Last year, Channel 4 aired a brilliant series called Humans. The protagonist was a ‘synth’ and the context was the rise of robots providing a range of public and private sector services including, in some instances, personal and wellbeing related support. Slight ‘spoiler alert’ but a rules based health and care plan delivered by a robot did not fully achieve dignity, choice and control. This is television, not real life but it did prompt thinking on the relationship between technology and care – which can be a bit of a marmite topic.
Does technology make things better?
It absolutely has the potential to and for the first time in a long time our limitation is not the capability, availability or even the affordability of the technology. It’s the human element; the how, when and where it is applied, supported and used to plough the furrow for a greater shift in the way we engage with and support people to achieve their personal outcomes.
So far, so good? Uptake and impact to date has been mixed. Even the original digital conqueror, ‘Case Management the First’ - still has varied coverage across and within organisations, with a combination of digital and analogue mechanisms for monitoring actions, outcomes, spend etc. Valuable tools, but to deliver a positive resident experience still requires a lot of leg work from professionals navigating various systems and information sources to deliver seamless care. Understandable then, we see cynicism when tenaciously working to convince an organisation to be digital by default.
Online & mobile ‘self-services’ such as brokerage, IAG, assessments etc - are making some headway but there is still trepidation with respect to wholesale roll out of these. Significant funding challenges in social care have limited the capacity and resources available to maximising these tools, investment in changing culture, process and practice in line with the digital capability deployed. Care and support stakeholders can also be sceptical as we also sometimes struggle to evidence, at scale, the tangible difference made to both the people who need support and professionals trying to navigate them. These factors are not mutually exclusive and I suspect explain why the demand management benefits of signposting are still emerging.
So, do robots care, or even make the tea?
We are in full flow of the 4th industrial revolution. Assistive Technology (AT) and the Internet of Things (IoT), Virtual Reality (VR) and Intelligent Automation (IA), collectively and individually, are game changers in the world of work, life and play. But what about in care and support? For me there are some starting principles (and I have steered clear of I, Robot!)
The world of care and support is the world of work, life and play.
If personalisation has taught us anything, it’s that care and support services should enable people, as far as possible to be independent and live life, love, work and play. We have a habit of assuming everything needs to be specially configured for the care market, when there are as many solutions that can be loaded onto your mobile phone as there are undignified red panic buttons that pass for AT. ‘Alexa - Call Help’ is just one of the exciting developments in a market where providers are working to personalise devices for different ‘consumers’; noticing that different gadgets and devices work better for different people. What this does is start to change our mind set in terms of how AT is marketed, to who and when. Today’s octogenarians might not be tech savvy, tomorrow’s will be. This is a huge opportunity for the social care sector and government to work differently with employers, carers, the media and the technology and retail sectors to get people used to meeting their needs - except, and this is really important, those people don’t see it as meeting needs – they see it as living life!
AT has such huge potential benefits. Never before have we had this potential to understand our clients. This could change the face of consultation! The ability to drive a new model of care across commissioning (real time care info), provision and the care pathway (dynamic care planning) is so exciting. But new kit alone won’t do the job, to make this work sustainably, the way we deliver it is as important as the shape of the service. Commissioning and management of AT can’t be fragmented and separate from the rest of support services; disconnected from other providers; or rolled out ad hoc.
Technology is not a replacement for professional judgement and meaningful human contact.
I had a really interesting conversation in a scenario planning session a few weeks ago. For anyone who has tried this, it’s a great tool for business planning and allows for the creation of ‘alternative realities’ to help think through how businesses’ / sector etc. would respond. One alternate reality created was that ‘Diagnostics technology outperforms human, professional interpretation and processing’. This posed the question ‘Do we employ actors instead of doctors to communicate with patients’. Whilst, in this reality, you require empathy rather than technical knowledge, authenticity and trust remain important. The concept of an actor delivering these messages, potentially breaks this trust but the idea of mental health support professionals doing this role feels less uncomfortable. Back to a less alternative reality…The process really helped to think through the implications as a result of technology and what the change principles should be.
Bring on the industrial evolution?
EY has recently been working with Xantura on Early Intervention across a range of cohorts experiencing poor outcomes. What has been very obvious are the clear opportunities in the tech/ human interface, where technology and data are supporting professionals and commissioners to improve practice and deliver on the prevention agenda. As well as macro level analysis on the difference interventions have made to outcomes, the range of ways you can look at data and the use of Natural Language Generation (a form of Intelligent Automation), make it very simple for professionals to get the information they need, quickly and in a format that essentially appears as case notes. This helps inform decisions about prioritising actions, resources and also understand which agency or professional in contact with the family or individual is best place to understand the impact of changes in circumstance which may create additional risk. It informs, empowers and enables professionals to more easily digest the wealth of information out there and take a ‘next steps’ call on that basis.
At this stage, the idea of driverless community transport, robot carers and chatbots to combat social isolation are interesting concepts to explore. But to get the most out of technology - and I mean in terms of better outcomes for our most vulnerable residents, we have to hold dear the value of human interaction for those we are trying to support. Working with emerging technologies is about augmenting the human element, not replacing it. Whilst this is challenging and complex to deliver, the outcomes and impact for people are much more visible that the old days of system reconfiguration. It is certainly a journey I’m thrilled to be on.