In our own work on development of the behavioral monitoring system that eventually came to market as GE/QuietCare^® we continuously used a concept which we called PAT—“Pay Attention To”. We began using PAT when we realized that there was often a tell-tale pattern to the combination of alerts that were being generated from the data collected by the motion sensors. The individual alerts themselves obviously had validity and meaning and were being used by emergency responders and carers. However, as we analyzed the specific combination of alerts for monitored individuals over time, it became clear that some of these patterns themselves required an “alert” because since they also provided valid information about the status and needs of the client. This finding became PAT and we incorporated it as a guiding principle in the monthly reports to carers on their clients who were being monitored. In this way, PAT became the focus of much more comprehensive discussions of the client's needs and the heart of the records being maintained on each client. We continued to use the PAT concept as we developed an electronic record to be used in the home environment and it became a core component of the mobile application that is being currently used in Europe.

Although we run the risk of being accused of being a “one-trick-pony” we want to use the PAT to focus this short Preface. Having spent hundreds of hours recruiting the chapter authors—many of whom have never written an academic publication—cajoling them to produce the chapter, editing subsequent drafts of the chapters and then formatting them, we believe that we can extract the most salient themes from the chapters. This does not mean that the reader could not and will not do the same thing, just as the carers could have “read” the alerts and determined the underlying pattern. It's just that we can use the PAT concept to allow the reader of the chapters to look for the patterns among the chapters more efficiently.

So here's the PAT for our book:

1. How innovative care organizations have attempted to integrate Telehomecare into their care delivery model, because the only way to evaluate Telehomecare is to observe how it is being employed in the real world of care provision;

2. How pilot studies have been used to evaluate various Telehomecare applications, especially their emphasis on testing of the technology, rather than on its impact on care outcomes;

3. How implementation of Telehomecare applications face a series of barriers that have much more to do with organizational culture than the use of new technology;

4. How a vicious cycle exists that is driven by a lack of evidence supporting the claims made for Telehomecare, leading to the reluctance of care organizations to introduce the applications, that restricts the market for Telehomecare, which limits the investment of the companies involved in the development of Telehomecare that would make the applications more widely available, that would increase the installations, that would produce the evidence needed to...

5. How the absence of a viable business model that answers the fundamental question of, who pays, is at the heart of the slow implementation of Telehomecare.

Of course there are many more points to pay attention to than these five, both within individual chapters and within the book as a whole. But, we believe that of all of the significant points made by the authors coming to Telehomecare from a wide variety of backgrounds and perspectives, these five points are the ones that coalesce at the top of any scale of importance. Please do not only focus on these points, but also please pay attention to how these five points tie together the chapters, whether the authors are from the United States, the Netherlands or the United Kingdom, whether the authors are care providers, business people, developers, or academics and whether the authors are enthusiastic or cautious about the future of Telehomecare. In the great digital era, we are witnessing many rapid scientific and technological developments in human-centered, seamless computing environments, interfaces, devices, and systems with applications ranging from business and communication to entertainment and learning. These developments are collectively best characterized as Active Media Technology (AMT), a new area of intelligent information technology and computer science that emphasizes the proactive, seamless roles of interfaces and systems as well as new media in all aspects of digital life. An AMT based computer system offers services that enable the rapid design, implementation, deploying and support of customized solutions.