Observe the American obsession with health and looks (rather than care and function) in yet another Wall Street Journal (WSJ) design-related item, just a month after the last. At least Can a Medic Alert System Be Stylish? has a less snarky take on the topic of design for older people. Well, looks will soon be the battleground for UK telecare manufacturers, as we reported from the TSA conference last year.
12 thoughts on “Can a medic alert system be stylish?”
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Can you back this up with any facts? I’m not taking issue with it, it just seems that there is a point you’d like to make – are iPhone sales less there? Are there other “care and function” things that sell better in the EU or UK that are not selling in the US? Again, I’m not taking issue with the point, I’d like to understand if you think there is really a cultural difference with the importance of design, and if you have any facts/research/studies on the topic.
There is considerable evidence to show that up to 40% of older people reject telecare when it is offered as part of a care plan – and the cost doesn’t seem to be a major factor. At the same time, more than 50% of people with a social alarm pendant don’t wear it for most of the time. These are topics that are frequently raised at forum events so we have had many opportunities over the years to try to understand the reasons why acceptance is not as high as it should be, and why wearing compliance is poor. There are many theories but the clunky appearance of equipment is one factor that keeps being raised, though its ranking is currently only third. The challenge seems to be one of making telecare equipment appear cool both in the living room and when carried on the body. This means more than looking good; it means having “must have” functionality so that alarm triggers or sensors will always be carried by vulnerable people in the same way as younger people carry their MP3 players and mobile phones and others carry their keys, wallets, handkerchiefs and keys. Perhaps smart phones can achieve this by offering a level of personalisation as assistive technology devices. A smart phone has the necessary internal sensors to allow down-loadable apps to convert them into anything from a fall detector through to an electronic key, wallet, hearing aid or magnifying glass. It follows that the physical appearance of telecare equipment may become irrelevant if older people can be persuaded to carry smart phones. That may be one step to far for many of the very oldest in society, but could be achievable for everyone else as they begin to accept digital TVs, and set-top boxes that offer functions such as teleconference, on-line appointment booking and the monitoring of physiological functions. I suspect that community groups, charities and social enterprises will take the lead in Europe while the US approach may rely on market forces and innovative marketing
Totally agree with everything you wrote – I was more interested in the claims of cultural bias and looking good. I think the bigger, more successful (but harder!) challenge is having them not “look” at all – “looking good” does have consumer and cultural bias. Being hidden completely makes that easier. Then we can focus on “comfort” and the cultural issues Cathy mentioned. Pipe dream, maybe – but good to dream…
… it’s only a pipe dream if we do nothing about it Geoffrey and I agree with you that not “look” at all sensing is a good place to aim.
Nothing wrong with taking on hard challenges … offers bigger opportunities!
The predominant cultural bias currently is whether or not there is a Local Authority with a duty of care to meet assessed needs … if there isn’t AND individuals are sourcing solutions directly then aesthetics have a bigger role to play.
I would like to ask Kevin; If appearance is third on the list of “issues”, what are 1, 2, 4 and 5? Apologies if you have stated the list already, but it would be helpful to hear it again, for the designer community.
Hi John.
The top 6 reasons that have emerged from the various surveys and questionnaires in the UK are:
1. Denial of need (give it to someone who needs it rather than to me)
2. Size (make it the size of a small button on my cardigan!)
3. Appearance (disguise it – it can never be pretty!)
4. Ease of use (improved access to alarm function – why does it need to be a button?), and
5. Avoidance of false alarms (hate looking like a fool!)
6. Lack of speech channel (lots of the people offering opinion were hard of hearing)
It’s surprising how all these problems seem to melt away after a serious incident when the alarm would have worked well. The bottom line here is that alarms are symbols of vulnerability, ill-health or dependence.
I believe that good design can overcome some of these problems, but that a more universal communication system (based on smaller and intelligent DECT or mobile handsets) would be the solution. The question is how do we persuade older people to embrace items of retail digital technology in the same way as younger people do. We can learn a lot from the experience of digital changeover – and the way that people had to swap their old television and remote controls for newer ones and set-top boxes. Maybe a smart remote control that fits on the wrist but with an alarm button may be the answer. I suspect that we need more radical solutions and that designers shouldn’t spend too much time trying to improve a wireless technology that is already many years out of date.
I agree that the drivers in the US & the European markets are different, as Kevin indicates, and I’ll let Kevin provide his “issues” list for you
… but one of the significant reasons for non compliance is because many of our older people were brought up not to ask for help and not to trouble others. A recent encounter with an acquaintance (outwith my Authority area)went as follows:
“I have fallen 18 times in the last 2 months” “Have you got a Community Alarm?” “Yes, it gives me peace of mind” “So you called for help when you fell?” “No, I didn’t want to trouble them they are so nice”
So she and I had a frank dialogue about this. On meeting a month later I was informed
“I wear my pendant all day now at home and I have pressed it a couple of times” “Good, that is why you have it ” “I never used to go to the bathroom at night time but now I keep the pendant by my bed and carry it with me and hang it on the bathroom door right next to me so I feel safe”
In this case it would not have mattered what the pendant looked like, this woman had a perception that she was being a nuisance.
Where the design effort needs to be going is into our services; into how we enable people to benefit from the technology; how we encourage them to ‘be a nuisance’ and use the technology available; and how we encourage protective families to allow them the freedom to be enabled by it.
The UK market is changing and increased ‘self-management’ and personalisation will mean that service users will consider design, as they do when buying a TV or a car. However, they still have to carry/wear the telecare sensor to achieve the desired outcome so the reliability, interoperability and usability must all still be there but design will become more important when individuals are spending ‘their’ money on it rather than an authority providing it. So we need to find the balance.
Thanks to both Cathy and Kevin for your replies – I still don’t see how that proves any difference between the US and the UK, specifically, but the facts you put out there are very helpful to those of us building solutions. It’s just very hard with such large populations (including immigration) when we see such “sweeping generalizations” as the article suggested, to effect positive change. Thank you both for your input, it’s helpful. Thanks for taking the time to do that!
@ Geoffrey
I’ve held off commenting as I was enjoying the development of the others’ comments. However, I should say that my observation of the cultural differences was just that, based on years of reading press releases and websites from both sides of the Atlantic. I doubt that anyone will have researched it.
Regarding the ‘health’ v ‘care’ element, perhaps I need to elaborate a little.
Taking pendant alarm systems as a starting point, in the US these are always marketed as something that you would want in case you have a medical emergency, such as a heart attack or stroke. In the UK they are promoted as something that will enable you to live in your own home for longer and the health implications – even for falls – are played down.
It interests me that a person who falls and who can not then get up is seen in the US as someone who automatically needs an ambulance. However, in the UK he or she is seen as someone who needs help to get up and then checking to see whether or not medical attention is needed, with the aim of avoiding a hospital admission if possible…because it helps you stay in your own home…
Regarding ‘looks’ v ‘function’, it’s perhaps less clear, especially with smarter looking kit now arriving on the UK scene, thanks to feedback from users.
I do sense that in the US advancements are only seen as ‘better looking pendants’ or ones that you can talk through, whereas in the UK advancements are seen in terms of improved functions such as the integration of sensors that trigger automatic alerts. Take, as an example of this, the SeNCit device featured in this morning’s news items. It’s a totally logical outcome of the UK’s approach, but how would you sell it to a health-emergency fixated market in the US?
Steve, I think the US mindset is changing, but slowly. A lot of pendant advertising is still stuck somewhere in the 1980s with pain point prominent. Telecare itself (remote sensor based monitoring) still cannot break through to private homes (most units are in assisted living), and when it does I believe it will be an adjunct to home care. (See WellAWARE’s arrangements with Masonic Homes and with investors GSS and VOA)
Hello Steve,
Thanks for the reply, and I fully understand why you’d wait a bit on the comments. I really appreciated the angle on the “keeping in home” vs. “needing an ambulance”. This is *much* more interesting and tangible to me than the simple cultural bias. This is interesting. In the US, I think that perception is probably dominated by the “fallen and can’t get up” commercials that are nearly pop-culture in the US. Those are ultimately over dramatic, people falling down stairs sensationalism that don’t reflect well on the market, and the lack of the market’s ability to take off only furthers the issue. I think there is a fair amount of investment globally in the integration of traditional “PERS” and pendant systems with other sensors and remote monitoring – AMAC has tried with both Health Hero (now Bosch) and Philips has tried through acquisitions. The biggest problem in the US market is the lack of a payment incentive for such systems and most people have a disbelief in a consumer market (due to a similar lack of incentive), which leads sadly to a lack of good design. Thank god, 2011 looks like a year when design – good, high quality design – is coming back to this field and remote patient monitoring, with people like Aza Raskin and others coming to the field, it’s going to change for the better. Fingers crossed, anyway.
Recently I was looking at 2 mhealth business plans, in particular the parts about sensor design.
The sensors should be wearable to guarantee permanent monitoring.
What struck me was that both companies were looking at “patient acceptance” as a HUGE hurdle for sensor sales.
Looking at the design of their devices, I understood their problem better: “They are UGLY!!!”.
The devices had that typical “designed by a medical professional from the former USSR” signature.
[b]If you want to solve patient acceptance, let Louis Vuitton or WESC take care of your design.[/b]
The burden of being sick and the necessity to be monitored can be worsened by making you wear ugly or uncool devices, especially with children.
Parents want their sick kids to grow up like ‘normal’ children.
If you can give these children a sensor that is cool to wear, this coolness might even ‘lighten’ the situation a bit for that child.
All types of wearable, unobtrusive sensors will have a great future because of simplicity and ease of mind.
Nick Hunn already gave fine examples like doorknobs and toothbrushes for monitoring, but why don’t we also use helmets, clothing, wigs, earphones, scarfs, seats, …?
[b]I’m convinced that if you trow in more designers, this will make the sickness easier to wear (ha!)[/b].
Fashionistas for healthcare!