The challenge of how to successfully provide cost-effective care to the elderly and infirm at home is the same right across Europe.
In Denmark, Viewcare has pioneered the large scale use of video communications and remote healthcare management to address this need. Working with several of the largest municipalities, Viewcare has deployed a solution which drastically reduces the manpower required to manage healthcare in the home.
This has been achieved by focussing on the many instances where field care workers are only required to observe the subject, rather than provide hands-on care. Typically this applies to more than 30% of home visits and may only require the care worker to monitor the taking of medication – or the drinking of some water; trials showed that 23% of hospital admissions for the elderly were simply due to dehydration!
Instead of a field care worker perhaps needing 20 minutes to travel to the subject’s home, find parking, gain entry and then observe, a total of perhaps 30 minutes or more of their time, a single 3 minute video call is all that is required. Moreover, many subjects much prefer the video call as it is much more likely to happen on time, freeing them from waiting around if the carer is late.
The result is typically a three-fold improvement in resource utilisation, reduced travelling costs and a much improved carer and subject experience.
Across a large population, such savings are hugely significant, perhaps as much as 15-20% of the entire budget for field-based carers. As a result, most municipalities across Denmark are now employing Viewcare’s technology for this purpose.
The care of chronic conditions such as COPD, heart problems and diabetes is a growing problem for healthcare systems across the western world. In this case the technology provides two distinct functions:
The patient is provided with monitoring devices and supporting “Telehealth” software which stores each measurement made and displays trends. These can be used by the patient to manage their own condition and uploaded and shared with a remote clinician during scheduled review sessions; devices might include spirometers and/or monitors for blood O2 saturation/pulse, blood sugar level, weight and blood pressure;
The video “Switchboard” technology allows for regular calls to be scheduled with a clinician to review the patient’s progress and can provide an emergency help service where urgent care is required.
Experience has shown there to be many benefits:
The principal benefit to the patient is a better outcome. Self-management of their condition, with “light-touch” clinical supervision, has been shown to provide highly effective control. Remote management avoids the need to visit hospitals or clinics (which, due to their condition, many find extremely difficult) improving the patient’s quality of life.
The benefit to the healthcare system is a reduction in required interventions: through better self-management of the patient’s condition, care worker home visits, GP visits, ambulance call-outs and hospital admissions are significantly reduced. A UK study showed a 30% reduction in hospital admissions and a more than 35% reduction in bed-days through the use of telemedicine to manage COPD patients at home; in Denmark, COPD patient readmission was reduced by over 65% through this application of telemedicine and the overall cost of managing patients in their own homes was shown to be reduced by more than 12%.
Another very similar application focusses on post-operative care. Discharged patients or their home-based carers are provided with temporary on-demand access to acute department clinicians. Field-based care workers are also provided with remote access to clinical specialists. The intention is to discharge patients early but without increasing the risk of later readmissions.
Viewcare’s experience in Denmark has shown that this approach is highly effective. Analysis of a clinical trial in Denmark showed post-operative readmissions were reduced by around 40% overall; a similar capability allows premature babies to be discharged 3-4 weeks earlier than would otherwise be the case.
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