Technology Enabled Care That Does More Than Monitor | By Louise Murray

In my 40 years in clinical homecare, remote monitoring, and NHS implementation, I have repeatedly seen the same gap. Today’s technology can show us what is happening in someone’s home. Whether it’s a fall, a missed medication, a change in activity or even an unexpected reading. But what that technology can’t do by itself is decide what should happen next.

We need to understand who is receiving the information and what it means for the individual. Who’s going to own the response, and who has the authority to act on it? An alert without a response model is not a care service. It’s simply a notification that could easily be missed.

Over the years, I’ve seen many situations where patient notifications pile up, but the responsibility for acting on them remains unclear. The technology clearly works, but the service around it has not made ownership and escalation clear enough.

One of the primary reasons for monitoring someone at home is to support earlier intervention, reduce distress and help prevent avoidable admissions. When a service user can see that concerns are noticed and acted upon, it builds trust in the clinical team and confidence that care at home is a genuinely safe alternative to hospital-based care.

Where the model breaks down

Traditional telecare still has an important role. When a service user activates an alarm, the monitoring centre should respond and follow an agreed process. But Technology Enabled Care now has the potential to do so much more than respond to individual incidents.

Falls detectors, medication devices, activity sensors, environmental monitoring and remote patient monitoring can all help build a fuller picture of how someone is managing at home. A single alert might not mean much on its own. But a change in routine, fewer movements around the home, or repeated missed medication doses may indicate that a service user’s needs are beginning to change. The real value here lies in recognising that change early enough to actually do something useful about it.

It all sounds straightforward, but this is often where the model breaks down. The technology may be visible and easy to procure, but experience tells us that the harder part is designing the service around it.

We still need someone to interpret all this information. They need to decide whether a concern requires a call, a video consultation, a care visit, a clinical review or simply reassurance that no intervention is needed.

The equipment also has to be selected properly, installed correctly and explained in a way that makes sense to the person using it. It needs to be maintained and reviewed as circumstances change.

Things often go wrong when these responsibilities sit across different organisations. One provider supplies the device, another monitors it, and yet another team is expected to respond. What’s more, clinical oversight may sit elsewhere again.

Each handover creates another opportunity for information, responsibility or time to be lost. The issue isn’t necessarily the technology. It’s more likely to be the fragmented operating model around it.

Designing around the person

The reality is that people do not experience health and social care in neat organisational categories. Someone coming home from hospital may need clinical monitoring for a short period, but they may also need medication support, falls monitoring, personal care and reassurance for their family.

As they recover, that support may sometimes be reduced, while other elements may remain in place to help them manage a long-term condition or continue living independently. The crucial point, though, is that from their perspective, this is all the same experience.

But from a system’s perspective, it may involve an NHS trust, a local authority, a technology provider, a monitoring centre, a care organisation or even family members.

Technology Enabled Care needs to help connect the dots in the pathway rather than create yet another layer alongside them.

It needs to support hospital discharge, reablement, community care, long-term condition management, and social care, while supporting step-up or step-down as someone’s needs change.

The starting point shouldn’t be which equipment is available. It should start with the service user's needs.

Now for some, that might mean managing medication with greater confidence. For others, it may mean moving around their home safely or simply rebuilding their independence after a hospital stay. Whatever the need, the technology should follow the outcome, not the other way around.

And this same principle applies to how services are measured. The number of devices installed tells us very little about whether the service is working. The real value is in understanding whether risk has been identified earlier or whether a discharge has been made safer. Has a care package been avoided or has someone become more independent?

Commissioners need to see what changed for the service user and what action followed, not just how much activity took place.

Technology with the capacity to act

At Kensa Health, our view is that Technology Enabled Care should be designed as an operating model, not purchased as a collection of separate products.

When I first joined Kensa, what attracted me was the opportunity to bring together parts of the service that are too often commissioned separately. Technology, monitoring, clinical oversight, engineering support and practical care in the home all matter. The real value comes from making sure responsibility does not disappear between them.

So the acid test is not whether a device can detect a change, or a platform can create an alert. The real test is if that information reaches the right team and whether the service has the operational capacity to act.

When commissioners look at Technology Enabled Care, the most important questions are not only about devices, platforms or features. They should also be asking who receives the information, who interprets it, who owns the response, how quickly someone can act and how the response connects with the wider pathway.

They should be able to see whether the service is actually changing anything for the service user, not just generating activity.

At Kensa Health, this is the gap we are working so hard to close. By bringing together Technology Enabled Care, virtual care, analytics and practical support in the home, we can help partners build services that do not stop when an alert is generated.

The exact model will depend on what is already in place. Our role is not to replace effective services unnecessarily, but to connect the technology, insight and operational capability needed to make the whole model work.

Technology Enabled Care reaches its full value when monitoring, judgement and practical response work together. The measure of success is not how many devices have been deployed. It is whether the service can recognise change, coordinate the right response and help someone remain safe and independent at home.

That is the difference between monitoring a service user and being able to really support them.

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