Mobile strategy helps deliver healthcare to Ontario’s elderly

A healthcare delivery professional arrived at the residence of a patient to find the elderly man missing on a freezing winter day, and his daughter distraught and unable to find him.

This sort of scary scenario is often encountered by the frontline staff of Mississauga Halton Community Care Access Centre, says Donald Stokes, the director of information management and technology at the institution west of Toronto. In this case, everything worked out well as the man was found wandering in a nearby park. But it illustrates the potential dangers of elderly people with mental health conditions trying to live as independently as possible.

“Today we have the technology that could have located him, with a simple mobile device,” Stokes told the Mobile Health Summit in Toronto on Wednesday. “The informal caregiver isn’t always with the patient and you need to give them the data on where they are.”

Not only could it save lives and prevent injury, but such a solution could unburden the healthcare system by avoiding trips to the emergency room, the required treatments, and it keeps more hospital beds open. It’s one illustration of how mobile technology can help Community Care Access Centres (CCAC) across the province that run “virtual ward” programs that send healthcare professionals to the homes of the elderly to keep them out of hospital and in their own homes.

As Ontario’s population shifts over the next two decades to include the largest demographic of seniors and elderly than ever before, hospitals and regional health networks are looking for ways to treat them efficiently. Over the next 20 years the number of Ontarians older than 65 will double and the number older than 85 will quadruple. Since 70 per cent of them will have chronic conditions, the costs their care could cause healthcare expenses to skyrocket.

Taking care of those seniors in their own homes could help reduce the costs, according to Sharon Baker, the chief operating officer at the Ontario Association of Community Care Access Centres (OACCAC). Home care currently costs an average of $42 per day, compared to $126 per day in long-term care facilities, or $842 per day in a hospital. Ten years from now, there’s no reason to think homecare won’t be even more effective, and more seniors will be cared for this way.

“The kind of world we’ll live in, the kind of connectivity we see … will enable us to talk about housing and community planning for healthcare,” she says. “The way we use smartphones, all the talk about wearable technology now, these are things that weren’t part of the conversation 10 years ago.”

Other CCAC programs have patients updating information and communicating with caregivers from a home computer. (Image: OACCAC)
Other CCAC programs have patients updating information and communicating with caregivers from a home computer. (Image: OACCAC)

When Baker and Stokes talk about mobility, they don’t just mean smartphones and wearables. Case in point is a pilot program that’s outfitting the frontline staff at Mississauga Halton CCAC, with 55 case co-ordinators now using hybrid PCs during their home visits, according to Dave McLelland, chief technology officer at OACCAC. Both Dell XPS and Fujitsu Q702 hybrid PCs are being tested, allowing users to switch between a tablet-mode with a touch screen and stylus input, and a standard keyboard. The devices run Windows 7 and include cellular connectivity.

One of the goals is to take the 300 laptops, 130 cell phones, 70 BlackBerrys, and 170 air cards used by the centre’s frontline staff and consolidate down to one device they use while on a patient visit, McLelland says. More importantly, the project seeks to actually increase the number of visits a worker can make in a day by eliminating redundant work.

“It’s removing the people process and moving right to the electronic process,” he says. “Instead of taking a manual assessment form at the home, and then rekeying the information back at the office, they are doing that at the point of care and uploading it.”

In focus groups and surveys with the 55 pilot program workers, the new form factors are proving successful, McLelland adds. The caregivers are taking the tablet to the bedside more often then they would a bulkier laptop.

There are challenges ahead of the attempts to enable caregivers to be completely mobile, he says. For example some spots of the Mississauga-Halton region still has unreliable cell connectivity. So staff need an application allowing them to input data offline, then upload it later.

Still, the centre is going ahead with deploying hybrid PCs to care co-ordinators as leases for their current equipment expires.

Hopefully it will lead to more care being given by the bed sides of the elderly, and less panicked searches for a patient that’s wandered off.

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Brian Jackson
Brian Jackson
Former editorial director of IT World Canada. Current research director at Info-Tech

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