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Human factors that influence the performance of the telecare system
The Role of Telecare in Older People’s Daily Lives:
experiences, practices and attitudes
Working Papers from the AKTIVE project 2011-2014
AKTIVE Working Paper 5
Lifestyles in Later Life:
identity, choice and stigma
Kate Hamblin
Oxford Institute of Population Ageing
University of Oxford
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Human factors that influence the performance of the telecare system
Published by CIRCLE, University of Leeds, April 2014
©University of Leeds, University of Oxford and the author
ISBN 978-0-9928741-6-2
Online version: http://www.aktive.org.uk/
Also available from: CIRCLE
Centre for International Research on Care, Labour and Equalities
University of Leeds, Leeds, LS2 9JT, UK
Tel: (+44) 113 343 4872
Web: http://www.sociology.leeds.ac.uk/circle
Email: CIRCLEadmin@leeds.ac.uk
Acknowledgements
Research, analysis and development of the working paper
Data discussed in this paper were collected and analysed by the author and researchers responsible for the AKTIVE
fieldwork: Kate Hamblin and Emanuela Bianchera (University of Oxford) and Emma-Reetta Koivunen and Gary Fry
(University of Leeds). With Sue Yeandle (who directed the AKTIVE project and edited the AKTIVE working papers), these
colleagues also advised on the content and development of this paper. The author gratefully acknowledges their
contributions.
Research participants
The research team is extremely grateful for the contribution made to the study by the older people who took part,
sometimes in difficult circumstances, who allowed us into their homes, gave generous and thoughtful interviews,
permitted us to observe their living situation and assisted us by completing diaries, taking photographs and in other
ways helping us gain a full picture of their everyday lives. We also wish to thank their family members, home care
workers and others involved in their care who agreed to be interviewed or observed or who completed questionnaires.
These contributions were vital to the study, which would not otherwise have been possible. To protect the
confidentiality and privacy of those who took part, all names, and some identifiable details, have been changed.
Funding of the AKTIVE project
The main funding for AKTIVE was provided by the Technology Strategy Board (TSB), which developed the scheme
through which the project was funded in collaboration with the Economic and Social Research Council (ESRC) and the
National Institute for Health Research (NIHR). AKTIVE industrial partners Tunstall Healthcare (UK) Ltd and Inventya Ltd
also contributed resources to the project. AKTIVE was originally funded under the name ‘The Potential of Assisted Living
Technologies for Older People at Home: creating a knowledge base for businesses developing technology for dementia and
falls’, contract reference number 400215 / 2592-25185.
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1 Human factors that influence the performance of the telecare system
1 Introduction
The AKTIVE research study has afforded a unique opportunity to study how frail older people and those
who support or care for them are interacting with today’s telecare systems. Those studied include not just
the 'end users' of the telecare service, but also the care support groupwhich may be involved with them
(e.g. relatives, friends, neighbours), those working in monitoring and response centres, assessors and
reviewers of end-user requirements and even those who install and maintain the equipment and services.
The in-depth nature of the study has enabled the social dimensions of the system to be observed and
explored providing rich, in-depth data that has not before been gathered. These data form the basis for this
working paper on the human factors that influence the performance of the system, where difficulties or
failures have or could occur and how improvements might be made.
Telecare may be considered as an example of a complex socio-technical system. The human factors aspects
of socio-technical systems have been extensively studied the past and, more recently, in a number of
healthcare scenarios (Buckle, 2012; Carayon et al, 2006; Hignett et al, 2013). However, there is little evidence
that this approach has previously been undertaken to investigate performance and failure issues with
respect to telecare services.
We have presented here the research component of the study that investigated where and how telecare
systems might fail, generate errors or under-perform. Undertaking such analyses is standard practice in
many industrial socio-technical systems. They are all based on an understanding of factors that influence
human performance and the likelihood of human error (Reason, 1990; Rasmussen et al., 1994).
In many industries (HSE, 1999), and particularly in the health sector (Ward et al., 2010a), they have proved
immensely helpful both in reducing the likelihood of errors (notably human errors) and in enhancing the
performance and quality of the system. This is because the methods used often indicate where
improvements to the design of the system may be beneficial in optimising human performance. These
design improvements are not limited to the physical elements of the system (e.g. in the case of telecare the
pendant alarm or bed detector) but may also address shortcomings in the design and flow of information,
training programmes and even the design of the service itself.
During the AKTIVE project we have also considered the idea of individual risk and freedom afforded by
telecare from a number of perspectives (Yeandle, 2014a; Hamblin, 2014). The context and findings
presented in Hamblin's paper provide a useful context within which failure of technologies, human error
and design limitations may be understood.
This element of the study has used human factors (also known as ergonomics) approaches to identify risks
(Wilson and Corlett, 2005; Stanton et al., 2005). We do not believe this approach has been used in this
manner with telecare previously, and thus the research was 'ground breaking'.