Examining perspectives on telecare: factors influencing adoption, implementation, and usage

David Barrett,1 Jonathan Thorpe,2 Nick Goodwin3 1Faculty of Health and Social Care, 2Knowledge Exchange, University of Hull, Hull, 3International Foundation for Integrated Care, Oxford, UK Abstract: Telecare, or the use of remote care technologies to support safe and independent living, offers great potential to mitigate the challenges faced in a time of changing demographics. By supporting people to live for longer in their own home, telecare can enhance quality of life, reduce reliance on institutional care settings, and reduce costs. Despite these potential opportunities, the adoption of telecare has not been as fast or widespread as it might have been. This article discusses some of the factors acting as drivers or barriers, which have influenced adoption and impacted on implementation. The implications of the availability of such a wide range of telecare applications is explored; this diversity of choice allows for services to be tailored to the specific needs of users, but also causes a tangled web of terminology that can lead to confusion and lack of clarity. In terms of the evidence base, although evaluations of telecare services often demonstrate a high level of cost benefit and user satisfaction, primary research findings are not as positive. This paper focuses particularly on the Whole System Demonstrator, a large-scale, randomized controlled trial that raised questions about the value and cost-effectiveness of telecare. The paper also discusses the ethical, governance, and resource issues associated with telecare implementation and the organizational complexities inherent in such exciting but challenging changes to services. The policy perspective is also summarized, highlighting how much of the adoption of telecare to date has been influenced by top-down initiatives. Telecare will continue to evolve as our understanding and the technology continue to develop. This paper provides information and advice for commissioners, providers, and practitioners regarding the factors that will shape the future of telecare. Keywords: telecare, barriers and facilitators, perspectives, assisted living, independent living