‘Inclusive technology’ the new blog from Scottish Care CEO Dr Donald Macaskill

Inclusive technology


Every so often a report comes across my desk – admittedly not often – that is worthy of more than a single read – one of these was published last week – it is the report from the team behind the Technology Enabled Care work in Scottish Government. See http://www.gov.scot/Publications/2016/10/3839


We live increasingly in an age where technology assist and enables our daily living and can be a positive contributor to our health and well-being. At a very basic level it is clear from what the report indicates that many of us use technology to self-diagnose, so for instance:


  • 1 in 4 UK adults currently self-diagnose;
  • Internet is first port of call for health information for adults under 65;
  • 75% of the UK population goes online for health information;
  • UK second in the world behind the US for use of online self-diagnosis.

The report highlights the valuable project work underway including the use of video conferencing in care homes to support GP and Allied Health intervention. It underpins its focus by identifying five principles which should lie at the centre of all activity. These are:


  • Citizen-centred: work with citizens, users and patients to co-design and develop solutions which support the management and delivery of their own health and wellbeing, with a particular focus on addressing health inequalities;
  • Flexible: facilitate flexible solutions which expand choice, control, coverage and accessibility;
  • Familiar: build on existing and increasingly familiar technologies and favour the adoption of simple, low cost approaches which can be tailored to the individual, utilising users own technologies where and when practical to do so;
  • Facilitative: Support service redesign to integrate new ways of working into mainstream service provision and pathways;
  • Innovative: secure continued investment in innovation to ensure a pipeline of ‘next generation’ solutions for the benefit of our citizens and our economy,


It is fundamentally important but this work has to recognise the issue of age related use and comfort with technology. The sad reality is that for every one ‘silver surfer’ there are another 9 left on the beach!


This has been highlighted in the Scottish Household Survey, published last month which shows that older people face continuing barriers in their ability to participate in the technological world.


For example, the survey reveals that older people are more likely to be sidelined by the digital revolution.


  • Although 82% of adults regularly use the internet, this rate substantially reduces with age (only 69% of those aged 60–74 do, and this drops to 30% among the 75+ age group).
  • Older people who do use the internet use it less often, are less likely to use sites which request personal or financial information (such as for online banking and shopping), and are less likely to take recommended security measures such as using unpredictable passwords and changing them frequently.
  • They are also less likely to use digitally-enabled devices such as tablets and smartphones (88% of 16–34-year-olds use their smartphones to access the internet, but only 36% of those aged 65–74 and 19% of those aged 75+ do).


These statistics become even more challenging as public services are moved online.  This will be something the new Social Security system will hopefully take on board and appreciate. In addition as we continue to develop exciting new technology that enables information about individuals to be passed from one professional to another issues of confidentiality and privacy will come more sharply into focus. Equally the importance of a workforce being skilled and equipped to use smart technology in the workplace to assist and promote greater control and choice by those who use services and supports will increasingly demand a recognition from commissioners and purchasers of these services that technological innovation requires investment and resource.


But we must be careful of making sweeping assumptions and generalisations. The use of technology in care demands person centred approaches to technology and I am not wholly convinced we are there quite yet. The work of academics like Prof Rebecca Eynon from Oxford who has highlighted the issue of digital poverty and the affects that has on a person’s sense of identity and wellness is an important contributor to this debate. Technology even technology in care is not neutral.


Technology is a massively positive potential innovator in care but we cannot ignore the reality of digital poverty, the psychological impacts of using technology and the effects on the human environment. If we do the irony will be that technology designed to enable inclusion will result in exclusion on the grounds of age.


Dr Donald Macaskill

CEO of Scottish Care

Last Updated on 28th October 2016 by Scottish Care

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