Will IoT care for me?
In June 2020, VOICE, an international network of patients, carers and the general public with a shared interest in helping shape the direction of research into healthy ageing, organised an online workshop with the title, ‘Will the Internet of Things care for me?’
The event was attended by around 30 members of the public, who listened to an overview of the use of the Internet of Things (IoT) for care by Stephen Potter and Ceri Batchelder, representing both CATCH at the University of Sheffield and the Pitch‑In programme, before engaging in some scenario-based group discussions and offering their opinions about the role that IoT could play in their lives.
The overview presented an IoT system as implementing a remote ‘feedback control loop’, with sensing devices sharing data that can be analysed and acted upon. This control model chimes well with the notion of care provision as a cycle of observation, deliberation and intervention.
The appeal of using IoT for care arises from the promise it holds of extending care coverage not only in space and time (for instance, into people’s homes at all hours of the day), but also to particular populations who, for whatever reason, find it difficult to access conventional care services.
IoT for care applications can be considered to fall into one of three areas:
Personalised care: IoT is deployed to maintain or improve the health and wellbeing of individuals.
Public health: IoT is used to provide community-wide health or care services, or to monitor the health of communities or their environments.
Smart logistics: IoT is applied to improve the efficiency of or access to care services.
Given to the nature of the event and its attendees, the workshop was to focus on the first of these, personalised care, which can be divided further into:
Lifestyle management: helping users to stay healthier and live better for longer.
Condition management: providing help with rehabilitation or with the monitoring and control of known health conditions.
Assisted living: supporting those with disabilities to lead better, more fulfilling lives.
After patiently listening to the speakers (and enduring some technical hiccoughs!) it was time for the rest of the participants in the workshop to have their say. Although some of the issues with IoT for care – such as privacy, security, usability, effectiveness and cost – had been touched upon, they had not been treated in any depth. Instead, the intention was to allow people to voice their own concerns during the group sessions.
The participants were divided into three groups, each corresponding to one of the three types of personalised care, namely lifestyle management, condition management and assisted living. All participants had been supplied in advance of the workshop with a set of six scenarios, two scenarios for each of these three types. Each scenario described the possible use of an (existing or proposed) IoT system to meet the care needs of a fictional character, who was furnished with backstory and personality traits.
Each of the groups was asked to consider whether the suggested use of IoT would be beneficial for that character, what advice they would give them, and what further clarifications or guarantees were thought necessary.
Figure 1. One of the IoT for care scenarios.
Across the three groups a number of issues emerged, which, expressed in terms of the implications of IoT at a personal level, can be grouped thematically as follows:
Compatibility: does the technology fit into my life and context, or does it create an additional burden for me? Are the interfaces suitable for my needs and me? Who or what will help me to use the system? How does it fit into or alongside existing care systems, including emergency response?
Obsolescence: will the technology be obsolete within a year or 18 months because of technical changes? Will it be obsolete within a year because my condition, my environment, my needs or my lifestyle have changed?
Trust: does the technology work as advertised? How secure is the technology? How reliable is it, both in general and for me, in my particular circumstances? How private is the technology and its data?
Unintended consequences: will I have to adapt my behaviour to be compatible with the technology? Will the technology increase social isolation? Will it make me feel as though I’m being spied upon? Will the ‘human touch’ in care be lost? Will it lead to diminished personal responsibility for health?
Costs: what does ‘cost-effectiveness’ mean for me? What about those (or their local councils or health bodies) who lack the resources to pay for the technology – will they be left behind? What are the long-term costs of use and maintenance? What alternative provision models might there be, such as sharing or hiring? Does the desire to reduce costs and seek efficiency savings run counter to the idea of personalised care? Are there simpler (cheaper, better) alternatives for some people?
In addition, participants were asked to complete a short questionnaire in the days following the workshop.
The results indicate that the majority of respondents felt that IoT for care was generally a good idea, and although most had no objections in principle to its use, once again concerns were raised about privacy, social isolation, obsolescence and cost.
Among the suggestions for the most appropriate use of this technology, several respondents identified health monitoring, especially where this involves data sharing with and feedback from healthcare professionals. However, it was also noted that the area is confusing, not so much because the technology is difficult to understand, but rather because there is a lack of clarity about IoT for care systems at the moment, with many technologies promoted by many providers but little in the way of clear, informed advice about those technologies, their practicalities and effectiveness, and the costs they entail.
The concerns and suggestions of the participants will help to shape the concrete proposals for ‘How to do IoT for care’, another project in the Pitch-In health and wellbeing theme, alongside contributions from academics and technologists working in this field.
Many thanks go to Catherine Butcher, VOICE project manager, for organising the event, and to Catherine and her VOICE colleagues Katherine Jacques and Charlie Wilkinson for helping to run it and facilitate the group sessions. The event was sponsored by the Pitch‑In IoT for care – awareness-raising workshop programme.