Using Technology to Change the Human Services Delivery System

Schoech, Dick; Cavalier, Al R.; Hoover, Betts

doi:10.1300/j147v17n02_03

Cited by 10 publications

(2 citation statements)

References 8 publications

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“…For people with disabilities more widely, inclusion of ICT in day to day lives has been shown to be closely linked to issues of independence, quality of life, and empowerment (Schoech, Cavalier, andHoover 1993, Vicente andLopez 2010). For participants, the internet was described as an essential coping strategy, providing them with a method of taking some control over their illness and independence.…”

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confidence: 99%

“It Gives Me My Freedom”: Technology and Responding to Bodily Limitations in Motor Neuron Disease

Pavey

Warren

Allen‐Collinson

2015

Medical Anthropology

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People living with Motor Neuron Disease (MND) experience profound and rapidly progressing impairment. In order to maintain their physical and social functioning, people so affected employ a range of technologies and technological aids (body auxiliaries) to enhance their life and maintain wellbeing. Using a phenomenological study design, we explored the experiences of 42 men and women who had been diagnosed with MND. Although many participants initially resisted the adoption of aids (often-electronic devices that enabled continued participation in daily life) or tools (the instruments that allowed achievement of specific tasks), such technologies offered a way for people with MND to overcome, to some extent, the limitations posed by their physical degeneration. Through generating a sense of 'normality', these kinds of 'enabling' technologies promoted social engagement and the maintenance of valued relationships or activities. Technologies can provide people with MND with some positive experiences within a way of being-in-the-world that has become so difficult and challenging. Much research on MND emphasises reduced mobility and ability to communicate as the most debilitating aspects of the disease (Leigh et al. 2003, Brown and Addington Hall 2008, Hughes et al. 2005. Constantly changing symptoms impact progressively on both sufferer and caregivers, as the individual's lifestyle becomes increasingly restricted (McCabe, Roberts, and Firth 2008; Sakellariou 2015). The lived experience of MND reflects experiences of chronic illness more broadly, including generating feelings of isolation, loneliness, and being a burden to others, in addition to financial pressures, but it is a unique and particularly debilitating illness (Charmaz 1993, Jeon et al. 2009, Vassilev et al. 2010, Sakellariou 2015.Much has been written about the challenges of living with MND (Robinson and Hunter, 1997), but with little attention given to how people obtain a sense of positivity or wellbeing despite these restrictions. Employing a phenomenological framework (Allen-Collinson and Hockey 2011, Pavey, Allen-Collinson and Pavey 2013), in this article we explore how forms of enabling technology and technological aids can enhance quality of life for people living with MND, and in doing so, highlight the tensions that sometimes emerge in living in and through a 'blended body' (Pavey 2013). We draw extensively on the idea of 'bodily auxiliaries', a concept that describes the relationship between the body and matter that is not organically attached, yet which ceases to be an external object (Merleau-Ponty 1962) and rather becomes a bodily extension. This focus on embodiment -and the social and cultural ways in which people 'live' their bodies in everyday DIFFERENT MODES OF BODILY BEINGA healthy 'normal' body has been conceptualized as one that recedes into the background of conscious thought, and comfortably disappears (Leder 1990). This is a body that is to some extent un-mediated, hidden, and 'recessive' so that a person is not overtly awar...

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confidence: 99%

“It Gives Me My Freedom”: Technology and Responding to Bodily Limitations in Motor Neuron Disease

Pavey

Warren

Allen‐Collinson

2015

Medical Anthropology

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“…In the USA, recent research indicates it was the costs of running mental health hospitals that motivated deinstitutionalisation policies[11], rather the needs, tastes or preferences of patients and carers (Stancliffe et al , 2005). Technology is also a key driver (Schoech et al , 1993), with many policy reforms (such as online or distance‐based support, electronic communication, etc.) being implemented because the cost‐reducing technology exists, rather than because new needs and demands have developed.…”

Section: Other Economic Considerations Affecting Service Deliverymentioning

confidence: 99%

Macro‐, Meso‐ and Microeconomic considerations in the delivery of social services

Freyens

2008

International Journal of Social Economics

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PurposeIn the wake of public service liberalisation in many OECD countries, economic interventions into the purpose and implementation of social policies have gained a lot of interest in recent years. The prime aim of this paper is to describe the nature of these interventions. The paper examines the reasons for pursuing elusive efficiency objectives in the conduct of public policy, rationales for purchaser‐provider splits, evaluation of cost‐quality relationships, service costing and pricing, and the influence of “external” economic variables.Design/methodology/approachThe paper breaks the analysis of public policy down to three layers of economic interventions: macroeconomics (allocative efficiency, intervention rationales and macroeconomic environment), mesoeconomics (economics of delivery in “social industries”) and microeconomics (agent behaviour, contracting, pricing and evaluation). Each level of economic intervention is illustrated with examples, mainly taken from Australian public policy and mainstream social economic research.FindingsSome of the most critical questions in policy implementation (outsourcing, pricing, contracting and agency problems) can be traced back to economic reforms. Experiments with new modes of service delivery are driven by a changing economic context, yet the efficiency gains from these innovative approaches may come at the expense of service quality.Practical implicationsChanging macro‐, meso‐ and microeconomic variables profoundly alter the parameters of service delivery. Designers and managers of service delivery systems need to be aware of – and skilled in – the practical application of economic principles, concepts and methods.Originality/valueExcept for the health sector, there is a lack of consistent research on the interrelationships between the standard economics toolkit and the delivery of public services. Yet the two are profoundly intertwined. The paper helps distinguish these relationships by putting together elements of conceptual analysis and fieldwork.

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The promise of the Internet for disability: a study of on‐line services and web site accessibility at Centers for Independent Living

Ritchie

Blanck

2003

Behavioral Sci & The Law

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The Internet provides individuals with disabilities numerous tools to live independently. In the convenience of the home, a person can access an abundance of information, an electronic community, updates on the latest disability advocacy news, education through distance-learning classes, and on-line shopping for books, clothes, assistive technology, and a host of other consumer goods. Centers for Independent Living (CILs) are consumer-run, non-profit grassroots disability service organizations at the forefront of the disability rights movement. Providing services to individuals across the range of disabilities, CILs have begun to use the Internet as a complement to their traditional service delivery methods. This article examines the emerging trend of independent living services on the web. The investigation examines 200 CIL Internet sites across the United States during the period of April to August 2001. Information is collected and analyzed about how CILs are using the Internet to provide their services and programs. In addition, the article examines the technological accessibility of their web sites. Implications of the findings for CILs, consumers with disabilities, and disability policy are examined.

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Using Technology to Change the Human Services Delivery System

Cited by 10 publications

References 8 publications

“It Gives Me My Freedom”: Technology and Responding to Bodily Limitations in Motor Neuron Disease

“It Gives Me My Freedom”: Technology and Responding to Bodily Limitations in Motor Neuron Disease

Macro‐, Meso‐ and Microeconomic considerations in the delivery of social services

The promise of the Internet for disability: a study of on‐line services and web site accessibility at Centers for Independent Living

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