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Ethical Guidelines for Telehealthcare in Practice

July 2011

Document Status Final Version Version Number V0.7Authors Nessa Barry, SCTT

Donna Henderson, SCTT

Date 21.07.11

Ethical Guidelines for Telehealthcare in Practice 2011

Table of Contents

Section Number

Section Title Page Number

1 Introduction 3

2 Purpose Purpose of document Consultation process Exclusions

4

3 Defining telehealthcare Telehealthcare definition Types of telehealthcare interventions

5

4 Ethical Principles and Telehealthcare Application Principles for telehealthcare Accountability Benefiting service users and service providers Safety & Security Advocacy and trust of service users Autonomy, independence and empowerment

8

5 Examples from PracticeExamples of telehealthcare (telecare and telehealth) scenarios which present ethical challenges.

13

6 References, resources and acknowledgements 17

Ethical Guidelines for Telehealthcare in Practice – V0.7 of 19 July 2011


1.0 Introduction Telehealthcare is a growth area within health and social care services in the U.K. Gradually, pilot and small scale developments are moving towards mainstream service provision.

Increasingly, it’s being recognised and accepted that Telehealthcare has the potential to:

re-orient services towards the user; provide access to much wider range of expertise; reduce the time and costs associated with travelling to obtain care advice;

and enhance communication and sharing of good practice1.

However, as a result of our consultation with health and social care staff during this work and related work streams, it is clear that for some health and social care professionals, there remains a degree of uncertainty about telehealthcare. This uncertainty can be a barrier to fully integrating telehealthcare into routine service delivery. This uncertainty is raised particularly regarding ethical and legal issues associated with the delivery of telehealthcare interventions. The research literature on the ethical and legal issues around telehealth/telemedicine and telecare has been developing for the past two decades.2

The uncertainty extends to: establishing and maintaining effective practitioner / user relationships; concerns about the effective / appropriate use of technologies under the

umbrella of telehealthcare; the transmission, handling, security and confidentiality of personal health

information using such technologies3.

The issues highlighted above present potential barriers to the sustainable implementation of telehealthcare and, as such, one of the ways to address them is through the delivery of appropriate policy guidance, training and education.

The Joint Improvement Team (JIT) and Scottish Centre for Telehealth & Telecare (SCTT)’s joint Telehealthcare Education and Training Strategy Action Plan4 identified the following actions in relation to ethical considerations when using telehealthcare:

Establish common principles – research evidence base on ethical considerations relating to telehealthcare

Establish and agree common principles for telehealthcare

1 2011, Wootton, R., Bahaadinbeigy, K., Hailey, D. www.biomedcentral.com/1472-6963/11/185

2 2006, Stanberry, B. Legal and Ethical Aspects of Telemedicine Journal of Telemedicine and Telecare 12; 166-1753 Feedback from Telehealth Champions Network meetings in Scotland 2010-114 Telehealthcare in Scotland: Education and Training Strategy 2010-12. www.jitscotland.org.uk/publications-1/telecare/


http://www.biomedcentral.com/1472-6963/11/185


Develop an ethical framework for telehealthcare

2.0 Purpose

2.1 Purpose of documentA key part of the work of the SCTT includes supporting sustainable telehealth and telecare in Scotland. For telehealthcare to become routine practice staff delivering services using telehealthcare require guidance frameworks. This document sets out a summary of ethical responsibilities for service managers and staff when planning or delivering telehealthcare services.

This guidance will also inform the work underway by the Scottish Centre for Telehealth and Telecare on standards/code of practice for telehealth.

The document brings together commonly agreed ethical principles, as identified in the Social Care Institute for Excellence (SCIE)5 work in the area of telecare, and applies them to different telehealthcare settings.

The document also draws on relevant publications in telehealth/telemedicine or telecare and existing good practice guidance in the area of using technologies in support of health and social care service deliver. For example, the Mental Welfare Commission (MWC) document ‘Safe to Wander’ (2007)6, while it focuses on tracking and tagging technologies, the MWC document has useful guidance principles when choosing technologies.

2.2 Consultation process In Spring 2011, the authors circulated the draft document to members of the SCTT team and also a number of the members of telehealth and telecare learning networks in Scotland to invite comment on the content of this document. The feedback on the document was broadly positive; guidance which reflects pragmatic choices and decisions was welcomed. The consultation also helped to strengthen the focus – who the document is aimed at, resulted in the inclusion of the flow chart on page 12, and led us to incorporate the scenarios which are drawn from experience.

The final iteration of the document will be circulated to a range of organisations including:

Scottish Social Service Council NHS Education for Scotland Royal College of Nursing Social Care Institute for Excellence

5 SCIE Report 30: Ethical issues in the use of telecare (May 2010); www.scie.org.uk/publications/reports/report30.asp

6 Mental Welfare Commission: 2007 www.mwcscot.org.uk/web/FILES/Publications/Safe_to_Wander.pdf


http://www.mwcscot.org.uk/web/FILES/Publications/Safe_to_Wander.pdf

http://www.scie.org.uk/publications/reports/report30.asp


Scottish Centre for Telehealth and Telecare Telehealth practitioners Remote and Rural Health Educational Alliance Telecare Service providers NHS 24 British Computer Society (Scottish Branch)

Once consultation was completed (July 2011), the final document will be made available via JIT/SCT web sites and the new NHS Knowledge Network Telehealthcare community of practice website7.

2.3 ExclusionsWhile the principles outlined apply to all forms of telehealthcare consultation and intervention, this document does not deal specifically with cross border / cross Health Board telehealthcare interventions or encounters.

This document does not include a discussion of the ethical issues associated with the costs of implementing telehealthcare, whether these are borne by health and social care providers, or individuals, or a mix of both.

3.0 Defining telehealthcare

3.1 Telehealthcare definitionThe prefix “Tele” comes from the Greek word root and meaning ‘at a distance’ or ‘remotely’. The “tele” prefix is applied to any area of healthcare where technologies are employed to diagnose, manage or treat at a distance. Collectively the purpose of these technologies is to mitigate the effect of distance in healthcare.8

Telehealth and telecare are increasingly used as an umbrella terms to refer to the technologies used by practitioners and patients/citizens to support either acute care scenarios or, care management on a daily basis.

Telehealthcare may be defined as:

The convergence of telecare and telehealth to provide a technology-enabled and integrated approach to the delivery of effective, high quality health and care services.

7 http://www.knowledge.scot.nhs.uk/telehealthcare.aspx8 Sood S, et al., What is telemedicine? A collection of 104 peer-reviewed perspectives and theoretical underpinnings. Telemedicine Journal and E Health. 2007;13(5):573-590.


http://www.knowledge.scot.nhs.uk/telehealthcare.aspx


9

For the purposes of this document, the term telehealthcare is used as an umbrella term for both telecare and telehealth interventions.

9 SCTT 2010



3.2 Types of telehealthcare interventionsThe telehealthcare interventions most currently in use have been categorised in this document as follows:

1. A telehealthcare intervention where the purpose is diagnostic decision support or care management. In this scenario a patient/service user may not be directly involved. This includes case conferences or, Managed Clinical Networks between health and care professionals. Video conferencing is the usual medium and the conference may include image/data transfer.

2. Telehealthcare encounters also referred to as telemedicine, which do involve a patient /carer/ service user consultation such as video conferencing i.e. a consultation (often facilitated) between health professional and patient, patient education, mentoring and monitoring as well as remote support and ill health prevention.

3. Telehealthcare in home and community settings which may include telemonitoring, data is transmitted to monitor long-term medical conditions, or the environmental and personal safety of service users. In this scenario a service user/patient /carer and /or a health or care professional may obtain the data and operate the system 10.

4. We acknowledge that telecare is the term more commonly used by social care staff to describe equipment for example, detectors that provide continuous, automatic and remote monitoring devices in the home. These devices include fall detectors, movement and heat sensors as well as medication reminders

Practitioners using telehealthcare are, therefore, those who are supporting indirectly or directly delivery of care using a range of technologies to gather, transmit and analyse information relating to the service user/ patients health, safety and wellbeing as well as ill health status.

All service users have the right to know their personal health/monitoring information gathered from the telecare equipment and sent to the call monitoring centre information is handled in a manner that adheres to professional and corporate information governance standards in any form of consultation or intervention.

The starting point when discussing ethics in telehealthcare is to note that existing professional and corporate practice guidelines (e.g. information governance: data protection), are equally applicable when developing and delivering telehealthcare services.

Adherence to such guidance on: consent, practitioner-patient /service user relationships, documenting advice both clinical and advice in relation to care records and professional standards in general, will go a long way to overcoming the barriers

10 Bower, P., et al., 2011, http://www.biomedcentral.com/1472-6963/11/184


http://www.biomedcentral.com/1472-6963/11/184


to use. This approach to practicing and implementing services in health and social care settings is consistent with the ambitions of the Quality Strategy, that services are Safe; Person Centred and Effective.

4.0 Ethical Principles and Telehealthcare application

4.1 PrinciplesThe principles for telehealthcare are presented below. Following on from these principles, practical steps on how the principles can be applied prior to, and during the routine use of telehealthcare are outlined for those implementing, supporting and practicing telehealthcare.

4.1.1Accountability (and responsibility)

All professional and organisational standards (confidentiality, security, information governance) which apply to a traditional face-to-face consultation/intervention do apply equally to telehealthcare consultation/intervention. Existing frameworks which are in situ re: organisational and professional standards should be adhered to.

Prior to implementation / service delivery The organisation should produce guidance & appropriate local protocols for

the use of telehealthcare. Guidance should be developed for staff and service users/patients, including record keeping and remote conduct.

All staff using telehealthcare as part of their role should be aware that all professional standards and corporate ethical guidance which applies to their practice in face-to-face settings also applies in a telehealthcare encounter.

Staff responsible for implementation should consider appropriateness of telehealthcare for the individual or, group of service users /patients.

Post implementation Local protocols regarding the appropriate use of telehealthcare e.g. in

specific scenarios & demonstrating ability to operate the technology safely and effectively should be developed.

A routine period of review of telehealthcare protocols should be established and completed by relevant line managers.

4.1.2



Benefiting service users and service providers

Based on evidence of good practice Telehealthcare must be adopted primarily for the benefit of users, and in line with care priorities. The use of telehealthcare should be as a result of service providers and eventual users (or their advocates) making an informed decision that balances risks to safety, security etc., against expected benefits, which include reduction in travel and carbon emissions.

Prior to implementation / service delivery Organisational leads should identify and document the anticipated benefits

and challenges of using telehealthcare.

Plans for routine service audit/evaluation should be in place and data gathered at pre-determined intervals to monitor the service benefits.

A process for obtaining informed consent for using services should be agreed. Service provider should support service user / patient and staff by providing information materials in appropriate format to enable an informed consent process.

Users should be aware of the alternatives to using telehealthcare. In addition, SCIE guidance re: telecare states that regarding the installation of

telecare equipment ‘Installers need training and education to acquire the core competencies necessary to support a person-centred service for people with cognitive impairments’(7).

Post implementation Once the decision is taken to use telehealthcare it should be viewed as one

part of an overall care plan. Or in the case of telecare, it may be the solution in itself. The care plan which includes face-to-face contact and when it is used in the home, a plan which includes contact with professionals and peer support activities.

Benefit should be reviewed in the framework of overall assessment. Staff should be aware that individuals e.g. using telehealthcare at home, may over-use, repeatedly trigger or, become unable to manage the equipment.

Good practice would be to provide guidance which balances benefit against incorrect use and staff ability to intervene in this situation.

4.1.3



Safety & Security

Telehealthcare should be practiced in an environment that protects the privacy, dignity and safety of users. Telehealthcare must be delivered in accordance with professional and organisational security policies. When delivering telehealthcare, the use or transmission of personal data should not expose the user to unnecessary risk.

In health settings, where images are to be recorded staff must adhere to the local Health Board IT/eHealth or medical illustration policy.

Prior to implementation / service delivery Relevant corporate (or, professional) security guidance should be reviewed

re: issues around the use of telehealthcare.

All staff users should be aware of relevant organisational security policies around the handling and use of personally identifiable data.

In telehealth (not usually applicable to telecare) where a range of professionals are going to be operating the service - guidance pertaining to telehealthcare should be shared and standard approach agreed.

Assessment of any security or safety issues around the environment where telehealthcare is used or the equipment, for example, suitability in homecare setting undertaken in advance of deployment.

Emerging security and safety issues should be documented and routinely

reviewed as necessary.

When data from monitoring devices is sent to a non-NHS / local authority site, those implementing must ensure a data processing agreement with associated responsibilities and rights is in place.

Any training needs should be identified by senior staff and addressed within the existing staff development processes. Training should be relevant to the role requirements and may include instruction in how to use the equipment, rationale for use and can incorporate elearning content as well as face to face delivery

Adherence to local and professional standards re: transmission of service user / patient data should be routinely reinforced and reviewed.

Adherence to organisational policies should be reviewed at routine periods.



Post implementation Steps to respect privacy and confidentiality should be explained to

patient/service user. In telehealth (not applicable to telecare) any persons not involved e.g. in teleconsultation should be asked to leave the room unless consent given by patients (e.g. students)

4.1.4 Advocacy and trust of service users

Use of telehealthcare must be based on informed consent.

The process of informing user choice should include detailing the anticipated benefits and challenges of telehealthcare as well as being made aware of the purposes of data transmission, the uses to which it will be put and by whom data will be viewed.

Users should be aware of any exclusions which limit the use of telehealthcare e.g., physical capability, language or, access to the internet from home.

Prior to implementation / service delivery Informed consent must be obtained. Users/patients/carers/parent/guardians

must be able to understand and choose between the options available e.g. alternative services if choosing not to use telehealthcare. Staff must be clear about how consent will be obtained and what their obligations are to record that consent was given/declined.

This process will include informing the service user /patient about: o how information will be transmitted, used and stored.o when video conferencing, the user should be aware how many persons

will participate in or, observe the consultation. o reassurance that no images will be recorded unless clear prior consent

has been sought and given – in adherence with local medical illustration policy.

o in Local Authorities, the use of telecare (e.g. alarms and pendants) has been well established. However, as the technologies develop new challenges must be considered. Chief among these is that the use of telecare supports independence and is a choice made by the user.

Post implementation Provide staff with clear guidance about protocol for response route and need

to verify up to date contact information. An accessible contact route should be available to service user/patient/carers

that have questions or concerns about telehealthcare process.

When the service is operational, in the event that a user’s capacity to consent is impaired detailed consideration of the appropriateness of use (carer support etc.,) will be necessary.



During the consultation on the draft of this document our colleagues in Perth and Kinross Local Authority provided us with there own very clear guidance for staff – with their permission we have reprinted the consent flow chart from the guidance document, this helps staff to work through the options when dealing with the issues outlined in this document.

Flowchart: Perth and Kinross Council Housing and Community Care, Community Alarm and Telecare Services, Principles of Good Practice Guidance: The Ethical Use of Assistive Technology

4.1.5Autonomy, independence and empowerment

Telehealthcare should support independence not dependence. Users (and staff) may have unrealistic expectations of telehealthcare. Managers should ensure staff have clear expectations regarding use.Telehealthcare does not come without risks; practitioners should be aware of potential risks and balance these against the potential benefits to users. Practitioners should always inform service users / patients / carers of the potential risks during the decision making process prior to implementation.


Is the service user capable of giving / refusing consent?

Is consent given?

Assessment & installation of appropriate technology

Advise on consequences of refusal

Yes

Yes

No

Has a welfare guardian or attorney been appointed?

Does Guardian / Attorney consent?

Can section 13ZA be used?

No

Yes No

YesNo

Assessment & installation of appropriate technology

Consider use of AWI act

Yes No

Flowchart of Consent Options – Figure 1


Prior to implementation / service delivery Although referring organisation may be very keen for telehealthcare to be

used, staff must be made aware that the service user/patient has the right to refuse telehealthcare and is aware of alternatives. Examples of alternatives should be fully explained.

When assessing individuals for telehealthcare staff should note discussion (including declining telehealthcare option).

When using telehealthcare at home, identify the staff who will be supporting the service and consider a confidentiality statement to be signed by all staff and contractors going in and out of the house.

Risks associated with the use of telehealthcare and mitigating actions should be identified and processes to manage risks be established.

o Risks may include: technology failure; risks to integrity of personal health information; inadequate support for the system; technology provider changes contacts and increasing social isolation of users.

Post implementation Identified risks should be monitored at routine intervals.

Regarding interactive systems, users should have the ability to decline/withdraw from a telehealthcare service without adversely affecting the care they receive. This does not apply to some telecare quipment e.g smoke/heat detectors.

Do not encourage over use of equipment. Telehealthcare can be continued beyond usefulness, each assessment of an individual for telehealthcare should include a stated review point.

Telehealthcare providers should continue to review whether the use of telehealthcare is promoting independence or encouraging dependence.

5.0 Examples from Practice

This section contains examples of telehealthcare (telecare and telehealth) scenarios which present ethical challenges.

Accountability (and responsibility)

ScenarioA telehealthcare monitoring system is set up in a person’s home. If the system is not linked to general practice system, monitoring may be ad hoc and in addition to normal duties for staff.

How do we mitigate risk and deal with this in a practical way?Use organisational guidance and if necessary implement local protocols to support monitoring as part of staff role. Work with local IT/eHealth and health staff to overcome non-integrated



There may be a risk of inadequate attention being paid to responses. Service users are sending data in good faith unaware that the system is inadequate to monitor them.

systems

Inform service users of the nature of the monitoring frequency. Talk to staff re: managing expectations of new technologies and balancing workload.

Benefiting service users and service providers

Scenario Quite a lot of telehealthcare is driven by testing devices. 'Because they were there' for example, giving users peak flow meters in COPD, which most clinicians think is not supported by robust evidence. The result is users being over burdened by the requirements of unnecessary tests. We have to recognise that in some cases telehealth may increase the burden on some patients with little return. The SCIE guidance for telecare (Ref.7) notes that regular assessment and review of the telecare installation is essential to appropriate use.

How do we deal with this when developing new services?

We have to consider the true rationale for the service, evidence and where the benefit lies. How often does BP have to be measured etc.? Getting it right will result in less intrusion and a more sustainable system.

For example if they feel well rather than going through the daily questionnaire and tests, could they not press a button saying I feel great? Involving service users in the development of new services at an earlier stage will help to reduce the burden on patient/client users overcome some of these excessive functionality problems.

Safety & Security / Advocacy and trust of service users

Scenarios For example, the video conferencing facility is in a side room of a busy out patient unit.

This may cause problems with respect to the confidentiality of the tele encounter and maintaining the privacy and dignity of the patient who is participating.

In a telehealthcare at home it is

How do we deal with this in a practical way?Staff should consider the impact of sound and image on their ability to diagnose and provide care for which they are accountable.

Put a sign up on the door to alert others that a clinical session is taking place so that we are not disturbed.



inevitable that Telehealthcare will introduce more people into a service users life/illness. There is always a balance between the benefit that the system can derive and the autonomy of the user.

Potential problems include a perception that privacy is being invaded.

Equipment failure which results in staff coming into fix or replace, more worrying is a failure to send information to centre and patient unaware that his/her data is un-noticed. This may lead to potential failure to spot deterioration

Set the volume on the machine to such a level that ensures we could easily hear the ‘other end’ but it does not heard from outside the room. Check that all those that take part on the encounter, where confidential data is discussed, are known to us or being there for the right reason.

We must ensure that the user really understood all that was said as technology we use for the remote interaction can be overwhelming.



Advocacy and trust & Autonomy of service users

ScenarioMany clinicians who use telehealth argue consent is not a major issue; their rationale is that patients do not formally consent when they come to see GP/Practice Nurse/A&E Drs/ENPs etc face to face.

In these situations consent is considered a given by the very fact they have come to see a health professional for advice. However, using telehealthcare can introduce privacy and confidentiality concerns into the consultation which are not perceived to be a problem in face to face consultations.

How do we address concerns in a pragmatic manner?Adhere to organisational and professional guidance. When assessing a patient for telehealthcare inform the patient of the purpose of the telehealth encounter. A verbal explanation of the available alternatives to using telehealth should be given. Allow the patient to decline the option of telehealth.

Inform the patient who will be present at the video conference and their role. Consent (explicit) will be needed if the session is going to be recorded.

When using telehealth in the home to monitor – assess carefully considering users’ needs and capacity to use technology appropriately. Regular review dates should be set and kept. Don’t encourage over dependence.



6.0 References and resources

6.1 References

1. Estimating travel reduction associated with the use of telemedicine by patients and healthcare professionals: proposal for quantitative synthesis in a systematic review. 2011 Wootton, R., Bahaadinbeigy, K., Hailey, D.

www.biomedcentral.com/1472-6963/11/1852. 2006, Stanberry, B. Legal and Ethical Aspects of Telemedicine Journal of

Telemedicine and Telecare 12; 166-1753. Feedback from Telehealth Champions Network meetings in Scotland 2010-115. Telehealthcare in Scotland: Education and Training Strategy 2010-12.

www.jitscotland.org.uk/publications-1/telecare/6. Mental Welfare Commission: Safe to wander principles and guidance on good

practice when considering the use of wandering technologies for people with dementia and related disorders. 2007: http://www.mwcscot.org.uk/web/FILES/Publications/Safe_to_Wander.pdf

7. SCIE Report 30: Ethical issues in the use of telecare (May 2010); www.scie.org.uk/publications/reports/report30.asp

8. http://www.knowledge.scot.nhs.uk/telehealthcare 9. Sood S, et al., What is telemedicine? A collection of 104 peer-reviewed

perspectives and theoretical underpinnings. Telemedicine Journal and E Health. 2007;13(5):573-590.

10. Bower, P., et al., 2011, http://www.biomedcentral.com/1472-6963/11/184A comprehensive evaluation of the impact of telemonitoring in patients withlong-term conditions and social care needs: protocol for the Whole SystemsDemonstrator cluster randomised trial BMC Health Services Research 2011, 11:184

Background ReadingCurrent Legal and Ethical Concerns in Telemedicine and e-medicine, Silverman, R.D., Journal of Telemedicine and Telecare 2003 v.9 supplement 1: S1 67-69

Ethical decision-making regarding Telehealth: Zur, O. http://www.zurinstitute.com/ethicsoftelehealth.html

ATA Practice Guidelines for videoconferencing based telemental healthhttp://www.nachc.org/client/ATA_TelementalhealthEBP_public_comment_6_1_09.pdf Ethical Perspectives in Evaluation of Telehealth, Cornford, T., Klecun-Dabrowska, E. 2001 Quarterly of Healthcare Ethics (2001) 10, 161-169

ICT & Ageing, Users, Markets and Technologies. Ethical Issues Compilation Report 2009


http://www.nachc.org/client/ATA_TelementalhealthEBP_public_comment_6_1_09.pdf

http://www.nachc.org/client/ATA_TelementalhealthEBP_public_comment_6_1_09.pdf

http://www.zurinstitute.com/ethicsoftelehealth.html

http://www.knowledge.scot.nhs.uk/telehealthcare

http://www.scie.org.uk/publications/reports/report30.asp


Nuffield Council on Bioethics, Personalised Healthcarewww.nuffieldbioethics.org/personalised-healthcare-0#1

Scottish Centre for Telehealth, Information Governance and IT Security for Telehealth Solutions (2008)

Social Care Institute for Excellence SCIE: Ethical Issues in the Use of Telecare. Perry J. et al., 2010

The Legal and Ethical Aspects of Telemedicine, Stanberry, B. Journal of Telemedicine and Telecare 1998 v.4 supplement 1: 95-97

WOC Practice in Cyberspace: Legal and Ethical Issues, Hoyman, K., Journal of Wound Ostomy and Continence Nursing 2001: 190-198

Teleneurology: ethics of devolving responsibilities from clinicians to families and/or carers. Makenzie, R. Sakel, M., British Journal of Neuroscience Nursing 2011, v.7 no. 2: 490-493


http://www.nuffieldbioethics.org/personalised-healthcare-0#1


Acknowledgements

We wish to thank all the health and social care staff and SCTT staff who provided feedback, comments and scenarios for inclusion in this document. In particular we would like to thank:

The Telecare Learning Network (February 2011 meeting)Donna Fleming, Edinburgh City Council Lynn Maxwell, Perth and Kinross Council Marion Glover, Telecare Officer, DumfriesKeith Simpson, Shetland Telecare OfficerFiona Mair, Doctor, A&EBrian McKinstry, GP and Telehealth researcher, NHS LothianSharon Levy, (Paediatric) Telemedicine Nurse Specialist Anne Reoch, SCTT Lead for Cardiac and Stroke Audrey Cund, Clinical Coordinator, Strathclyde University

6.2 Resources

Telecare: the ethical debate. SCIE 2 videos suitable for staff training and education sessions on ethical issues.

http://www.scie.org.uk/socialcaretv/topic.asp?guid=b8f01ae7-ff97-4d32-90e0-c3163291ef71

What is the video about?Telecare offers a range of benefits for individual users, including safety and independence. However telecare also has the potential to threaten users’ privacy, autonomy and control and could leave them socially isolated. The film explains some of these ethical concerns and offers practical advice about overcoming them and ensuring service users gain the maximum benefit offered by telecare technology.

Who will find it useful?Social care and health professionals involved in the commissioning and provision of support services. It is also relevant to telecare providers and to individuals considering whether to use telecare to meet their own support needs.

Other useful training and education resources to be added in here….

Perth and Kinross Council Housing and Community Care, Community Alarm and Telecare Services, Principles of Good Practice Guidance: The Ethical Use of Assistive Technology. (See flow chart from this document reprinted here in the section on Advocacy and Accountability)

Additional materials/links to be added by portal users. Contact us if you wish to add any links to training material or, other resources you are willing to share. [email protected]




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