Kemuri: IoTLondon Showcase

The buzz at the IoTLondon showcase demonstrated the huge energy of entrepreneurs.  Kemuri was able to demonstrate tangible progress since the original presentation in February.  The strapline was a bit tacky, “Granny Monitor”, but all better suggestions are welcome.

People were interested in poking their fingers into the working demonstrator, thankfully it was in battery powered mode and not connected to the mains.  It contains:

• Temperature sensor – for hypothermia risk
• Power sensor – for dehydration or nutritional risk
• Motion sensor – for immobility or fall risk
• Controller board – to schedule data transmissions
• Communications board and aerial
• Power socket

All fitting into a UK standard double socket enclosure.  Mission accomplished.

We had genuine enquiries about selling to the general public.  The answer has to be “No”.  The equipment must be professionally installed and the first units will go to telecare companies or care agencies.  Furthermore, it was just a demonstrator and it has to go into a prototype, certification and pilot phase before it should be introduced at scale.

As pointed out in the Marketing Flyer, we are “seeking supporters, collaborators and funders” before taking the next steps.  Tell your friends.

Crowdfunding: Hosted by SOCITM

Kemuri is a start-up with ambitions to build a social enterprise that is co-designed and co-produced by Councils with Social Services Responsibility (CSSRs). It needs a national infrastructure for safely and securely storing personal data of vulnerable people living alone. The infrastructure would allow families to co-operate with care agencies by checking wellbeing on a daily basis by unobtrusive predictions of hourly activity.

Steve Halliday prompted this posting from his blog.  ” …  how about if each of 500 local organisations contributed £1,000? That would raise enough to recruit some useful people for each of the regions. I was delighted when the organisations I suggested the idea to said “Yes, let’s try that”. The IT and digital leaders society (Socitm) and then the Local Chief Information Officer Council (LCIOC) both gave it their support and many individual organisations have indicated they would contribute. So, we have just launched a local public service Crowdfunding initiative, hosted by Socitm.”

Rather than relying on the goodwill of the private sector suppliers the lowest cost provision for Kemuri would be by using a shared service open to all CSSRs and certified care agencies. Kent Connects has helped already by awarding a prize of £2000 to get a successful demonstrator of a product that predicts the risk of hypothermia, dehydration and immobility of vulnerable people living alone.

If 100 other CSSRs chipped in the same amount, then there would be no difficulty in securing the remaining funding for pilots and national roll-out. The benefits of daily identification of risk could prevent many emergency admissions to A&E, distress related to falls and even deaths of people lying unattended, unable to call for help. Crowdfunding by public sector bodies is ideal for social enterprises whose main purpose is community good, not pursuit of untaxed profits.

Kemuri: Benefits First

Kemuri Can Save Lives.  That bold statement was not contradicted by last night’s sell out audience at the IoT Meetup in Shoreditch.  It was the first presentation open to the public. The organiser asked for a non-techie talk, and got one – apart from the fact that everybody there would know that IoT is the “Internet of Things”.

Grannies living alone were the star turn.  As they grow older, the risk of hypothermia, dehydration and immobility increases.  After a fall or a stroke, they can lie on the floor unattended for hours or days.  In the worst cases they are discovered dead.

The first putative customer gave the benefits case.  She was taken into hospital on Sunday night.  ‘If I had installed the Kemuri kit, I would have seen that her heater was broken on the Monday before, had it mended, saved enormous distress and the saved the State the high cost of an emergency’.  He drew the chart in the slide pack.  He can have the first off the production line.

All the techie stuff was missed out, leaving time for plugging Adrian McEwen’s book, simplicity, design and teamwork.

Care Bill: LAs should prepare now

The Care Bill will need massive ICT change within Local Authorities (LAs) by 2016.  The Department of Health (DH) have issued, for discussion, a guidance note on social care information and technology (DH Care Bill Guidance).  Priority actions are:

1. Roadmap: Plan with suppliers to satisfy a new charging regime by 2015.  Back office systems will need updating.  LAs will also have to provide information and advice to citizens – especially signposting citizens to care services.
2. Self-Funders:  Consider on-line assessment for self‐funders within wider changes in information and systems.
3. Better Care Fund:  Use the NHS Number as the primary identifier to comply with Integrated Digital Care Records Guidance.  There is capital fund open to NHS providers applying for resources to support the development of Integrated Digital Care Records, including with adult social care.  The second round will open shortly and LAs are strongly encouraged to work with NHS providers to make a compelling proposal.
4. Open APIs:   Think about embracing open APIs when procuring, renewing or refreshing its IT systems.
5. Technology Enablement:  Work with DH and national partners, to develop technology that drives improved outcomes, citizen experience and efficiency.

LAs should take this opportunity to consider joining forces to support a social enterprise that provides a national infrastructure with Open APIs into citizen controlled Personal Data Stores, keyed on the NHS number.  Co-production is the best opportunity in decades to provide interoperability between health and social care records, including self-funders recording expenditure against their Personal Care Budgets.  A social enterprise, such as Kemuri, could provide such an infrastructure, with suitable funding.

Funding a Social Enterprise

Ideas are free.  Concepts are beguiling and an excuse for inaction.  Improving the wellbeing of an ageing population seems to be a noble social enterprise.  People don’t want intrusive monitoring – but digital technology can help.  Kemuri has taken the first steps in providing a passive wellbeing monitoring service that will cost less than £1000 in the first year and less than £500 in subsequent years.  One year in a residential care home costs at least 10 times this amount, or more likely, 20 or 30 times.

The technology for Kemuri’s simple well-being monitor uses the Internet of Things.  It may be a buzz word, but when Google invests £2 billion on such products, it is not just hype.  Adrian McEwan’s book on the Designing the Internet of Things has helped to identify the action needed for a start up.  The chapter on a Business Model Canvas provides a nine point process for showing what must come next. The benefits are clear, the costs are containable, so how can funds be raised to deliver at scale by 2016, when the impact of the Care Bill becomes clear to the general public?

The proposition is that funding should be forthcoming if there are sufficient provisional orders.  Provisional orders would be financially risk-free for care commissioners.  If the products and services do not meet pre-determined conditions, then the order need not be fulfilled.  The financial risk is taken by the funders.  The big question is the size of the market at the price point selected.

In the UK, here are approximately 2.5 million people aged over 75 living alone in own homes, sheltered housing or care homes.  Any one of these is a potential beneficiary of passive wellbeing monitoring.  2,500 provisional orders would be just 0.1% of the potential market.  2,500 provisional orders represents a turnover of £2.5 million.   Is this attractive to Angel funders or Venture Capitalists?  Time will tell.

Ageing: Put the Social back into Care

At last, some recognition from people who understand the need to put the Social back into Care.  The “SmokingChimney” prototype won a £2000 prize for the Kent Connects challenge “How can we make it easier for people to help each other?”

It was not led by Technology – but a real life story from one of the attendees who joined the team.  He was so impressed that he wants the first version off the production line.  He created the strapline and enthusiastically gave the winning presentation.  It is an example of how designers should listen to people who want something very simple – the refinements can wait.

Have a look at the SmokingChimney slide pack to see the simplicity of the prototype.

Ageing Better: The message is getting through

Via the Public Service Launchpad, Quarkside has identified a blog promoting the understanding of the social issues surrounding our ageing population.  Claire Ritchie is worth following if you are interested.

Ageing: What do People Need?

Ageing impacts everybody in civil society.  We all grow older; we observe the ageing process with mild disinterest until it affects us personally. Who are the key stakeholders in sustaining a reasonable quality of life for our ever increasing ageing population?

• Older people living independently
• Relatives, who may live many miles away
• Carers providing voluntary or commercial services
• Local Authority Social Services officers
• Voluntary Sector advisors

At the Health Technology Forum (November 20th, 2013), Mike Clark informed us that there are 1.5 million people employed in the Social Care industry.  In addition, there are about 5 million more providing unpaid care to relatives, friends or via voluntary work.  Before may years have passed, more then 9 million of the UK population will be personally involved in providing social care.   It is beginning to have a major impact on UK productivity with so much time and effort being deployed in caring. Technology enables people to do more, with less effort, improving outcomes in health and wellbeing.

Before rushing into a care technology solution, Quarkside recommends taking stock of what each stakeholder group needs, with answers to simple questions for each group:

• What are the benefits of monitoring activity in the home?
• What are the risks?
• How much activity should be monitored and stored, if any?
• How much data should be shared, and with whom?
• What are the critical privacy requirements?
• What is affordable?

These questions are being posed at Kent County Council (November 23rd, 2013).  The results should should inform any care ecosystem design for the technology products that will largely have to be self-funded.  The State will not provide for things that only provide peace of mind and improved levels of wellbeing of older people and their relatives.

Ageing: Prepare for self-funding

One of the biggest sources of health care costs is dementia, £23 billion according to Age UK.  Falls currently cost £1 billion for health and social care, rising to £2.2 billion in 2050 (AKTIVE).  Adult social care costs for the Elderly are £8.9 billion (HSCIC).  The nation cannot afford to increase funding to meet these levels of growth.

Budgets will be capped in 2016, without annual increases.  It is inevitable that more social care costs will be paid by private individuals – self-funders in the jargon.  The Dilnot Commission “Fairer Care Funding“, provides much evidence for changes in policy.

• The current system is confusing, unfair and unsustainable. People are unable to plan ahead to meet their future care needs. Assessment processes are complex and opaque. Eligibility varies depending on where you live and there is no portability if you move between local authorities. Provision of information and advice is poor, and services often fail to join up.

To protect people from extreme care costs, Dilnot recommended capping the lifetime contribution to adult social care at £35,000, increased by the Government to £72,000.  Thereafter, people should be eligible for full support from the state.   In practice, it means that self-funding will increase and that many people will not get any state contribution to care costs.  As has been observed – there is a risk of smart people ‘gaming’ the rules to obtain earlier access to state funding.

Dilnot also recommended a statutory duty placed on local authorities to provide information, advice and assistance to all people, irrespective of how their care is funded or provided.  This must include local knowledge about care homes and care services.  In addition, people should be made aware of assisted living technology that is emerging from innovations in the Internet of Things.  Older people living independently and their distant relatives can obtain better outcomes by embracing new concepts of care.

 

Co-production: Agree Local Policy First

Transforming local public services through co-production is a recent mantra.  Birmingham University has reviewed the evidence and produced one unsurprising finding.

“The case for co-production is often made in terms of its potential relationship to efficiencies and cost-savings. But, the evidence base on co-production is limited and suggests that efficiency savings are not simple to achieve in the short-term.

‘it’s becoming a byword for passing responsibilities onto the communities and that’s leading to cynicism and anxiety’”

But there are also many positive messages and grounds for giving advice on how to move co-production forward.

• Delivering co-production is less about ‘scaling up’, than taking a localist approach: ‘scaling out’ through sharing practice and spreading innovation between organisations.

They also list implications for policy makers:

• Neighbourhood community budgets, neighbourhood plans and community rights all offer a potentially significant shift of power to communities providing grounding for transformative co-production of local public services.
• But how the ambition of transformative co-production is communicated is crucial.  The message needs to engage with values and aspirations in order to motivate and mobilise people to work differently and take action.
• Communication will need to be different within and across communities, localities and professional groups.
• Transformative co-production depends on working with communities to bring together existing assets and resources in new and creative ways.
• Local public delivery partners (as broadly defined, including voluntary, social enterprise, co-operative and mutual models) may be best able to understand and engage with such priorities and values ensuring that opportunities are communicated in credible and locally appropriate ways.
• Community rights–particularly the ‘right to challenge’–have been communicated as an opportunity for the community to ‘take over’. This message has been interpreted on the ground as exacerbating an adversarial relationship between existing service providers and communities, rather than encouraging collaboration and synergy, and so may be counter-productive.
• In commissioning services, the Public Services (Social Value) Act 2012, which requires public authorities to have regard to economic, social and environmental well-being in connection with public service contracts, can help to ensure that small, local public and community organisations are able to compete fairly.
• Incentivising and inspiring, through peer-to-peer learning which feels ‘real and relevant’ is crucial to spreading co- production.
• Neighbourhood community budget pilots have demonstrated that flexible, innovative approaches are important to initiating and continuing the dialogue between professionals and communities. Co-design and creative practice offer ways to build a credible commitment and incentivise different stakeholders.
• For neighbourhood planning, spatial and visualisation tools (such as digital maps, computer games and touch- tables) seem particularly appropriate way of engaging the community in problem-solving.