Tuesday, October 8, 2013

Remote Control

Last week was a big week for technology in the world of supports and services for individuals with intellectual and developmental disabilities. On Wednesday, October 2, The Coleman Institute for Cognitive Disabilities hosted its 13th Annual National Conference, highlighted by the official unveiling of a Declaration of Rights of People with Cognitive Disabilities to Technology and Information Access. If you haven’t done so, please click on this link and endorse that declaration.

The day after the Coleman Conference, the American Network of Community Options and Resources hosted its annual Technology Summit and Showcase. For me, the highlight of the ANCOR event was the final breakout session of the day, entitled “The Ethics of Remote Monitoring” and hosted by Amy Hewitt, PhD, Director, Research and Training Center on Community Living, University of Minnesota, and Sandy Henry, Senior Director, Sengistix.

The description of the session stated the intent of the discussion was to: review service changes over time and implications for the use of technology; discuss ethical considerations from the family perspective and in comparison to the DSP Code of Ethics; and look at rights, responsibilities and risks comparing on-site DSP support and remote monitoring.

Despite the session being at the end of two days of conferencing, where even the most enthusiastic attendee can start getting a bit fatigued, the discussion that ensued during this session was lively. Although I hadn’t intended to, I eventually jumped into the discussion to make three main points about remote monitoring. (SPOILER ALERT: I’m all for it).
  1. Some session participants expressed mistrust in what potentially could happen with the remote video feed. Could an inappropriate video or photo end up on YouTube or Facebook? Well, the short answer to that is yes, it could happen. But I would argue that risk already exists using a more traditional model of supervision involving an employee being on premises, as opposed to monitoring remotely. I can say without hesitation that the majority of folks currently working those types of jobs have smart phones that they could easily use to take inappropriate videos or photos and share them. We trust the employees working face to face with clients to do the right thing, so why would that be any different for remote monitoring? The risk for either situation is the same.
  2. Another point was set forth that parents were concerned about companionship for their children who have developmental disabilities. Much of that companionship came in the form of paid staff members who provided services to the individual, and there was a risk that that companionship would be lost in a move to remote monitoring systems. I would respond by saying that we don’t actually know that to be true. In fact, using remote monitoring might free up more possibilities to explore natural support options, resulting in more friendships and companionships that are based on genuine mutual affection as opposed to a paid person who is obligated to spend time with the individual. We won’t know until we give remote monitoring a shot.
  3. Finally, I put forth an argument that much of our debate on the subject will soon be rendered moot. The agencies and organizations that regulate the field of serving individuals with developmental disabilities have all sorts of regulations designed to keep the individuals served safe – things like mandatory smoke alarms or sprinkler systems. Mark my words – once these regulatory bodies catch up with technology, remote monitoring will become mandatory for safety reasons. Then these questions about the ethics of remote monitoring won’t matter, as we will all be obligated to use these systems.
While the conversation about the ethical implications of remote monitoring was fascinating, I actually think it came a little too late. Remote monitoring will be used in the not too distant future, and now is the time for providers to accept that fact and figure out how to use the tools in the safest and most efficient ways possible. Ignoring remote monitoring, or fighting its implementation, will only become more difficult and time consuming moving forward.

Then again, what do I know?

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