For
people who require technological assistance, the current situation can
be anything but dependable, as the social care/health professionals are
unlikely to have the time, energy or resources to access the up to date
information on the technology that is available. Moreover, there is no
standardised assessment protocol that has been developed to match
people to a specific technology, or to determine the relative merit of
a device or assistive technology.
Through the fieldwork work on the DIRC project by Lancaster University in developing a dependability model
for domestic systems; it became apparent that many systems provided to
people who needed appropriate technology were receiving substandard
solutions. There are a number of reasons for these inappropriate
solutions being used but of the many it became clear that lack of
knowledge, availability and understanding how to translate a person’s
need into a technological solution were to the fore. The dependability
of the systems was called into questions and the systems failed due to
the initial design and specification not being related to the actual
requirements of the users.
The MDDS checklist (formerly named CATCH and before that CATS)
was designed to assist in the appropriate choice of assistive
technology system to meet the needs of an older person in their home. MDDS
provides a number of key questions which can be asked about the user’s
relationship to the overall technology system as well as specific
technology related (system derived) questions.
The intention and purpose of MDDS
is to allow social care professionals (Occupational Therapists, Social
Workers, Support Workers etc) who would normally be assisting in or
having input into specifying or commissioning this form of technology
to determine appropriate questions. By using the MDDS
checklist correctly, the user should be provided with a set of clear
questions that can be used in determining the appropriateness and
dependability of any particular AT system they design or are
considering using.
The
Checklists follow the outline of the dependability model for domestic
systems and highlights areas where key dependability characteristics
should be considered. The questions (with sub-questions not shown here)
in the initial assessment checklist are:
1. Why is a new system being considered?
2. Will the system do what is expected of it?
3. How will the system make the user feel better, safer, or more in control of their environment?
4. In what ways will the system enable the user to undertake tasks previously too complex or difficult?
5. Is it important that the system be non-confusing for the user and easy to operate?
6. Will the system constrain the user to act in certain ways or modify
their behaviour in order for the system to work appropriately?
7. How is it suited to the user?
8. Could the user benefit from further system enhancements
9. Will the system meet budgetary constraints?
This
checklist is intended to be used in conjunction with design guidelines
that we propose. We suggest a list of 20 good practice guidelines for AT system design. Some examples of these guidelines are:
*
Think about system failure - The more complex the design, the greater
the chance of things going wrong. In larger systems, you might want to
build in a level of redundancy (more than one device monitoring the
same task) so that if one system fails the other should take over.
* Check that the user really wants the technology - Often people are
given technology because others think that they can benefit from it.
Users are not consulted and consequently may never use the AT system.
* People care about how things look - Modern technology might not look
good to the person having it in their home, so attempt to blend
technology into the fabric of the building wherever possible.
* Avoid actuators wherever possible - Actuators (motors that open or
close things such as doors and windows etc) can be costly and
unreliable and may require changes to the structure of the building.
Fixing is often problematic and costly.
After
completing this initial analysis, the system designer should have a
clear idea of what the user really needs and should have established
the type of assistive technology that is most suitable to the user
needs. They then move on to a more detailed analysis, driven by the
attributes of the dependability model.
MDDS contains three main checklists:
The first checklist is a “Location Space Form”
which allows the different elements of the home form is split into four
sections (Fitness for Purpose, Trustworthiness, Acceptability,
Adaptability) and each section is split into subsections (Transparency,
Requirements, Availability and Reliability, Safety, Confidentiality and
integrity, Maintainability, Survivability, Usability, Learnability,
Cost, Compatibility, Efficiency, Responsiveness, Aesthetics,
Configurability, Openness, Visibility, User Repairability) which allows
different facets of interaction to be considered.
The second checklist entitled "Main Technology Assessment Questions" promotes the correct decision, or whether an alternative method of assisting the person is recommended.
The third checklist entitled “Assessing a System: What to look for and what to avoid”
is made up of highly detail questions about the system both in relation
to the technology (and its properties and configuration) and the person
(their activity patterns, use and understanding of the proposed
system). The questions follow the order preset in the first “Location
Space Form” and the order laid out in the dependability model for domestic systems.
The
product of using the checklist is not an answer as such, rather the
user should be guided to think about the systems from a number of
different perspectives and have a list of questions that should be
addressed before the design continues. The other feature of MDDS is it can be reused throughout the design process as more information comes to light the MDDS checklist can be redeployed to see if the issues and information that has come to light will effect the design requirements.
MDDS is undergoing constant review and update whilst in the evaluation process.
URL's
http://www.smartthinking.ukideas.com/Design%20index.html
Download Version 43 of the draft (these versions will be available shortly)
is
now in four parts. Download them all and the evaluation
form and let me have your comments (good and bad).
MDDS Part 1
MDDS
Part 2
MDDS
Part 3
MDDS
Part 4
MDDS Evaluation form and in Word
MDDS is
in the developmental stage and consequently
constantly requires evaluation. If you
download a copy please send your thoughts both
good and bad to smartthinking@ukideas.com
Your comments do matter and they will be reflected in future versions of the checklists.
DTA - The Dependability Telecare Assessment Tool
Through research conducted between 2002 and 2008 nine aspects of technological viability were developed (Figure 1) which allowed technological interventions to be empowering. This meant that the person in receipt of the technology (telecare or AT system) was not a passive recipient but actively engaged in the process and the design (Figure 2). Furthermore, this interaction between technology and the person can be broken down into four main elements: Acceptability; Trustworthiness; Adaptability and Fitness for purpose. A person must have technology that is fit for intended purpose, it must be acceptable and trustworthy as well as adapt to their changing needs. Each of these elements can be broken down further to other dependability characteristics that demarcate the socio-technical system (Figure 3).
Figure 1: The empowering nature of technological intervention
Figure 2: The relationship between the person and the technology
Figure 3: The telecare dependability characteristic
So when a person is assessed from any service within the council, health or mental health service the should receive an holistic assessment that includes a telecare assessment based on the dependability criteria in Figure 3. Clearly, not all aspects of the table are to be prevalent with each assessment but as a guide the elements have proven to be useful in ensuring person fit to technology as well as adapting the living spaces to be more acceptable for the occupant. The other clear advantage of the DTA tool is that it does not mean technology is foisted on people but rather is arrived at through a process of negotiation and discussion with the parties who have an investment in its use. This means it is rarely over used and most importantly when technology interventions such as telecare are used it is a limited intervention which is person-specific and solely needs based.
Figure 4
When we start to use the standard dependability elements from MDDS to work for telecare we find that some elements are redundant and other elements need to be brought into play. Figure 4 summarises these changes. DTA is a practical application of MDDS and as such is still in its infancy, but by using the above diagram as a reference model, it explains the necessity of person-centred design of telecare systems and alerts the assessors to the potential dependability issues within the design. What is clear is that where it says end in the diagram is really the beginning.
