Smart Call: Monitoring and signalization technologies within integrated LTC measures

Why was this example implemented?

The example is run by the local administration with the aim to overcome the well-known problems of fragmented LTC services, uncoordinated administrative procedures between health and social services, and different types of professional working.

ICT solutions can contribute to close the gaps that are generated by health and social care staff operating in different administrative departments and organisational settings, e.g. in call centres, home care departments, social residential institutions, hospitals, General Practitioners. Technical applications can in particular support the effective cooperation of health and social care professionals with other professionals operating in other community services such as housing, police and fire departments.

The “Smart Call” technology is particularly useful for risk groups such as older people living alone at home. For instance, in case of falls, acute illness or mobility problems they face major difficulties in calling for urgent help. Providing coordinated measures for older persons via the ADCC eliminates a duplication of needs assessment by different bodies (health and social) and enables professionals to use already obtained data and information to concentrate on providing suitable and fast help.

The primary target group of the ADCC are older people living alone, but their relatives who care for them on a regular basis are also implicitly affected.

Description

Since January 2009, monitoring and signalization through call centres has been implemented as a new kind of social service in Slovakia. With the Act No. 448/2008 Coll. on social services, a practice that had been piloted by non-governmental organisations in 2005-2006 (with support of European funding) became a mainstream service.

The service described in this example is funded by the town of Nitra. The Assistance Distress Call Centre (ADCC) was set up in 2006.  The purpose of the call centre is to prevent crises situations faced by older people living at home (in particular those living alone) and to offer them and their relatives suitable solutions of how to keep them safe in their home as long as possible. Within the comprehensive service health services, social services, police and fire departments are coordinated and deployed using ICT solutions.

The ADCC in Nitra works with the so-called “Smart Call” solution: in case of an emergency the client can simply push a button on a device which is waterproof, shock resistant, and always at hand. To ensure the latter, there are several possibilities: the device can be worn hanging around the client’s neck or as a bracelet around his/her wrist. The device can also be used to answer incoming calls. In addition, an alarm button placed on the phone set can be pushed to activate the ICT system which connects the client with the ADCC operators who are trained and certified professionals. ADCC holds medical records on their clients and after evaluating the client’s situation the operator coordinates the assistance by appropriate professionals from health and social care services, and even police or fire brigade, if necessary. The assistance is provided 24 hours a day, 7 days a week and 365 days a year. The ICT solution also provides the opportunity to arrange conference calls so that the various professionals/partners can communicate with each other (e.g. client, GP and social worker). After the assessment various forms of emergency help can be deployed, e.g. care workers or health care assistants can be sent to the client’s home, if necessary also an ambulance or police.

The ADCC can provide its clients with other supportive services using constant monitoring information gathered from supplementary scanners of the wireless electronic equipment included in the “Smart Call” system. This monitoring information includes the identification of smoke, movement or the opening of doors and windows. Furthermore, the solution permits to monitor prescription drug use and water usage at a distance. It may also be used to ensure regular contact with relatives, e.g. if the client has difficulties to contact them for any reason. Finally, the system also allows the user to book transport services, to organise visits of home care services, an accompanied walk outside or just a conversation with the operator of the ADCC in a crisis situation.

The costs for the ADCC are covered at about 70% by the municipal budget according to the general social services’ funding rules. The client’s fee is 10 € per month, which cover less than 10% of the overall costs. The remaining 20% is subsidised by the state budget (employment office).

What are/were the effects?

It was assumed that using ICT solutions to coordinate responsive LTC services for care dependent older people would enable cooperation between professionals from health and social areas and from different administrative bodies. The aim has been to support independence and self-care at home for as long as possible, eliminate fears relating to isolation, increase safety and confidence, and encourage family members to reconcile working and caring commitments.

According to ADCC data, in the period from 2006 to August 2010 the centre responded to 4,596  alarm calls and provided emergency help to those in need. At present, the ADCC works with 26 clients who have installed “Smart Call” in their homes.

A report prepared by staff from the ADCC highlights the effects of the service:

• reduction of clients’ days spent in hospitals,
• reduction of total cases of hospitalisations,
• providing preventative health care and (in some cases) life-saving treatment,
• delay of placement of older people into residential  care (approximately 5 years), 
•  probability of admission to residential care is 10 times lower than with people who have not installed “Smart Call”,
• the ADCC and “Smart Call” allow family members to better reconcile their  working and caring commitments.

However, there is no firm evidence to support these findings and up to now, no qualitative research has been undertaken to analyse the impact of this new kind of social service, based on an ICT solution.

What are the strengths and limitations?

Strengths

• ADCC is based on regular national legislation (Act on Social Services).
• ADCC overcomes and prevents gaps that are created by health and social bodies that work autonomously.
• Quality of life of older people and their relatives is supported as they are able to remain securely in their familiar environment.

Weaknesses

• Comprehensive LTC services that are managed via ICT solutions are rare (at present in Slovakia there are 7 providers in total).
•  IT based monitoring and signalization services are not prioritised and therefore are undervalued by municipalities.
• There is a lack of financial sources for all services, including this one.

Opportunities 

• Good experiences and real benefits of employing ICT solutions could be shared much more among clients, their families, and service providers to increase uptake.
• Using ICT can increase the effectiveness of provided services.

Threats

• Low trust in ICT solutions among many older people.
• ICT-based social services are generally considered expensive and are often not a priority for local authorities. 

Credits

Links to other INTERLINKS practice examples

• E-health unit

External Links and References

• Zákon o sociálnych službách (the Act No. 448/2008 Coll. on social services) 
• Informácia o poskytovaní služby Monitorovanie a signalizácia potreby pomoci Centra tiesňového volania v Nitre (Information about providing the Monitoring and signalization of need to help of Assistance Distress Call Centre in Nitra).
• SWOT analýza sociálnej služby – monitorovanie a signalizácia potreby pomoci občanom v meste Nitra; na osobné vyžiadanie (SWOT Analysis of social service - Monitoring and signalization of need to help for citizens in town Nitra; on a personal request). 2010
• Dokument Centra tiesňového volania v Nitre na osobné vyžiadanie (Document about the Assistance Distress Call Centre in Nitra on a personal request). 2010