Dr. Richard Wong: Consultant Geriatrician, University Hospitals of Leicester NHS Trust

‘Anything that can be done to lessen the burden and requirements on individuals to have to interact in a formal sense with the technology and the less intrusive on their everyday life this is, the more likely there will be a positive and cooperative relationship between technology and care’

Healthcare Voices On Smart Technology Opportunities interview series talking with Dr Richard Wong. As a consultant geriatrician, Richard shared his view on technology in social care.

Technology is taking every aspect of our lives, but how has it changed the home care industry in the past years?

Despite technology touching so many aspects of our everyday lives, one of the few areas it has only skirted around so far has been the social care setting. Even in the domain of actual healthcare, it is only relatively recently that there has been adoption and harnessing of some of the available technology potential. So going back to social and domiciliary care, although technologies now exist to potentially support and connect vulnerable or isolated individuals, these have not been adopted or evaluated at scale, probably in part due to cost. Those technologies that have been utilised under the umbrella of ‘assistive technologies’ have been focused more on alerting safety (for falls and wandering in older individuals with cognitive impairment and frailty) or prompting for medication compliance and whilst offering some support, they have not transformed the ability of the care sector to meet the growing demands of the ageing population.

Which tech adoptions would you name as the most important in social care so far?

There have not been a large number of technologies that have been widely adopted in the social care setting as previously mentioned, and so the reality is the current social care setting in the UK has the option of the assistive technologies that have already been discussed. These can provide some reassurance to carers, both lay and professional, that there are some safety nets in place for particular events such as missing medication, falls and wandering but do not address other aspects of care monitoring and importantly do not address the monitoring period before somebody becomes so frail as to need these interventions.

Is domiciliary care a tech-friendly space in general? Why or why not?

A space or vacuum certainly exists in domiciliary care for technology, which if appropriately applied, could only be of reassurance and benefit to individuals and their carers. How well-received and welcome such technology is in this arena would depend on key aspects of efficacy (doing what it says it should do), affordability and perhaps most importantly the simplicity of use and adoption. Anything that can be done to lessen the burden and requirements on individuals to have to interact in a formal sense with the technology and the less intrusive on their everyday life then the more likely is that this will be a positive and cooperative relationship between technology and care.

Apart from the pandemic, what have been the biggest challenges that you’ve faced during your career in social care?

I am not alone in the professional challenges of social care and indeed these challenges pale into insignificance with the challenges faced by informal and formal carers. These problems centre on the ageing population, not just in chronological age, but also in frailty and care requirements and the complex interactions that physical and mental health has on each other. All this is in the context of a care workforce that increasingly struggles with the capacity to support this, both at a professional and informal level; this reflects the time required to support these individuals, knowledge about the presentations of frailty and also anxiety faced when carers are not physically able to be with the individual and monitor their wellbeing.

Which of those challenges, technology could have helped you to solve, and how?

Technology certainly has a role in monitoring and using the monitoring information to provide alerts when an individual is managing less well. Additionally, technology could analyse the data to look for trends of new decline that might signify the early onset of illness or decompensation of an existing long term condition. There is also a role for technology to act as a communication aid with carers and families and provide some form of personalised interaction that could aid in some of the issues of isolation experienced by some.

What breakthrough technology do you think will be changing domiciliary care in the next 5-10 years?

I do not see one particular translation of technology being dominant but can see that there could be different areas where it proves fruitful. Two key areas might be improved smart monitoring of health and wellbeing and also digital personal assistants which can act as a digital friend, coach and network communicator to enable access to outside services or friends/family, in an extended way to how some current proprietary voice assistants help us.

What are your company’s biggest ambitions for home care going forward?

I work in healthcare so my ambition is to see the NHS and local authorities adopting some ready technologies (and exploring some more nascent technologies) to use in the contexts I have already discussed, particularly with regards to smart home care monitoring. To see this tested at scale would be really important to see if it is a way we can fill some of the current gaps in domiciliary care.

Bonus: Is there anything else you would like to add about the role of technology within social care?

My experience to date is that there is still quite a widespread hesitation to the adoption and concept of technology in social care amongst the older population. This stems from past experiences with technology that was not necessarily positive, concerns over data protection and privacy and perhaps also a lack of awareness of how syndromes of frailty may play out the older and frailer we become. There is naturally always a self-protection thought of “it will not happen to me”. Therefore any technology role needs to be carefully pitched and explained and there is a big role for communication, use of social media and getting this message across; this will inevitably involve the children and younger carers of those in the frail/older population as they will also be touched by the use of such technologies and will need to be on board and supportive of this.

Dr Richard Wong

Consultant Geriatrician, University Hospitals of Leicester NHS Trust