Current state and future possibilities for ambient intelligence to support improvements in the quality of health and social care.

Many of us working in health and social care might not immediately understand the term 'ambient intel-ligence' (AmI). The 'intelligence' referred to in AmI is the microprocessor which is able to glean knowledge from the 'ambient' environment of the individual and respond accordingly. The environment in this case encompasses the social, psychological or physical circumstances of the individual as well as their surroundings. AmI was a term coined at the turn of the last century by Eli Zelkha and Brian Epstein who organised a series of presentations on behalf of Phillips to envision how information communication and technology would evolve in the 21st century. Another definition of ambient, although now obsolete, is 'ambitious or aspiring' but this seems particularly apt with regard to AmI. 1 The application of AmI to health care has great potential for quality improvement 2 in terms of user experience, 3 patient safety and effectiveness (efficiency), but to what extent is this vision realistic or illusory? This question is the subject of a new report by Schuurman and colleagues from the Netherlands. 4 The concept of AmI provides a future vision for health and social care where information and communication technology have developed to a state where human–computer interactions are ubiquitous, pervasive and persuasive and where they are able to influence an individual's quality of life and health. It is a vision of computer technology which is subtly embedded in the individual or their surroundings ('integration'), which is able to recognise and monitor the person or their environment ('context awareness') and capable of responding to ('adaptation') or even anticipating ('anticipation') physical, psychological or social changes and needs in an individual way ('personalisation') by informing or prompting the individual or their networks of formal or informal care. Most present day examples of AmI described in the literature are still in their prototype phase. 5 The AmI concept is a development of a perhaps more familiar concept in the UK, 'telecare', which has been defined as 'a service bringing health and social care directly to a user, generally in their own homes, supported by information and communication tech-nology'. 6 In the UK the Department of Health, by allocating £80 million for telecare to local authorities from April 2006 (through the Preventative Technology Grant), made it clear that the use of new technology was seen as a key element of the support system for people with long-term care needs. …