How Digital Health is Making a Difference in 3 Care Settings

It’s Digital Health Week, and we at Aetonix are in the mood to celebrate.

Each year, technological advances make healthcare delivery more convenient and efficient. Innovation makes medical information more accessible for health professionals, as well as patients and their families.

But what does this progress look like? And where is it making the biggest difference?

Digital health isn’t just for patients and physicians who are on the cutting edge of technology. Across health care environments and circles of care, digital technology is already being implemented—and getting results. And this is just the beginning.

In this post, we’ll look at how digital health is improving patient outcomes and service provider efficiency in acute care, long-term care, and home and community settings.

Home Care 

Home care is becoming more critical. The healthcare system is seeing an influx of patients with chronic conditions, and many of them can best manage their health at home.

Thanks in part to the growth of digital health, there’s more support for home care patients than ever before. Health apps are playing a significant role in providing this support. From automated medication reminders to wearables that provide blood glucose monitoring, the ways that digital tech can improve self-care are truly incredible.

Then there’s telemedicine, which has been around for decades—and it’s only becoming more popular. The global market is expected to reach $36.2 million by 2020.

How has telemedicine improved in recent years? Mobile devices have made videoconferencing between patients and medical professionals more convenient than ever before. Reliable internet access and touch-screen technology enables patient of all ages and abilities to connect with providers easily. On the provider side, remote check-in visits can be critical to the health, safety, and wellbeing of at-home patients.

We’d be remiss if we didn’t mention the value of information-sharing. Electronic medical records (EMRs) allow care team members to view a patient’s complete, updated medical information. Likewise, care plans that are accessible to care teams digitally ensure truly responsive and coordinated care.

As patients take on increasingly active roles in managing their conditions, electronic records are enabling them to view their own information—quickly, and without a hassle.

In the past, security issues posed a major challenge to electronic information sharing. But as digital technology evolves, it’s also becoming more secure. Today, the right app or digital tool will be compliant with privacy legislation—such as PHIPA and HIPPA.

Long Term Care

When we think of digital health, we don’t often think of long term care. In settings where residents require round-the-clock care, the direct human connection is key. That said, digital technology can improve the operational efficiency of long term care facilities. And ultimately, it’s residents who benefit most.

When it comes to monitoring residents, ethical and logistical issues often arise. But digital technology can help staff ensure the safety of all residents—without compromising privacy.

Discreet bracelets that alert staff to wandering episodes or falls are a great example. Connected to the right digital systems, these wearables can provide silent mobile notifications to on-duty nurses. At a time when facilities are moving away from using disruptive bed, floor, and chair alarms, this technology holds enormous promise.

Digital technology can also be a great source of comfort for residents. Loneliness and social isolation can greatly reduce quality of life. A caring and compassionate staff isn’t always enough to help residents overcome these feelings.

Videoconferencing technology offers residents a way to reach out to loved ones. Some apps have become incredibly intuitive. Touch-screen technology makes connecting with a wife, son, or niece as easy as tapping a picture on a tablet screen.

In long term care, another frequent family challenge often arises. In many cases, close relatives act as substitute decision-makers for residents. Any changes to a care plan must be approved by the right decision-maker.

Unfortunately, it’s not always easy for staff to reach the right person to obtain approval. All too often, nurses can’t get in touch with substitute decision-makers by phone, fax, or email. As a result, a resident may not receive medication that could reduce her pain or increase her quality of life.

Digital communication and information-sharing apps streamline the communication process and make document-sharing simple. It’s never been easier for staff to obtain instant approval.

Acute Care

Tools that improve communication and information-sharing between frontline workers can make a real difference in acute care.

A recent Deloitte report notes the value of pairing 24/7 emergency responsiveness with technology that allows for the instantaneous transfer of vital patient information. An easy-to-use app for responders could improve coordination between emergency services and receiving hospitals. By providing a method of transferring patient information that’s both quick and secure, this type of digital tool could save precious time.

In the emergency department, electronic triaging software promises to make care more efficient. One such application has been in use in The Scarborough Hospital (TSH). The software assesses symptoms inputted by a triage nurse. In waiting rooms, there are kiosks that allow for ongoing patient-driven reassessment. The result? Triage time has been cut in half.

Lastly, digital health technology can improve acute care by ensuring medical devices are always accessible when needed. Sensors can track the location of equipment (such as IVs, pumps, and mobile nursing stations) across hospitals. Given that medical device hoarding is a serious problem in many facilities, tracking solutions will prove valuable in the years ahead.

In general, the Internet of Things (IOT) has the potential to connect hospital devices. By enabling pieces of equipment to “talk to” one another (where one device triggers action in another), IOT has amazing potential to streamline acute care workflows in the future.

Of course, technological advancements toward more efficient and patient-centred care are ongoing. And when it comes to digital health, there’s a lot to get excited about.

Feature image courtesy of Andrew_Writer

 

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COPD Education – Onboarding

Objective

To complete a thorough needs assessment / initial evaluation for a COPD patient of an outpatient clinic

Actors
Patient, Educator (Nurse, RT, the Physician could also be the educator)

Timelines
One 60-90 min session with the Educator

Description
  • This protocol should be established for all COPD patients from a given clinic, independently of whether they are new patients or they are known to the clinic. This protocol is the basis to engage the patient into other protocols such as education, exacerbation follow-up, etc.
  • We need to identify patient goals/concerns to guide the interventions
  • A thorough evaluation is carried on, with the objective of understanding where the patient is on their disease journey and follow-up treatable traits: dyspnea, exacerbation or dyspnea and exacerbation.
  • It includes the use of objective questionnaires such as the mMRC, CAT, HADS, Frailty Scale, etc.
  • Identify if the patient needs to be referred to other resources (e.g. Physiotherapist, social worker, occupational therapist)
  • Once Onboarding is completed, the patient continues to the COPD Education workflow
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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).
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COPD Respiratory Status Follow-up

Objective

Monitoring of stable patients from a clinic in order to identify early any aggravation of symptoms (exacerbation) and implement an action plan

Actors
Patient, Educator (Nurse, RT or Physician)

Timelines
Scheduled regular automated follow-up to the patient symptoms. Intensity/Frequency can be adjusted by the Educator depending on patient needs (e.g. daily, every week, etc.). Ongoing through the year.

Description
  • Launch: Patients who have completed the Core Educational including setting-up an action plan.
  • Regular automated questions allow to identify any change in patient’s symptoms and severity.
  • If an exacerbation is detected the patient gets a reminder to engage their self-management strategies while waiting for the Educator to call back.
  • An alarm is generated for the Educator, so they immediately call back the patient. At this call they will evaluate any further intervention required and schedule additional follow-up.
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