Proactive Care

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Monitoring Patients at Home

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Patients with special needs often require assistance with day-to-day care at home. We help organizations develop custom programs for using our platform to guide and coach patients at home while monitoring their status.

Care Maintenance

Care maintenance

Coach patients through care pathways and telehealth to help them stick within care plan guidelines.

Safety

When patient travel is impossible or unsafe, remote care is the solution. We keep patients and caregivers connected with the rest of the circle of care, from the safety of the home environment.

Safety

Proactive Care

Proactive care

By monitoring patients’ condition and staying connected with their network, healthcare professionals can proactively adjust care plans to guide patients toward better outcomes.

What our customers say about us

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I see the impact in helping chronic patients at home is that we’re moving from a coordinated care model to more of a connected care model and patients feel more engaged. They feel more empowered and they kind of feel like the CEO of their own state of affairs and I think that’s really important.

James Thompson

Healthcare Affairs Manager, Boehringer Ingelheim

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Schedule a discovery call

Wondering if we are a right fit, or have any particular questions that you want answered? Let’s discuss.

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COPD Education – Continuous Maintenance

Objective
To cover in depth all the necessary elements of self-management education as per the LWWCOPD, with priorities based on patient goals and identified treatable traits

Actors
Patient, Educator (Nurse, RT or Physician)

Timelines
A number of “Core” educational modules have been identified which cover the basic COPD education from the LWWCOPD program. Additionally, optional modules can be used to respond to patient needs. The timeline (frequency, number of modules to be covered at a given education session) is fully customizable, although we recommend to have education sessions every 2-weeks during the “active” phase of education. Once this is completed, the patient continues to the Maintenance Mode (see below).

Description

Launched at the onboarding protocol
Provide basic overview of COPD self-management based on LWWCOPD (medication adherence, inhaler techniques, PLB technique & energy conservation) up to the development of an Action plan for early exacerbation recognition and management.
Prioritize self-learning by the patient (e.g. watching videos, reading educational materials, completing homework) in addition to live sessions with the Educator. Educational materials are sent to the patient directly via the platform, and become the patient’s own library. The Educator can customize which “homework” the patient receives.
Educators have access to “User guides” to standardise their educational intervention. These user guides include: objectives, interventions, suggested questions, evaluation of self-efficacy, and learning contracts for each module.
Once the core education is completed, the patient can continue to the Respiratory Status Follow-up Workflow (run in parallel)

The Maintenance Mode

As soon as the maintenance mode is engaged, the frequency of visits Educator/Patient is reduced to once every 6 months.
During the Maintenance Mode sessions, the educator has access to all the education modules and can choose any piece of content that needs to covered with the patient.
A streamlined evaluation (similar to the initial eval.) is done during each “maintenance” visit to identify any substantial changes on the patient’s needs that will require some adjustment. The patient could come back to an “active” education mode (more frequent education sessions, e.g. every 2 weeks).