Home Care Technology Report

Technology for Keeping People Safe and Well

by Audrey Kinsella

Loretta B. is middle-aged and the primary — but not live-in — caregiver for her 79-year-old mother, who is mobility impaired and has a heart condition. And Loretta's mother still drives. Needless to say, Loretta spends much of her time worrying. Or, at least she used to.

Carl Q. is young but obese and struggling to learn how to manage his newly-diagnosed diabetes. Daily testing, a revised diet, and injections are a strange new world and his non-dementia forgetfulness, some would call it orneriness, frequently lands him back in the hospital. Or, at least it used to.

Loretta signed her mother up for "Splash," GreatCall's wearable, proprietary, medical alert device, and Carl's healthcare at home nurse recommended during his last hospital admission that he use an in-home reminder and communication system from Health Recovery Solutions.

Amid all the noisy promos for the latest and greatest high-tech products and services from new market entries promising to keep people with chronic conditions safe when they live alone, these two actually seem to live up to their claims. This is important in an era when providers of healthcare at home services have little time left to read pie-in-the-sky promises that cannot show what their product or service can do to support their mission to keep people well at reduced costs. "Just show me."

Health Recovery Solutions
This New York City-based company provides high-risk, chronic disease patients with its “Patient Connect” product, a patented, clinical software program that helps patients learn how to manage their condition at home after hospital discharge. The tablet-based health coaching system was introduced to Carl in the hospital, just prior to discharge. It has 4G connectivity and came pre-loaded with HRS software that was customized to his diagnosis, living situation, age, and computer skills.

A nurse taught him to use the system so that, when he took it home, he knew how to access educational videos about living with diabetes, reminders about his specific medication schedule, and exercise and dietary suggestions customized to his age, size and weight. His home and neighborhood were assessed in advance for 4G availability.

Being connected is different in many ways from simply reading about one’s condition. Using the HRS interactive system, Carl records side effects he experiences from his medications and receives prompt responses from someone on his care team, keeping him on track with his care plan. HRS users do not merely leave the hospital with directives on how to take care of themselves for a few days or even months. They learn, through on-demand interaction with members of their care team, to self-manage and live with their conditions over the long term.

Apparently, it works well. One case of heart failure patients using the HRS overseen by Penn Medicine’s Penn Care at Home Recovery Solutions (Philadelphia, PA),  reports how HRS  patients’ use of the software reduced readmission rates by 53% in 6 months (see: http://finance.yahoo.com/news/hrs-patientconnect-tablet-reduces-congestive-104500183.html).  Commenting on the patients’ success with HRS, the home health agency’s CMO, Anne Norris, MD, said: “There’s a secret sauce here, using this tool to engage patients in their own care.”

HRS currently targets high-risk patients suffering with CHF and COPD but plans include expanding into pediatric asthma. People with these types of conditions need care and help with condition management over many years, not just a page of instructions while learning how to use the HRS system. This is where in-home caregivers increase the effectiveness of Patient Connect. They continue to need coaching to help keep them on course and out of hospitals. The system encourages Carl to enter his data and to confer with doctors and specialists to learn what to do to stay on track. Without a trip to the office, these clinicians receive real-time data on how Carl is doing and use it to inform the appropriate person on his care team if any changes need to be made.

According to COO Rohan Udeshi, the eventual reach of HRS is considerably broader than just CHF and COPD patients. "Our next goal is to be an 'all-cause readmission [prevention] platform.' Everyone living with a chronic condition will be helped to get well and stay well." HRS provides Patient Connect on a monthly fee basis; the fee includes the 4G cellular connection.

GreatCall
Loretta checks in every day, sometimes more often, on the Great Call Link app
to keep track of her mother and make sure she is okay. Other than the "Splash" medical alert device that she wears on her wrist or clips to her belt, her mother is independent and living alone. She likes the hands-off way her daughter keeps tabs on her.

According to company materials, GreatCall offers personalized care through ready access to professional healthcare caregivers, as-needed. There is a one-button app for access to “urgent care” services, which patients use to connect with an RN, who will either answer the patient's questions directly or triage them for review by a board-certified physician, who will call back the patient directly. Home nurses and concerned family members have ready access to a patient's whereabouts and well-being.

Tracking her mother’s activities in a hands-off way is simplified for Loretta by the GreatCall Splash device, which is also easy for her mother to use. The system was designed with the needs of seniors in mind: ease of use, 24/7 care and communications available on their own terms. GreatCall has emphasized ease-of-use for seniors since its first products, the Jitterbug5 flip phone and the Jitterbug Touch3 smartphone, were released along with a list of related services. Concepts such as large buttons, a bright color screen, and a powerful speaker capable of delivering loud, clear sound reappear in Splash.

Another Splash user, with different needs from those of Loretta's mother, shows a benefit for family members living at great distances. Christopher D. suffers from a rare disease and wears the Splash device from the moment he wakes up until he goes to sleep. His niece, who goes to school in another city, loves the Link app because it allows her to know he is safe whatever he is doing while she is away. If he leaves the house, she can see exactly where he has been, by tracking the device's GPS signal. Christopher concurs with GreatCall's catch phrase: “Keep you connected, protected, and in control.”

Both certified and non-medical healthcare at home agencies should find the GreatCall product line affordable. 5Star Splash is priced at $50, with monthly packages starting at $19.99. Health and Safety Packages that include GreatCall Link, Urgent Care in addition to 5Star service start at $24.99, with fall detection and device replacement available in the Ultimate Package for $34.99. Prices are lower with volume purchases.

Audrey Kinsella, MA, MS, is HCTR's telemedicine reporter. She has written on home telehealthcare and new technologies for home care service delivery for 20 years, in 6 books, multiple web sites, and more than 150 published articles. Audrey can be reached at audreyk3@charter.net or 828-348-5308.

©2015 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan's Home Care Technology Report. homecaretechreport.com One copy may be printed for personal use; further reproduction by permission only. editor@homecaretechreport.com