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Ebook: A Conflicted View of Telehomecare After a 20 Year Journey
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Telehomecare systems have been in existence, in one form or another, for at least a decade. At the outset, the concept seemed to promise both a solution to controlling rising health care costs and a means of delivering the improved care which would enable the elderly to stay in their own homes for longer; but although it received enthusiastic support from governments and care professionals, as well as the commercial sector, adoption within a given community has not yet been achieved, and overall success has been limited at best. This book addresses the question of why, despite the investment of so much time, money and effort, Telehomecare is not more widely used than it is. The author describes his 20 years of experience in the field as a journey which started with a concern over his mother's health, and ended with himself and a colleague selling a series of patents to General Electric. Drawing on his experiences as an inventor, entrepreneur, businessman, implementer and researcher, he conducts a frank and thorough consideration of what has gone wrong, and offers an unflinching set of suggestions as to how to make it right. Telehomecare must become more than just a passive emergency response system if it is to have any chance of achieving its full potential. The analysis offered by this book will be of interest to all those whose work involves the development or implementation of Telehomecare systems.
This book is largely a report on an unexpected journey that I took over the last twenty years. As I explain at some length, the journey started with a concern with my mother's health and ended with my colleague and me selling a series of patents and intellectual property to General Electric. Over the course of this journey, I assumed multiple roles and had a series of experiences for which my background as an anthropologist ill prepared me. As I reviewed my field notes, analyzed data from the various pilot studies in which I engaged and actually wrote the book, a single question kept reoccurring to me: how the hell did all of this happen? Although anyone who knows me at all will testify, reflection about my motivation and actions is not one of my strong points. But, given that I could not stop the question from popping into my head at the oddest times, I finally had to at least ponder it. The only answer I could come up with was one that I had used earlier when I was asked to give a talk about what motivated me to undertake research in such a large number of varied locations. At the time, I was Distinguished Visiting Chair of Gerontology at St. Thomas University in New Brunswick, Canada and I felt that if I, at least, didn't make the effort to try to discuss my motivation, they might alter my appointment to undistinguished chair. My answer then, as it is now, is that I'm really good at means, but really bad at goals. It was not my goal to have patents, to build a sensor array, to become an entrepreneur, to start a small business or to undertake research on a behavioral monitoring system in 14 different locations. In retrospect, I cannot recall any specific goals beyond trying to solve the next problem and in many ways, this solving the next problem was just a means—we really need to write better algorithms, we need to test our prototype in peoples' homes, we need to commercialize the system or it will never be used by anyone. As I reflected on this means versus goals issue, I realized that one of my strengths is that if I'm interested in the “game” I will learn the rules and eventually beat you at it. Not because I necessarily want to win, but because I like games so very much.
So this journey was really a great big game for me with the result being that I had to play many parts and learn many new sets of rules. I had to learn how to go about getting a patent which was a fairly big step for an anthropologist because I do not know of another cultural anthropologist with patents. Then I had to learn how to install a sensor array, connect it to a base station and establish thresholds so that I could get the information on behavior in which I was so interested. Next I had to learn how to work with, or not work with as it turns out, large corporations in joint development projects and, eventually, figure out how to play in the world of venture capital. This resulted in me being on the board of directors of a start-up company—another unlikely role for an anthropologist—and to the series of pilot studies on which I report in the book. Finally, I had to learn how to negotiate with a phalanx of lawyers, M&A (merger and acquisition) executives and investment bankers over the sale of our patents. How well did I do in assuming these different roles and learning the different rules of the game? Well enough to be regarded as a mediocre engineer when I presented our work at engineering meetings; well enough to be regarded as a pretty poor computer scientist when presenting papers to computer scientists; well enough to get a contract with a major corporation to work on a project to develop a behavioral monitoring system, and well enough to know when we had to break the contract; well enough to get venture funding to bring our idea for a behavioral monitoring system to market; and finally, well enough to not be completely screwed when we sold the patents.
The rest of the book, in many ways, is the chronicling of this journey through the many roles that I have assumed over the years. However, if I was only interested in describing the roles and the journey, I would not have written this book—perhaps a different book, but not this book. I have written this book because I believe that lessons that I've learned through the multiple roles I've assumed, the experiences that I have had, the work that I've undertaken, can benefit others working in Telehomecare. It is conceivably the height of hubris to believe so strongly that one's own idiosyncratic experiences can benefit others, but in this case, this is my belief. Only the reader can judge whether these lessons can benefit others, but it is my fervent hope that they can. And if they don't, perhaps the reader can, at least, enjoy some of my anecdotes and tales.