In the absence of significant deployment of these technologies in Australia, but with a preconceived view that Feros Care customers could benefit as shown overseas, Feros Care conducted a pilot program for the implementation of Telehealthcare. To help fulfill this mission, Feros Care investigated Telehealthcare and began a pilot program to determine the viability of implementing security, safety and health monitoring technologies in client homes. The addition of Telehealthcare services as operationally and financially viable options for Feros Care clients using community care programs and services.
The Pilot Program identified a number of potential benefits for telehealth care services and should be included and included as standard Feros Care service options. Due to the positive findings of the Pilot Program, Feros Care will increase its Telecare installations to 300 homes during 2011. Feros Care's vision is "to be recognized as an industry leader focused on innovative community, lifestyle and care for the elderly".
The pilot program began in January 2010, using an extensive range of products within both Telecare and Telehealth Technologies, deployed to elderly clients receiving Feros Care Community Services. The Feros Care Pilot Program was undertaken to establish an intuitive position that Telehealthcare Technologies could be effective and operationally and financially feasible for Feros Care in Australia.
Survey Instruments: Existing published survey instruments were revised, new surveys and instruments were developed, and collection and analysis tools were created to enable effective evaluation of the Pilot Program.
Clients
- telecare Client Group
- telehealth Client Group
The Telehealth client pool was selected based on individual health conditions/factors that would benefit from the technology as shown in Table 2 below. The Telehealth Group included 18 clients between the ages of 65 and 90, and 11 from the Telehealth Client Group also received Telecare equipment and are included in the Telecare Client Group.
Carers
- telecare devices
- telehealth peripherals
- the Client experience
- telecare
- telehealth
- the Carer experience
- telecare
- telehealth
- service provider experience
- Care managers
- Financial Findings .1 General
- Gp experience & Health professionals
- summary of Findings
Clients' perceptions of various emotions at the beginning of the pilot program were compared to those at the end using the Telehealth Client Wellbeing Impact Survey. Of the 18 Telehealth clients involved in the pilot program, 16 were able to provide Telehealth survey responses. The changes in perceived client well-being from the beginning of the pilot program were compared to the changes at the end of the pilot program as outlined in Table 7.
44% felt that their quality of life had improved compared to the start of the Pilot Program. The impact of Telehealth Technology, as perceived by Clients, was assessed by undertaking a survey at the conclusion of the Pilot Program, and generally measured the level of acceptance and intervention imposed by Telehealth monitors and Registered Nurse monitoring. As a result of the use of Telehealth Technology, 34 interventions were carried out during the Pilot Program period.
Of the 33 telecare caregivers, 19 responded to a survey about the perceived impact of telecare on both the client and the caregiver. To allow for comparison, a survey was administered at both the beginning and end of the pilot program, and the results are summarized in Table 11. Most importantly, caregivers who were able to respond to the surveys: Perceived impact of Telehealth on both client and caregiver is was assessed by surveying the client's primary carer both at the beginning and at the end of the pilot program to allow any improvement to be recorded.
They estimate that 35% of clients were less likely to need ongoing care at the end of the pilot program; and. At the start of the pilot programme, GPs were asked to provide cut-off values for individual clients' vital signs to provide guidance for registered nurse monitoring. Client health summaries and hospital discharge summaries were also requested to allow for comparisons at the beginning and end of the pilot program.
GPs were also requested to complete a final survey for each Telehealth client at the end of the pilot program with 7 out of 18 requests being completed. The data collected indicate that at the end of the pilot program clients generally felt safer, more able to cope independently and less anxious. Feros Care was able to provide Telecare services within the constraints of the target operating cost model prepared during the pilot program, however, the Telehealth operating cost model could not be met.
Client Case studies
Clinical Conditions
Client and Carer impact
Client profile: Beryl
Tends to be anxious about her health and live alone, but wants to stay in her own home. Provides Telehealth devices to take her own daily vital signs, including blood pressure, oxygen saturation levels and pulse. Handles the routine well on her own and is convinced that the equipment will help her stay in her own home.
Client profile: Betty
Client Case Studies (continued)
Provide devices to take her own vital signs, including blood pressure, heart rate, and blood sugar levels. Provide equipment to help live safely and securely: emergency pendant, smoke detector and emergency buttons in the shower and toilet. She has lost weight, stabilized her blood pressure, increased her mobility and improved her diet significantly.
Prior to the pilot program, Daphne may have been heading for complications related to uncontrolled diabetes, reduced mobility, and weight issues. With much better management of BSL and better dietary and health compliance, Daphne's health has improved significantly. The GP was very positive about the role played by registered nurse support and monitoring, and believes that telehealth technology has improved Daphne's compliance.
Client profile: daphne
Provide devices to measure his daily vital signs, including blood sugar levels, blood pressure, pulse and oxygen saturation levels. Providing Telecare devices for a safe and reliable life at home; fall detector, emergency pendant, smoke detector and emergency buttons in toilet and shower. Better understand your condition and how to relate blood sugar levels to blood pressure and oxygen saturation levels.
Combination of interventions by the Registered Nurse, and use of the personal alarm, initiated medical testing by a respiratory physician and eventual delivery of home oxygen equipment. Gerome has a challenging set of chronic conditions, but his comfort and safety improved through interventions initiated by daily registered nurse monitoring of vital signs.
Client profile: Gerome
Provide Telecare equipment to help with safer living; personal alarm with an easy-to-press adapter, smoke alarm and auxiliary buttons in the shower and toilet. Given the nature of MND, the aim is to preserve Leigh's independence to the extent possible. Being surrounded by his family in his home is of vital importance to the family.
Client profile: leigh
He feels that telecare has supported his independence as he can be more safely left alone or take care of his transfers, knowing that help is there if he needs it. Provide smoke detector i.v.m. previous fire alarms, personal pendant, fall detector and help buttons in shower and toilet. With the current support, he is as safe as a single person with dementia can be.
It is difficult to predict his long-term prospects due to the very high risk of accidents.
Client profile – Brian
- organisational
- Client assessment and selection
- liaising With General practitioners
- installation and operations
A high level of financial commitment and support is required from the executive board for implementations to succeed. Care managers and visiting staff should be able to assess the ongoing impact and benefit of each component of the technology in the client's home, as client needs can change very quickly. Visiting staff must be familiar with the technology and understand how to help the service provider maximize the benefits of each component to the customer and minimize the need for special.
Consideration should be given to establishing customer service agreements regarding ongoing operation and maintenance of equipment to better manage the resource impact to Feros Care. The relationship with the technology provider is critical to the success of the service provider's Telehealthcare services. Service Level Agreements should be in place to allow the service provider to install equipment securely (with vendor support) and to monitor client services in confidence that the equipment (and software) is working reliably.
The importance of good assessment processes is critical to ensuring that the technology being implemented meets the needs of clients and their families. This means that when evaluating clients for potential telehealth services, if they live alone, they must be prepared to be coherent, cognitively healthy, have good short-term memory, be dexterous, reasonably mobile, and able to cope when things go wrong. If any of these characteristics are not met, the client may need help measuring vital signs with regular visits from caregivers, family, neighbors, or the provider's nursing staff.
This should be considered when considering Telehealth as a tool to reduce unplanned visits to doctors. Any powered or telephone-based equipment should be isolated as much as possible from the customer's own equipment to avoid the perception that the imported equipment is a possible cause of faults in equipment owned by the customer (such as computers, appliances, etc.) . Wireless communication at the customer's premises is preferable to communication using the customer's land line, if possible.
This not only ensures isolation of the customer's facilities, but also allows for flexibility in placement and mobility of equipment in the home.
- For Feros Care
- For policy makers, Funding Bodies and training institutions
The Australian Academy of Technological Sciences (ATSE) released a report "Smart Technology For Healthy Longevity" (Professor W.J.McG Tegart) in July 2010. This ATSE endorsement does not imply endorsement by ATSE of this Feros Case Study document. The recommendations in the ATSE report address the broader issues and implications for these agencies to enable service providers such as Feros Care to embrace new technologies with some confidence that there is a solid foundation on which a service provider can support such a business approach.
Conclusion
Feros Care was able to
Furthermore
Building a smart House with telecare
