Using Technology to Enhance

Home Care Service Delivery

John Schram,President & CEO

We Care Home Health Services

September 8th, 2011

Home Health Care• The “next essential” service

• Less than 4% of health care expenditures

• $6.0 billion

• 70% Provincial and Territorial government funded• 30% private and third party funded• Aging in Place/Aging at Home initiatives across Canada

support the importance of Home Care• Technology must support the evolution of home care

Cost of Care

Qu

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f L

ife

Health & Wellness

Home Care

Residential Care

Acute Care

$ $$ $$$ $$$$

1

5

2

3

4

6

10

7

8

9

The Necessary Shift in Care

We Care Health Services• 1984 – Founded in Brandon, Manitoba• 2011 – 50 Offices across Canada serving

over 15,000 clients in 800 communities

• 3000 home care staff• 252,000 hours of service per month

Staff: RN & RPN 350Personal Care Workers 2400Home Care Aides 250

Challenges to Canadians & Our Health Care System

• Canada’s population is aging ....14% over 65 years 2011

... 20% over 65 years 2030

(Stats Canada)

• 80% of adults over 65 years have a chronic disease

• People with chronic conditions consume 70% of total health care expenditures

• 60% of hospitalizations due to chronic disease• Shortage of Human Health Resources

Solution to Address Challenges

• Provide wireless eHealth services for seniors living with chronic conditions at home

• We Care’s Remote Access to Care Technology (Re-ACT©)

• Partners : North Simcoe Muskoka CCAC

Healthanywhere (Division of Biosign)We Care Health Services

• Funded by “Aging at Home” initiative through the MOHLTC

Re-ACT©

• Provides remote monitoring of vital signs• Clients identified and family physician

provides a target range for clients’ vital signs

• Vital sign measured: Blood Pressure Pulse Blood Glucose Weight Pulse Oxygen

• We Care’s eHealth RN monitors results daily:

o High risko Moderate risko Normal

Bluetooth Medical Peripherals

Model: Spiro ProManufacturer: CARD GUARD

Model: One Touch Ultra 2Manufacturer: Life

Healthcare Professional Technology

Monitoring & Interventions

• Monitoring in the morning & afternoon

• Interventions include:– Telephoning client, home visit– Referring to Doctor, community groups

• Vital signs data sent to Doctor every month

• Preparing for Discharge

Performance Indicators Reported to LHIN

Jan 2009 – March 2010• % of clients placed in LTC from Re-

ACT – Target: Less than 10% Result: 3%

• % of clients requiring crisis placement– Target: Less than 5% Result: 1%

• % of clients able to remain in community– Target: Greater than 80% Result: 96%

RESULTS• 70% decrease in client falls• 35% decrease in ER visits• 92% of clients are better informed about managing their

chronic health conditions; are able to self-identify and problem-solve

• 80% of clients believe that Re-ACT©

made a positive difference in their lives.

• 70% of clients said that Re-ACT©

helped them learn more about their condition

• 92% of clients know what signs and symptoms to look for and when to make an appointment with their doctor

• 80% of clients feel they will be able to stay at home longer than before Re-ACT

©

• 88% of clients are very satisfied with the Re-ACT

©

program

Patient Comments• Mrs L – 93, lives in the country

– Diagnosis: Hypertension, frailty of age, severe arthritis– Client states – “It is difficult for me to get out to see the doctor – so my doctors wants my

vital signs checked so he knows that I m doing OK; Re-ACT© and the nurses’ helpful information about my diseases helps me keep on top of my health so that I can continue to live at home.

• Mrs M – 81 lives with husband – her main caregiver– Diagnosis: CAD, post-stroke, hypertension– Husband states – “The vital sign readings from Re-ACT

©

help me to know that a crisis is not likely to happen – it gives us peace of mind that everything we are doing is working and when it is not, the nurse keeps us on track.”

• Mrs. L – 75, lives alone– Diagnosis: CAD, COPD, Poor Vision– Prior to Re-ACT

©

client had several admissions to hospital– Client states – “When my heart rate went up and my oxygen level went down, the nurse

told me to go to the doctor. The nurse faxed all the data to the doctor. The doctor said that “it was good thing I came in because I was heading for another crisis.” Blood work and x-rays showed fluid in the base of her right lung and prescribed oral antibiotics and a steroid. The client was able to fight off the infection at home.

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