Figure 1: A generic telecare system model

In this model, the clients are generally considered to receive care services in their homes. The home will contain a number of sensors and perhaps other devices, such as display's and actuators which, where appropriate can communicate with the outside world either directly or via a base station or home hub. The data that is transmitted from the home might be raw sensor data, such as a blood sugar reading, or data from a set of movement sensors, alternatively the base station in the home may process the raw data and only issue high level calls for assistance or updates to a patient record.

The data from the home may be transmitted to a call centre operator, whose role is to monitor the client’s status. The status monitoring function may be undertaken by an automated process in a computer system within the call centre with only anomalous behaviours or trends flagged to a human operator. The operator role is usually one of coordination. It is the operator who will make a judgement about if and when to involve a third party such as a clinician, carer, family member or the emergency services. In some situations, depending on the degree of intelligence and autonomy within the home installation, and the configuration of the service, the coordination role is not required and becomes subsumed into the functionality of the client’s home system, in which case calls to third parties for assistance are made directly between the home and the clinician, carer or emergency services.

Telecare services will have many different configurations depending on the specific circumstances of the service provider and of the client. This will be influenced by the physical and cognitive capability of the client, the intelligence of the system, service provider requirements for automated or manual coordination and so on. However, the model in Figure 1 is a general model that will apply in almost any circumstance. In some cases a single person may perform two roles; for example the person in the home can perform the client and the operator role – deciding for themselves if and when they need assistance from their care provider.

The model is not prescriptive, however, it is our intention throughout this document to pay attention to the needs of all potential end-users of telecare systems and so we define three end user types:

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  clients – those individuals who are receiving the telecare service to support their independent living;
  
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  carers – those individuals who provide care to the client, mediated through or assisted by the telecare service; and
  
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  coordination agents – those individuals who coordinate the delivery of care through the use of the telecare system.
  

We have chosen to build our approach to telecare services on an extension to a framework proposed by Barlow et al [33]. They define a model of telecare services which includes information and communication, safety and security monitoring, personal health and activity monitoring and Electronic Assistive Technology.

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  information and communication;
  
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  safety and security monitoring;
  
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  personal monitoring; and
  
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  Electronic Assistive Technology, (EAT).