The factors driving change to our health care system are undeniable and mounting. An aging population, increase in life expectancy, rise in chronic and life-limiting illnesses and shortages in health human resources are shifting care from institutions to care within the home. Home care is shaping the future of care provision as it becomes one of the fastest developing areas in the health system. However, the question that fuels health care innovation remains: How can we provide better care and quality of life for Canadians into the future, while achieving system efficiencies? The answer is pointing toward technology-driven solutions.

Research evidence shows the potential of technological innovation in accelerating the quality and efficiency of care. According to the World Health Organization, the use of technologies to support the achievement of health objectives has the potential to transform health service delivery around the globe. As technology becomes an integral part of our lives, we have an opportunity to create new options for care delivery that enhance our health and social care systems.

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In the home care sector, technology holds a central role in enabling remote patient monitoring and interventions in a patient’s home rather than in a higher-cost institutional setting. This is especially beneficial for a majority of chronic illnesses that can be effectively managed in the home and community. Seniors are four times more likely to report having at least one chronic condition than adults ages 18 to 24. As a result, the prevalence of chronic conditions, such as diabetes, congestive heart failure and dementia, will increase as Canadians are living longer. These conditions can lead to premature death, decrease quality of life and have a negative economic impact on families and on society as a whole. With increasing demand and limited resources, the onus of care falls on family caregivers who provide the majority of home support services to seniors and to those with chronic, long-term conditions.

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“The Ontario Telemedicine Network has brought together technology and health coaching in its ground-breaking Telehomecare program. Patients with chronic lung or heart disease are remotely monitored while learning how to manage their condition. Telehomecare reduces hospitalizations by more than 70 per cent, keeping patients safe and at home,” says Laurie Poole, Vice President, Telemedicine Solutions, Ontario Telemedicine Network

It is important to note that the amount of health care services Canadians will use is largely driven by the number of chronic conditions they have, not their age. Although chronic diseases are among the most common and costly health problems, they are also among the most preventable. They are often impacted by lifestyle choices, and with the right prevention and management interventions, people diagnosed with a chronic disease can successfully live in their own homes, without a ripple effect on their caregivers.

Strategic investments in technological innovations will enable individuals with chronic conditions to be more independent in their home, remain in their homes longer and be more engaged in the self-management of their conditions. Other areas impacted by technologies include communication, medication management, daily activities, cognitive fitness and social networking. Technologies in the home can improve the quality of care, facilitate greater access to care, reduce inappropriate hospitalizations and emergency room use, reduce medical errors and enable the right care in the right place by the right person. They also empower action and help family caregivers provide support and care for individuals in their home. Independent of the moral benefits, technology will also raise productivity and ensure resources are used appropriately to create a high performing health care system. The result is the best value for our health care system.

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A variety of technologies can be adapted to the patient’s needs at home, such as:

• Telemonitoring. This innovative patient management approach uses technologies to remotely monitor patients at a distance and measure a diverse array of data (e.g., physiological, biological and behavioural data and images). The data are then sent to health care professionals so the patient’s condition can be monitored and evaluated in a timely manner, and sometimes in real time. New technologies that support telemonitoring include mobile smart phones and personal digital assistants that can also be used to engage patients in the management of their health and to promote self-care through education, training tools and a self-monitoring system.
• Telemedicine. Technologies that support medication adherence systems monitor the patient’s medication intake and remind patients in real time to take the medication as prescribed. The medication prompt reminder is available on user-friendly technology (i.e., watch, phone, TV) that is customized to individual patients and their family caregivers.
• Sensor Technologies. A networked system of sensors can range from wearable devices (e.g., pendants or bracelets) to the use of motion sensors in the home. The system monitors a person’s activities and if a problem occurs, it triggers and sends alarm signals to caregiver or medical response team. GPS devises in ID bracelets or watches—even in shoes—help keep track of the whereabouts of people with dementia. Typically, sensors can be used to measure any number of characteristics and detect a range of situations that could indicate potential hazards, such as falls, heart attacks or extreme temperatures.
• Social Networking or Communication Technologies. Communication technologies, such as senior-friendly smartphones, computers with accessibility features (e.g., Skype) and social networking sites, help seniors keep in touch with family, friends and the world. Social networking helps to overcome social isolation, which is a common outcome associated with negative health. Motivation for health behaviour change can also be increased through shared knowledge and support from others in similar circumstances.

Technological innovation will inevitably result in improvements to the quality and efficiency of care. However, innovation will not happen with a single event or in isolation—it is a process. Innovation requires a strategic approach that includes incremental goals, long-term investment, policy changes and change management approaches. There are no quick fixes. Strong and capable leadership is needed, as well as dedicated effort from different stakeholders to work together. The Canadian Home Care Association is committed to accelerating innovation in the home care sector through leadership, advocacy, awareness and knowledge. Together, let’s ensure the dignity, independence and quality of life for all Canadians, regardless of the care setting.