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Smart home technologies for health and social care support

Abstract

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Background

The integration of smart home technology to support health and social care is acquiring an increasing global significance. Provision is framed within the context of a rapidly changing population profile, which is impacting on the number of people requiring health and social care, workforce availability and the funding of healthcare systems.

Objectives

To explore the effectiveness of smart home technologies as an intervention for people with physical disability, cognitive impairment or learning disability, who are living at home, and to consider the impact on the individual's health status and on the financial resources of health care.

Search methods

We searched the following databases for primary studies: (a) the Cochrane Effective Practice and Organisation of Care (EPOC) Group Register, (b) the Cochrane Central Register of Controlled Trials (CENTRAL), (The Cochrane Library, issue 1, 2007), and (c) bibliographic databases, including MEDLINE (1966 to March 2007), EMBASE (1980 to March 2007) and CINAHL (1982 to March 2007). We also searched the Database of Abstracts of Reviews of Effectiveness (DARE). We searched the electronic databases using a strategy developed by the EPOC Trials Search Co‐ordinator.

Selection criteria

We included randomised controlled trials (RCTs), quasi‐experimental studies, controlled before and after studies (CBAs) and interrupted time series analyses (ITS). Participants included adults over the age of 18, living in their home in a community setting. Participants with a physical disability, dementia or a learning disability were included. The included interventions were social alarms, electronic assistive devices, telecare social alert platforms, environmental control systems, automated home environments and 'ubiquitous homes'. Outcome measures included any objective measure that records an impact on a participant's quality of life, healthcare professional workload, economic outcomes, costs to healthcare provider or costs to participant. We included measures of service satisfaction, device satisfaction and healthcare professional attitudes or satisfaction.

Data collection and analysis

One review author completed the search strategy with the support of a life and health sciences librarian. Two review authors independently screened titles and abstracts of results.

Main results

No studies were identified which met the inclusion criteria.

Authors' conclusions

This review highlights the current lack of empirical evidence to support or refute the use of smart home technologies within health and social care, which is significant for practitioners and healthcare consumers.

PICOs

Population
Intervention
Comparison
Outcome

The PICO model is widely used and taught in evidence-based health care as a strategy for formulating questions and search strategies and for characterizing clinical studies or meta-analyses. PICO stands for four different potential components of a clinical question: Patient, Population or Problem; Intervention; Comparison; Outcome.

See more on using PICO in the Cochrane Handbook.

Plain language summary

The effect of smart home technologies to support people at home

People who are ill (physically or mentally), or who are frail, may find it difficult to meet their everyday personal and social needs at home. Healthcare providers are trying to find ways to support more people at home, but finding home care workers and the money to fund this help is challenging. Advances in technology have created new devices to help support people. 

New devices are already starting to be used, such as mobile phones tailored to health care, or electronic sensors that sound alarms in emergency situations. Another new technology is sensors. Sensors can be placed in everyday appliances in the home, like the fridge, cooker or the door, and can send information to healthcare providers.  Providers can find out how people are doing in their homes and then make decisions about their care, such as how often to visit the home. Homes with these technologies are called 'smart homes'.

As with many new technologies, smart home technologies are often used without first testing if they are effective. This review aimed to determine what effect any type of smart home technologies have on people. The review produced a significant volume of literature on the use of smart technologies within health care, but there were no studies testing their effectiveness. The effects of smart technologies to support people in their homes are not known. Better quality research is needed.