reminded of the UK mail strike in 1988, when 150m postal items languished in sorting offices. That year sales of fax machines rocketed, and the technology became ubiquitous.

The lesson is that whilst new technology may enable a change in behaviour, the driver is the user’s wish to achieve a particular outcome.

Paradoxically, when the focus is on the desired result, people can be more accepting of a new solution, as long as it works, because we are unforgiving of technology that doesn’t!

This should give councils considering their care technology options pause for thought. Just buying TEC without identifying what they are going to achieve with it can mean being left with a storeroom full of unused devices. The Department of Health learned this in 2006-08 when councils spent their Preventive Technology Grant with the apparent aim of, well, just spending it.

Unfortunately, commissioning for outcomes is more complex and riskier than commissioning things that can be measured upfront, like pallets of devices, or price. No commissioner will be fired for appointing the bidder with the best price per TEC solution. But if these don’t go on to improve the lives of people with care needs or reduce the overall cost of care it’s not best value, it’s a missed opportunity.

Innovative digital solutions will fuel the next decade of growth in TEC, by integrating with peoples’ own stuff, and generating data to inform preventive action in ways traditional telecare never could. But, strong leadership from Directors of Adult Services will be required if councils are to commission the right thing and maximise the benefits of digital care technology.

Care technology commissioners must be given the confidence to negotiate through the fog of TEC hype. Having just evaluated the latest crop of digital TEC alarm units, I can confirm that no-one has yet got this staple of the care technology world 100% right. There are not, nor have there ever been, any TEC silver bullets out there; the focus must be on thoughtful selection of the right solution to achieve clear outcomes.

Twelve months of COVID has done more to increase the understanding and use of technology to achieve care outcomes than decades of effort by the TEC sector. This new ‘demand pull’ should come as a blessed relief from the relentless ‘supply push’ we previously thought of as normal.

Commissioners should tap into the zeitgeist and challenge the market to collaborate in preventing and solving care challenges at scale. Warmed-over telecare solutions from the days when fax was king need not apply.