SAFE 21 - New social alarm services via a proven infrastructure
Frank J.M. Vlaskamp
iRv, POB 192, NL-6430 AD
Hoensbroek, The Netherlands
tel: +31 45 523 75 37
fax:+31 45 523 15 50
email: frank.vlaskamp@irv.nl
1. Summary
Taking the SAFE21 product range as a point of departure, three products will be described that will provide opportunities for the extension of social alarm services.
The results of the SAFE21 user needs investigation will be described, showing what alarm providers and end-users expect from the SAFE21 product development. Furthermore, a short description will be given of how the user needs and technical ideas are merged into marketable products.
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2. Introduction
A social alarm is a system that provides a means to raise an alarm call by pressing a button on a small portable alarm trigger. Alarm calls are received by a control centre. The operator opens a speech link and organises help for the person in need. The control centre has a database with information about the subscribers. Control centres have a reliable 24 hours a day communication and help infrastructure.
Social alarm services are a good example of the use of technology in home care. Throughout Europe a few million households of elderly or disabled persons have a social alarm. Years ago it was already clear that the "young and successful" social alarm equipment and infrastructure had a growth potential beyond the simple "press a button" social alarm. Smoke alarm, burglar alarm, activity monitoring, medical tele-monitoring, all these possible features were discussed in the eighties. Until now, the development potential of social alarm has been exploited only on a very small scale. The TIDE-SAFE21 project aims to further develop social alarm products and services using the existing social alarm infrastructure.
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3. SAFE21 project
Safe 21 is run by a consortium of 8 organisations, with financial support from the European Commission. The range of products to be developed within the SAFE21 project include a new speech alarm trigger, a mobile social alarm, an information system, a model control centre sharing facilities with other local organisations, tele-medicine, and a social alarm for the deaf. The project runs from 1997-1999, with trials of equipment from late 1998.
During 1997 the SAFE21 consortium developed a set of questionnaires to help verify the needs of users for the product concepts which it proposes to develop. It carried out 40 interviews with alarm and care providers in 5 countries. Scripts were made to describe the use of the products in real life. In the beginning of 1998 the product concepts were verified with the help of "focus groups", consisting of end-users. Concept technical specifications of the SAFE21 products were finalised in March 1998.
In this article, three products will be discussed: "mobile social alarm", "tele-medicine" and an "information system". For a social alarm service, implementing these products requires organisational change: providing help for mobile subscribers (mobile social alarms), co-operation with physicians (tele-medicine) and providing an information source for subscribers (information system).
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4. Mobile social alarm
Existing social alarms are restricted to the area of the own home. For people who are mobile outdoors, there is no social alarm service which would provide help in case of an emergency. Present day social alarm organisations have a communication infrastructure (the control centre equipment and the home alarm units) and a help infrastructure (control centre personnel, volunteers and professional workers who give emergency assistance).
For a mobile social alarm service the home address and the place where an emergency happens are not necessarily identical. A position detection infrastructure is required to solve this problem: a graphical information system and mapping software in the control centre and mobile social alarms with position detection. A further consequence of the possible difference between home address and the location of an emergency is that the alarm organisation should have helpers available in the geographical area where the mobile social alarm service is operational.
In co-operation with the TIDE MORE project, the SAFE21 project aims to develop a mobile social alarm and mapping system. The mobile social alarm is an integration of a GSM mobile telephone and a GPS position detection system which receives signals from the Global Positioning System satellites "in sight". During an emergency raw position data are sent to the control centre, where the geographical position is determined with great accuracy.
The user needs investigation indicated that social alarm providers expect that there will be a slow growth of interest in mobile social alarms, as far as subscribers of today are concerned. A significant growth potential of mobile social alarms will come from new user groups, differing from the "traditional" user groups. Mobile elderly and disabled persons who do not want a social alarm system at home may want to have a social alarm for their outdoor activities. Other reasons than medical and psychological vulnerability may also apply to these user groups: fear for being involved in an emergency or getting lost, broken down car, accidents, robbery. An interesting possible new user group are the home care workers themselves, for reasons of care communication and individual safety while visiting patients.
A high reliability of GSM phone contact and GPS position detection is required (> 90% successful), furthermore accuracy should be better than 25 metres, and response time should be shorter than 15 minutes.
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5. Tele-medicine
Tele-medicine is the use of communication and information systems to conduct a clinical process remotely. Tele-medicine is a rather young but rapidly developing field, comprising robot-surgery, video-consulting (psychiatry and dermatology), video-nursing, monitoring and measuring of diagnostic values at a distance. For SAFE21 the latter two are relevant (tele-monitoring in short). But also video-nursing and video-consulting could be a very interesting extension for the future.
The SAFE21 project aims to show how simple monitoring can be carried out at home and how it can be incorporated at marginal cost, by exploiting the existing social alarm infrastructure. The monitoring system comprises a well proven monitor, able to take the following measurements: temperature, respiration, non-invasive blood pressure, pulse oximetry and ECG. The patient is taught how to apply the sensors and take a reading. The monitor automatically records the data, then sends the data via the social alarm system to the control centre.
Integration with a social alarm system provides a better quality of monitoring. The control centre can guard proper execution of home monitoring by the patient or caregivers (procedures, time schedule, etc.), in order to assure that the physician receives data of good quality, at the right time. Integration with a social alarm system means direct professional action by the control centre when values of measurements are outside pre-defined parameters, or in case of an emergency.
The patient will feel secure and safe in his own home, knowing that there is someone at the control centre who is in easy reach and who is familiar with the individual medical condition. Tele-monitoring can reduce health care costs: a short stay in the hospital, less home visits by professional caregivers and less travelling to the physician's practice or hospital for the patient.
The user needs investigation indicated that tele-monitoring can only be successful when the patient and the informal and professional carers fully accept tele-medicine at home. Furthermore, using the monitor requires some skills from patient and care-givers. For patients who run a high risk for a sudden deterioration of their condition tele-medicine is not advisable. The general responsibility for monitoring a patient shall be in the hands of a physician. Demonstrations of tele-monitoring, showing not only the technical details, but also the management of monitoring including organisational aspects, skills, protocols and procedures might help physicians to gain confidence in tele-monitoring, and to get them interested and involved.
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6. Information system
For present day social alarm systems speech contact is the only way to send information from the control centre to a home. This limitation makes it time consuming and expensive for the control room staff to issue information of a general nature.
The SAFE21 project aims to develop a practical interface for getting community information to the disabled and elderly. For this development SAFE21 co-operates with the TIDE IMSAS project. A prototype of an information system will be made, presenting messages and information on a text screen. This simple social alarm home unit opens many possibilities for access to community information (examples: public transport details, doctor on call, community news).
The information system has an optional keyboard and a SCART connector for using the TV as display. It will also provide a text telephone interface for a "deaf social alarm" and also a text interface for user instructions during a tele-monitoring session.
The information system adds a two-way data channel with a simple and easily understood home terminal to existing social alarm systems. The recipient of information will be alerted if a message is waiting to be read. There will be a means of acknowledging reception of urgent messages, the control centre keeps a record of those who did or did not receive the message. The control centre can send messages to individuals, or selected groups of people. For example, all those in a geographical area, who receive Meals on Wheels could be informed that traffic problems caused a major delay. Three categories of information can be sent out by the control centre:
- information only, e.g. changes to public transport timetables;
- warning of an event or trend which could cause a problem, e.g. rapid fall in temperature, or disconnection of power supply;
- alarms, when a predetermined threshold has been reached, e.g. if air pollution reaches to a certain level, asthma sufferers are alerted, or windows have to be closed, because there is a hazardous chemical fire nearby.
The information system will provide limited end-user access to the internet. The system works via a gateway to the internet at the control centre. With the addition of a standard keyboard, the system will enable people to send e-mail to anywhere in the world.
The user needs investigation indicated that an information system will be very useful for control centres and emergency services, to be used primarily as a home care tool (a means for issuing information). The usefulness of the information system as a source of information for present day social alarm subscribers is considered as limited. However, within the next decade a significant percentage of elderly and disabled people will have a PC at home. The social alarm information system can be a first step into the information age for people who would otherwise be excluded.
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7. Conclusions
The social alarm home unit has reached success as a standard product because it meets the needs of a large population, it is efficient, reliable, easy to install, and cost-effective. The combination of "care" and "communication" has proven to be very strong during the last twenty years. Developments of care provision and communication technology will change the market position of social alarm services. New services emerge, for new user groups, with new functions, and maybe provided by new competitors. Social alarm provision will no longer be a service by itself, but will be integrated with other services in a technical and organisational sense. For social alarm manufacturers and providers of today this development offers great opportunities. Their experience with service provision based on "care" and "communication" gives them a lead position over the competitors. The market niche where market players of today have growth potential is integration of care services on a local or regional level, using the social alarm infrastructure as a means for care communication and co-ordination in a broad sense. Competing manufacturers and providers may be successful with services aimed at the general public or highly specialised services for specific user groups
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Reference
SAFE21 is run by the following organisations: Tunstall Telecom (United Kingdom), Sintel (Spain), RGB Medical Devices (Spain), iRv (The Netherlands), Hulpnet (The Netherlands), KITTZ (The Netherlands), Artec Group (Belgium) and WS Atkins Consultants (United Kingdom). SAFE21 co-operates with the TIDE-IMSAS project and the TIDE-MORE project.
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