Author: David Banes, Chief Executive Officer, Mada - Qatar Assistive Technology Center. Edited by James Thurston, Microsoft Trustworthy Computing Group

Telecare
Increasingly social care is seeking to ensure that people with a disability and older people are able to live independently within their own communities. To achieve this, new care solutions have been introduced that allow users to maintain privacy whilst having support for social and health needs delivered through technology.

Telecare is made up of a number of features, some are passive systems that monitor the health and well being of individuals without their active involvement. Others are more highly interactive and require the introduction of assistive technologies to allow individuals to be an active partner in their own care packages.

We can explore an example of both:

1. Passive Monitoring
Telehealth monitoring has been proven to reduce unnecessary visits to the physician, emergency care and hospital readmissions, all of which means better health, greater patient satisfaction and improved quality of life.

Telehealth monitoring is the collection and review of patient data for the purpose of health supervision and management. Monitoring of health status, activities and symptoms takes place through an interactive monitor placed in the patient's home and remotely connected to a computer in the agency office.

Patient data collected by the monitor in the patient's home is reviewed on a daily basis by health professionals.

2. Active Care
Interactive telemedicine services provide real-time interactions between patient and provider, to include phone conversations, online communication and home visits. Many activities such as history review, physical examination, psychiatric evaluations and ophthalmology assessments can be conducted comparably to those done in traditional face-to-face visits. In addition, "clinician-interactive" telemedicine services may be less costly than in-person clinical visits. 

Telemedicine is most beneficial for populations living in isolated communities and remote regions and is currently being applied in virtually all medical domains. Specialties that use telemedicine often use a "tele-" prefix; for example, telemedicine as applied by radiologists is called Teleradiology. Similarly telemedicine as applied by cardiologists is termed as telecardiology, etc.

Environmental Control
Alongside solutions that meet health and social needs, effective independent living may be dependent upon the ability of the individual to have control over their immediate environment. Again such systems can be relatively passive, or more highly interactive and controllable.

Passive systems can be seen in solutions that control the immediate environment as a result of pre-agreed patterns such as heating or lighting being set to become active at specific times, alternatively systems that demand immediate decisions by individuals are also available. Such systems can be utilised to open doors, switch on televisions, open and close curtains, and in fact give total control over the local area.

Solutions in a users home, or even in the workplace, can be installed to ensure that maximum independence is achieved without the need for ongoing personal support from a carer.

Internet usage
For many disabled people, the ability to engage with all of the above will be dependent upon their ability to interact fully through the internet. This section of the toolkit will not focus upon the design of accessible websites. However it is worth noting the full range of applications and activities that disabled people have identified as being of personal benefit

• e-Commerce

• Messaging

• Voice and Video Over IP

• Virtual Reality

• Collaboration and Communication

• Community Activity

• Online Gaming

As we increasingly see applications and technologies delivered as a service from the "cloud" the opportunities offered will increase accordingly. However without effective design and support for assistive technologies these significant life enhancing opportunities could be lost.  See more in the section on website accessibility.

Leisure and Entertainment
Assistive technologies open up new opportunities for leisure and entertainment for people with a disability, and hence contribute significantly to quality of life.

Specific areas that are worthy of further content include:

• Access to Broadcast Media

• Access to Gaming

• Access to Arts and Culture

• Access to Music

The following are examples of each of these:

1. Broadcast Media

• BBC iPlayer

BBC iPlayer provides access to a full range of BBC broadcasts through an Internet connection. The accessible player allows users who use assistive technologies to control their viewing through the use of alternative keyboards or pointing devices.

• SlingBox

Slingbox is a system for transmitting and viewing your television remotely. It allows you to view digital TV or your home player anywhere in the world. As such it is especially valuable for people who need to go into short term care, or respite services and want to access the entertainment that they use at home.

2. Gaming

• Adapted controllers and Specialist games

www.oneswitch.org.uk provides very wide range of information on accessible controllers for computers and game consoles. These range from modified controllers for the Xbox 360 or PS3 to switch accessible guitars for Guitar hero ! In addition downloadable games for switch users and people with a visual impairment can be found on the site. 

3. Arts and Culture

• Online museums and galleries

There are many online art galleries and museums that can be browsed online. Examples include the Tate Collection in London, Louvre online from Paris and the New York Metropolitan Museum of Art. 

4. Music

• Appreciation, Composition and Performance

There are many examples of music collections that can be listened to online and include huge collection through tools such as iTunes or Napster and Internet Radio.

Specialist technology can help make mp3 players accessible, or can offer opportunities to perform and compose using an instrument such as the Soundbeam.