eHealth pilot project brings diabetes management closer to home

In response to the Ontario government’s plan to strengthen community health care and relieve the burden on hospitals, Sunnybrook and Women’s College Health Sciences Centre in partnership with Etobicoke and York Community Care Access Centre (CCAC) is taking the lead and testing a new home telehealth diabetes management pilot project.

Using a tiny monitor that connects to clinical equipment such as a blood pressure cuff, patient’s readings are transmitted during the tele-visit to the physician, case manager or home health care professional. The patient, case manager, and other members of the care team can discuss results, answer questions and determine next steps in real-time with the physician.

“The home telehealth model will change the traditional face-to-face visit between a patient and health care provider to contact via teleconference, with the patient at home and the provider at the hospital,” said Sam Marafioti, Vice President of eHealth at Sunnybrook & Women’s. “This model presents opportunities for integration between hospitals and community services and may begin to relieve the burden on hospitals.”

“Home telehealth has the potential to make a range of health care services traditionally provided in the hospital, available in a patient’s home. This will strengthen the link between physicians, case managers, and other members of the care team at the hospital and in the community. The patient benefits as the model paves the way to a more seamless continuum of follow-up care, education, and services,” said Cathy Szabo, Executive Director at Etobicoke and York CCAC.

The pilot project will test the delivery of multidisciplinary diabetes care in patient’s homes using eHealth solutions. The project has two phases, the first phase is a five month pilot which will be a spring board to launch a randomized controlled trial to determine the efficacy of eHealth technology versus traditional care delivery. In addition, researchers will study and assess patient and provider reactions to the technology and the change in health care delivery.

“Patients will benefit from more frequent contact with, and closer follow-up from, the health care team than they would ordinarily receive,” said Dr. Ivy Fettes, Director of Endocrinology Division, Department of Medicine at Sunnybrook & Women’s and pilot project clinical lead. “This will provide patients with more opportunities to receive person-to-person education, ask questions, address problems and reduce the anxiety associated with intensifying diabetes treatment.”

Home telehealth services may be most beneficial for patients who require frequent contact with health care professionals. This particular pilot project is focusing on the diabetic population since people with diabetes require frequent outpatient physician visits. The average diabetic person in Ontario has 16 physician visits per year, but those aged 75 or older average nearly two visits per month. Patients who are unstable or are changing their therapy, for example by initiating insulin treatment, require more physician and nursing visits as well as services from other health care providers.

“Our health care system is evolving in areas of prevention, continuity of care, patient satisfaction and patient education,” said Leo Steven, President and Chief Executive Officer, Sunnybrook & Women’s. “At the same time, the province is dealing with a shortage of health care professionals within hospitals and in the community. eHealth or home telehealth models, although in early stages of development, are emerging as innovative strategies that will create a more dynamic and responsive approach to delivering services closer to home and to provide health professionals more flexibility with patient care.”

Home eHealth solutions have the potential to reduce the geographical barriers for the delivery of quality health care. The emergence of eHealth strategies for clinical, educational, and administrative purposes could have a significant impact on health care delivery in the immediate future.

About Sunnybrook and Women’s College Health Sciences Centre

SWCHSCis transforming health care through the dedication of its more than 10,000 staff members who provide compassionate and innovative patient focused care. An internationally recognized leader in women’s health, academic research and education and an affiliation with the University of Toronto distinguishes Sunnybrook & Women’s as one of Canada’s premier health sciences centres. Sunnybrook & Women’s specializes in caring for newborns, adults and the elderly, treating and preventing cancer, heart problems, orthopaedic and arthritic conditions and traumatic injuries.

About Etobicoke and York Community Care Access Centre (CCAC)

The Etobicoke and York Community Care Access Centre is helping more than 6,000 of its residents live independently in their homes by making the health care services they need accessible, responsive, and effective. The Etobicoke and York CCAC achieves this accountability through specialized and far-reaching case management services and dedicated staff and community partners.