TELEHOME CARE

1
TELEHOME CARE

• TELEHOME CARE IN THE NORTHERN LIGHTS HEALTH
  REGION CHANGING THE MODEL OF CARE TO BETTER
  SUPPORT HOME CARE CLIENTS THE TELEHOME CARE
  PROGRAM INVOLES A TELEMONITOR THAT ALLOWS NURSES
  TO MONITOR MULTIPLE HOME CARE CLIENTS AGES 12 AND
  UP WITH ONE OR MORE CHRONIC DISEASES DAILY FROM A
  CENTRALIZED STATION LOCATED IN THE HOME CARE
  DEPARTMENT

2
HEALTH REGION BOUNDARIES
3
Project Funding

• The Telehome Care project was funded for
  implementation at Fort McMurray from June 2005
  through December 2006 funded with a Clinical
  Grant fund from Alberta Health Wellness in
  the amount of 123,830
• The project was then enhanced and extended to the
  West side of the Health Region from June 2006 to
  March 2007 with an extension to December 2007
  funding from Alberta Health Wellness with
  investment from Canada Health Infoway in the
  amount of 79,980

4
Purpose

• Home Care caseloads as well as family caregivers
  in the community were being impacted by
• population increases, Fort McMurray being one of
  Canadas fastest growing cities
• early discharge of clients from acute care
• increasing demand for services and resources
• long term care wait lists
• Revolving door of ER utilization and acute care
  hospitalizations
• the large geographic dispersion of Home Care
  Clients, especially in the West

5
Planning

• The Telehome Care approach included a formal
  process for technology selection. A store and
  forward, Plain Old Telephone Service (POTS) based
  home monitoring system was selected. The client
  friendly hospital grade device utilizes a voice
  and visual prompt to guide the user through. The
  monitor collects a clients weight, blood
  pressure, pulse and oxygen levels, and is
  equipped with customizable prerecorded messages
  that ask the client a series of subjective
  questions about their condition.

6
Planning

• In addition, the home monitor is designed to
  accept information from other diagnostic
  peripherals.
• Videophones were also included in the selection
  process.

7
Project Implementation

• Telehome Care monitors were installed in client
  homes in Fort McMurray. Each monitor was
  installed with all the specific information
  pertaining to that client for regular vital
  signs monitoring.
• Telehome Care monitors were also installed in two
  outlying communities located 1-3 hours from Fort
  McMurray. A vital signs monitoring unit and
  videophone were situated in a Community Centre in
  each location. Clients were issued swipe
  cards. The client swipe cards contain each
  clients own specific information and, once
  swiped, initiate visual and audio prompts that
  walk each client through the process of taking
  their weight, blood pressure, heart rate, oxygen
  saturation levels and answering up to 10
  subjective questions.

8
Project Implementation Expanded and Enhanced

• In 2007 with the expansion of the program more
  client monitors were put in place in Fort
  McMurray and the program was expanded to the West
  side of the Health Region to include High
  Level, Fort Vermilion, La Crete, Rainbow Lake,
  Paddle Prairie, Zama City. This implementation
  has just taken place in May 2007 AND we are
  already short of client monitors!

9
Procedure

• This Data is automatically collected and sent
  over POTS (plain old telephone system) lines to a
  Central Station computer located at the Home Care
  office.
• Vital signs are received and stored on a central
  base station computer located at Fort McMurray
  for clinical review
• The software colour codes and triages all data
  collected so that the Home Care Nurse can
  identify warning signs or changes in the clients
  condition. This is meant to increase
  opportunities for early intervention and
  ultimately prevent complications, such as
  admissions to hospital. It was also intended
  that clients would become more knowledgeable
  about their disease and learn how to better
  manage their conditions.
• Using Telehome Care, Home Care nurses changed
  their model of care from traditional schedule
  driven models of care to a new model of care one
  where home visits are made when clinical needs
  dictate.

10
Specific Objectives

• Reduction in visits to ER
• Manage Home Care clients 7 days week
• Reduction in readmission to hospital
• Provide preventative and proactive care to
  clients
• Provide clients/and or caregivers a sense of
  security, peace of mind, resulting in a better
  quality of life
• Educating clients about their disease and learn
  how to better manage their condition on a daily
  basis

11
Current Results/Outcomes - Clients

• Telehome Care has given clients
• The ability to detect changes in their conditions
• Empowerment in the management of their own health
  care
• An increased quality of life
• A greater sense of security that someone is
  helping them with their condition

12
Current Results/Outcomes Nursing staff

• Nursing Staff have found that Telehome Care
• Reduces the pressure on limited resources
  (Nursing Shortages)
• Helps to streamline the processes used in client
  care
• Enables Home Care nurses to provide a rapid
  response to changing client needs
• Improves the access to and quality and efficiency
  of the Home Care services

13
Key Findings as of May 2007

• Important to have a champion nurse
• Communication and education is vital to the
  program to other health professionals,
  physicians, clients, family and caregivers
• Imperative to raise public awareness
• Initial Technical problems were an issue
• Some clients could become dependent upon the
  monitors never wanted them removed when they
  were no longer necessary

14
Key Findings as of May 2007

• Daily monitoring information on vital signs
  supported client education and motivated clients
  to learn how to manage their own health
  conditions
• There were substantially more telephone calls
  with Telehome Care clients than other clients at
  the start and then just slightly more after the
  client had the monitor for a month

15
Some Conclusions as of May 2007

• Nearly all clients found the home monitor easy to
  use
• Telehome Care and the focus on chronic disease
  management led to clients being less worried
  about their health condition and learning more
  about their health condition and needed lifestyle
• Many clients became more engaged in managing
  their own health conditions
• Improvements in quality of life and health status
  quality of life being more active, being more
  independent and experiencing fewer symptoms
  related to their health condition

16
Some Conclusions as of May 2007

• Information generated by Telehome Care monitoring
  led to telephone calls and/or in-person visits to
  clients, calls to family physicians and
  subsequent changes in medication, or other
  interventions. These interventions have resulted
  in clients avoiding trips to emergency
  departments and hospitals.

17
Evaluations

• Evaluation will focus on how Telehome Care
  impacts
• Emergency Room visits and readmissions to
  hospital
• Client compliance and satisfaction
• Clients increased ability to manage their own
  care
• Travel time/costs for the nurse and client

18
Evaluations - In Process

• Physicians interviews
• Staff questionnaires
• Client questionnaires
• Staff Focus Groups
• Technical/Trouble shooting issues
• Cost Analysis Hospital Admissions, Emergency
  Visits, Home Care In-Person visits, Telehome Care
  Visits

19
Future

• To continue to expand the Telehome Care program
  to positively impact all areas of the Health
  Region
• Look at adding more peripherals to the program
  such as
• Glucose meters
• PT/INR to accurately and easily measure
  prothrombin time and INR values

20
(No Transcript)
21
(No Transcript)
22
(No Transcript)