SMART: Self Management supported by Assistive, Rehabilitation and Telecare Technologies

Chronic health conditions are those that a person has over an extended period of time, or for life. The sufferer and their family have to learn to live with the illness and its consequences. The UK government is concerned about the extent of chronic ill health and the cost of providing quality services to all who need them. This has led to a major rethink. As a result, there are a number of new requirements for health and social services. These include recognising the expert knowledge that the person with a long term (or chronic) condition has developed over time and introducing ways to help them to manage their symptoms. Professionals are being asked to work in partnership with people with long term conditions, so that the individual is in control of their treatment and care plan and what happens as a result. More and more of us are using technologies in our everyday lives. This four year project will look at how technologies can be used to help individuals and their families to manage the consequences of long tem conditions and maintain quality of life, supported by professionals. It will involve:- 1.Identifying the technologies that are capable of providing relevant information to users with long term conditions so that they can be helped to achieve realistic life goals, agreed through their therapy plan2.Working with users and health care staff to test which are the best technologies for this purpose, how devices can be most appropriately used and what the best forms of information feedback are.For this project, we have decided to focus upon three very different conditions. The first is stroke. People who have a stroke were often fit and well beforehand. Stroke can leave the person suddenly physically disabled. Treatment and rehabilitation can continue for a long time to help recover mobility and ability to communicate. The second condition is chronic pain. This is a symptom of many long term illnesses and leads to very poor quality of life for sufferers. The third is heart failure. People with heart failure are restricted in what they can do and often have to go into hospital if their condition suddenly gets worse.We have chosen these conditions because the technology we develop will have to be capable of meeting differing needs. The last phase of our project will involve asking people from each of these user groups to test the technology in their own homes so that we can find out the extent to which it is helpful in assisting them to make necessary changes to their behaviour. An example of how the technology might be introduced to a person following stroke is as follows; Following discharge from hospital a community therapist visits the person in their home. The therapist undertakes a full assessment of need. They then log onto the home based computer and customise a programme of activity to meet the needs of the user using the 'stroke toolkit' element of the system, The person and the therapist then look at the library of life goals on the system and agree which the user would like to achieve or maintain over the next few months e.g. they may wish to be able to go to their allotment, to church or simply be able to get up from their bed to the bathroom during the night without falling over. The therapist then shows them how to wear a small sensing device which will record over time the amount or type of activity they are doing (walking, sitting, standing) and the quality of the activity they undertake. Once the user has practiced the programme of activity with exercises, understands how to score the achievement of their agreed goals and can attach the small sensors they will be left to manage their own individualised therapy plan. They are able to obtain feedback on progress through their computer and through email messages sent by the therapist who will be monitoring the user's progress from their place of work.