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Mobile Technology For Home Care Nurses

Community health care clients in Simcoe County may be pleasantly surprised the next time their nurse visits their home to provide service.

In all likelihood, the nurse will be carrying a hand-held wireless computer to track the client’s progress.

By accessing and transmitting real-time information electronically in the patient’s home, this state-of-the-art solution dramatically improves decision-making, the quality of point-of-care delivery, and greatly reduces paper handling costs so that resources can be targeted at other pressing priorities.

Spearheaded by the Community Care Access Centre Simcoe County (CCACSC) the Community Care Mobile eHealth (CCMeH) solution gives nurses real-time patient data at the bedside.

The software solution was developed by Allegro Mobile Solutions, in partnership with CCACSC, Bayshore Home Health, and McMaster University.

Unique in Canada, the mobile technology is part of the future of health care service. 

Every year more than 10 million pages of paper are inbound to CCACs from service provider agencies. This creates major paper handling costs and increases the chance for human error. So much paper could raise privacy concerns, and makes meaningful analysis more difficult.  

The secure, mobile, wireless solution provided to home care nurses also brings other job-specific functionality to the bedside, such as supply ordering. It reduces opportunities for errors and duplicate orders. From a security standpoint, the real-time technology linked directly into computerized patient records protects security and eliminates errors.

In the long run, it means more time spent with clients and less on paperwork.

“The growing importance of home care demands that administrative costs be reduced, so more dollars can be channeled to where they are needed most – to high quality care for clients,” says Jeff Doleweerd, Director, Partnerships & Planning, CCAC Simcoe County.

Home care nurses with hand-held computers are becoming more of a common sight, as this first-of-its-kind program rolls out across Simcoe County.

Bayshore Home Health and Saint Elizabeth Health Care each have more than 60 nurses dedicated to delivering home health care on behalf of CCAC Simcoe County.  For the past few months, Bayshore Home Health nurses have been using the hand-held wireless devices in the client’s home to transmit, verify, and review data and information.  

In a nutshell, two applications of the technology were deployed to nurses. They can monitor wound status at the point-of-care while streamlining reporting to CCAC. Secondly, nurses can order medical supplies in the field and the solution allows them to get real-time order feedback.

Wound care is a large component of Community Care Access Centre’s (CCAC) nursing and medical supply costs, says Kevin Arbour, Chief Information Officer of the Ontario Association of Community Care Access Centres. Sustaining best practice in the field requires real-time decision support and better management information for CCACs and their case managers.

“Home care nurses can now instantly see an accurate patient history to guide their on-site care and to order new supplies,on the spot, in response to a patient’s changing condition,” Kevin notes. “Better decision support at this level lowers costs for the health care system, as well as improving patient outcomes.”

Nurses say the ability to immediately know the latest patient status and to accurately order patient supplies is crucial for home care, and is especially vital in providing these health services in more remote and rural areas.

Andrea Carter, a nurse who has three years under her cap with Barrie’s Bayshore Home Health, says the new system will save her a lot of time. She was involved in the trials for the wireless system in two pilot projects, and is now using it in her day-to-day community rounds in the field.

“Before, we had to do the same paperwork twice - once at the client’s home and then again to fax it in to the office,” she says. “And faxing has been a huge problem. With this device, I can check my orders to see if the people who were supposed to receive supplies, did receive them.”

“With the touch of a button, this systems replaces three to four phone calls to find out if something is on back order, for instance,” notes Andrea Carter. “Eventually it’s going to be much better –I can see it saving me a lot of time.”

The client home is gradually becoming the pharmacy, stockroom, and dressing tray of the hospital. Ordering and delivery of medical supplies is a time-consuming, error-prone, and labour-intensive process. Nearly one million medical supply orders are processed across the province every year by CCACs. The mobile solution reduces opportunity for errors and duplicate orders and dramatically reduces the time required to get the supply to the client’s home.

Client status updates, equipment rental requests, admission reports, and discharge reports. This is the work of managing the care to more than 8,000 clients every day in Simcoe County.  “Home health nurses spend nearly half their time administering paperwork; and any new technology that reduces this overhead is a benefit for better health care,” Doleweerd points out.

Ontario’s health care system needs innovative ways of lowering administration costs so that more money is freed up for patient care, notes Doleweerd.

“This addresses just a small component of the administrative burden. Medical supply requisitions constitute 15 per cent of the paper load, and about 5 per cent of community care costs, and that number is rising.”

The effort is aimed at enriching care delivery by having the most relevant information – including up-to-date client health information – available readily at the point of care in the client’s home. Nurses and clients will have more time together for patient care, freed of distractions such as searching for, and filling out, traditional paper records.

While the current phase is addressing the ordering of medical supplies and wound care tracking and treatment, in the coming phases it is expected that CCMeH will evolve to include other aspects health outcome tracking such as pain and symptom management, admission reporting and status updates.

Other CCACs are looking at similar approaches, which are so crucial to the growing importance of home care that some experts say the Ontario Government should pay for these technologies as a province-wide resource.  It’s expected to be taken up by other health providers in Ontario and across the country.