30TH September 2014
by Damian Keane, Director, Earlsfort eHealthwatch Limited
Earlsfort eHealthwatch (www.eHealthwatch.ie ) delivers innovative health care services to elderly clients enabling them to live in their own home. Over the past three years we have established complex care programmes that have facilitated the early and safe discharge of elderly patients from acute hospital and step-down facilities. As part of these programmes we have demonstrated that successful partnerships with acute hospitals, step-down facilities, community intervention teams and home care agencies can deliver significant bed day savings, while delivering excellent standards of care through a consultant supervised multidisciplinary team.
Home-based model of Interim Care
Interim care (IC) traditionally takes place in an acute hospital or an off-site Rehabilitation/Transitional care facility. During times of increasing clinical demand (e.g. the Winter surge) the availability of this traditional bed base (Nursing home and Transitional care beds) is often problematic, leading to exit block from the acute hospital.
For the Winter period 2013/2014, The Mater Hospital in Dublin piloted a novel alternative model of Interim Care, delivered directly into the patient’s own home, supported by use of remote monitoring technologies and supervised by a specialist acute geriatric team. The Mater Hospital partnered with Earlsfort eHealthwatch to deliver this community based service. On discharge, a partner home care agency provided up to 3 visits per day to the patient. At each visit clinical parameters including pulse, blood pressure and oxygen saturation were measured, with weight checked weekly. The monitoring equipment transmitted the results directly to the cloud via 3G / 4G technology. The results were then assessed twice daily with significant variances triaged to one of 3 pathways: (1) Next day review at our Geriatric Rapid Access Service, (2) Domiciliary review by the Geriatrician, or (3) Referral to the emergency department.
The service was provided to the patient in their home for a period of up to 6 weeks with a decision then taken for the patient to (a) remain at home with or without an advanced home care package, (b) to be re-admitted to hospital, (c) to be admitted to a nursing home or (d) to exit the programme and to utilise a home care package.
This service is significantly less expensive than care in an acute hospital bed and the total package (home care, remote technologies and specialist geriatric care) can be delivered at a cost comparable to, or often less than, that of a nursing home equivalent. The service can be scaled up and down within the Hospital to match clinical requirements and is thus an efficient way of managing potential exit block.
Further information is available on request from Earlsfort eHealthwatch at +353 (0)1 839 6610 or firstname.lastname@example.org and also on our company website at www.eHealthwatch.ie