Mobility is fast changing aged care operations and service delivery. In this special report, Natasha Egan looks at how providers are adapting and some of the emerging trends.
Online is no longer enough for residential and community aged care workers. They need access to information and applications where they are; whether that is at the point of care or on the road.
As a result, developing or enhancing a mobility strategy is high on the agendas of many aged care chief information officers (CIO) across the country.
Andrew Alpe, CIO of the Royal Freemasons’ Benevolent Institution (RFBI), says they have already mobilised core products, clinical notes, medication management and nurse call messaging. Next, they will be looking at maintenance management and hotel services, he says.
“I would be delighted if we could mobilise all of our client-facing software solutions,” Alpe tells Australian Ageing Agenda.
He is in the process of upgrading the organisation’s iCareHealth electronic medication management program to allow what he calls true portability. It involves rolling out iPads and iCareHealth’s new MedMobile app to its 20 residential villages in NSW and the ACT to record the delivery of medications to 1,400 of its residents.
With MedMobile, workers can access and record medication administration information at the point of care using a tablet, with all activity synced back to the core program.
“Much of the care we provide is not in a medication room or at a nurse’s station. In order for our team to be able to maximise the benefits of iCareHealth we need them to be able to access our clinical and medication management systems whilst delivering care, wherever that care is being given,” says Alpe.
In the system being replaced, medications are entered via Panasonic Toughpads running the Windows 8.1 operating system. It is a desktop application and while Microsoft has made advances, Windows in any form is not a mobile-first operating system, he says.
“By moving to an app we gain access to hardware and software platforms that were built from the ground up for a touch-driven experience on devices that are not just mobile but truly portable.”
Alpe says this system will allow workers to spend more quality time with residents by delivering faster, more accurate clinical data.
“Our electronic clinical notes software is also provided by iCareHealth and is web based. Staff will now have the opportunity to record all of their clinical interactions in real-time whilst with the resident. For our business this is about improving the immediacy and accuracy of our information. For our staff it’s about cutting down on the paperwork and concentrating on spending time with residents.”
Further, Alpe says they are also anticipating a reduction in training and support costs.
“Apple were really thought leaders in the areas of intuitive user interfaces (UI) and user experience (UX). It’s great to see companies like iCareHealth putting UI and UX front and centre in their development. When you can pick up a device and it just works, everybody benefits.”
The mobile industry has set the standard in ease-of-use terms, says Adele Beachley, Asia-Pacific managing director of SOTI, a provider of enterprise mobility management solutions.
“Everyone wants to ensure if you take something out of the box, it is going to work. You don’t want to have to make 20 phone calls to turn something on or customise it,” Beachley tells AAA.
Many people are thoroughly educated on consumer technology and particular types of operating systems, which is an opportunity the aged care sector can leverage in their operations and services, she says.
“Where you have people who are used to using particular types of mobile phones and tablets, the ability to seamlessly provide certain types of services through those pieces of hardware is unprecedented.”
Looking at international trends, Beachley says “things are rolling out at a very rapid pace” such as the increase in aged care organisations providing clients with tablets to encourage social interaction, assist with medications or monitor vital signs.
Meanwhile all the technical work happens in the background leaving clients with nothing to worry about, she says.
“If services are easy to use, people will use them. If they are not easy to use, people either try and break your policy or stop using your service.”
The most exciting emerging area that could benefit the sector is the internet of things (IoT) where everything is a connectable end point, says Beachley. It includes smartphones and wearable technology on the consumer side, and managed assets, such as a refrigerator, on the provider side, she says.
“The ability to access and do a remote diagnostic on that asset, or end point, is critical. That’s where the practical application of mobility comes in.”
Elsewhere in IoT, Beachley says aged care could leverage the current use of mobility in the hotel environment where guests manage their entire experience from a tablet that is locked down to a single application.
“Somebody could be lying in bed and they could open the curtains. They could turn the air conditioner or the heating on or off, order room service, make a video call, or turn the television on and off. The same type of application is applicable for an older person who is either in an aged care facility or at home.”
Importantly these devices can be managed from a central location so if there is a problem, it can be addressed remotely, she says.
Dual user environment
In aged care, Beachley says the IT manager could be responsible for two environments if the end users are both staff and clients and while this can be tricky to manage, user experience is the common denominator.
“They are managing an enterprise-grade solution from an IT perspective but then they are also managing an end user scenario. They are slightly different but the ease of use is the same for both.”
It is a dual environment at community health and aged care organisation Silver Chain, which is using SOTI MobiControl to manage its national fleet of 4,600 mobile Android devices.
There are more phones (3,400) than tablets (1,200) and they are spread between staff and client devices, says Aaron Burt, Silver Chain’s group manager of technology services.
“In the last year to 18 months we have used SOTI to control and kiosk devices in homes, which is a bit of a game changer to the early days when it was purely focused on staff,” Burt tells AAA.
Silver Chain does a lot of video conferencing with mobile devices for team meetings and collaborations, which is ideal for their geographically spread teams, and more recently in telehealth programs, says Burt.
“We have a lot of our nurses talking to our clients. We are moving to a world where we will be able to pull in third parties and additional healthcare professionals who are not Silver Chain.”
Mobility offers a great way to provide more care for less cost because it allows services to be scaled a lot more broadly through telehealth, for example, he says.
“District nursing for us has always been driving from point to point but technology is allowing us to sometimes avoid that. It enables us to care for more people in a day by a single nurse or carer.”
The core program running across devices for staff is ComCare Mobile, says Burt. Certain elements including the play store are blacklisted, personal downloads are restricted, but other features are added.
“We present apps that we have triaged and checked for security in the internal app store that SOTI provides. We have a batch of mandatory apps that we push down on default on build then we put on a few bells and whistles and productivity tools they can choose to download from that internal store if they want.”
The mobile management solution allows them to speed up build time of new devices with automatic configuration and the 4,600 devices can be supported with just four staff members, says Burt.
“[My staff] can update, upgrade, pull apps on demand, push packages down to devices without users even noticing. We can control that and keep everything up to date. When they have troubles with their app, or their phone, they can call up the helpdesk and we can remote in and see what they see.
“That is a real big plus because our staff’s skills are nursing and caring. We let them worry about doing that and providing a great service to the client while their phone is left on the table and we will solve the problem for them.”
He says it is a similar situation with client devices, which are configured to allow only the features Silver Chain wants and kiosked so they only display relevant healthcare content for clients who can only use it for the intended healthcare purposes.
“If we are experiencing trouble with client devices, we have a feature where the nurses that are dialling them can do a remote restart if there are any troubles, which can refresh and fix the problem nine times out of 10.”
Burt says Silver Chain has other plans for mobility, and it is starting to look at the internet of things and how the mobile device will be the hub for that.
“It will centralise the data collection and things like that. We have a lot of big plans and a lot more mobile business intelligence and dashboards. The list is endless.”
Mobilising a small operation
Harnessing the benefits of mobility is not just open to large operators. After a four-month pilot, Western-Sydney aged care provider Able Tasman Village Association announced in April it is moving to fully implement a cloud-based mobility platform and managed service to initially be used by 20 home care workers who make around 7,000 home visits annually.
The solution allows community aged care workers to view rosters, locate and get directions to appointments, complete care notes and record vehicle logs via a mobile app.
This is the first aged care deployment for Australian-based enterprise application and mobile services provider BlinkMobile and the solution has been developed in conjunction with mobility and application development provider Multibase.
Darren Besgrove, BlinkMobile’s COO, says the geo-located solution allows workers to see and keep track of their calls and work as they make visits. The app interfaces with location beacons at client homes to activate arrival and departure times for time sheets and pre-load specific client information onto staff devices, he tells AAA.
“The note taking is all electronic. They can do voice-to-text dictation so they are not trying to hand type notes later. The photos can be annotated so if you’re doing an in-home inspection and you see a tripping hazard you can photograph it and draw on it to say what the issue is.”
The mobile solution they have developed is just the beginning, says Besgrove. “Most mobile solutions start and then they expand. If you try to do the whole thing in one go, those project typically fall down. You need to do something simple. You need to get it working, build credibility and build support.”
Beachley agrees and says organisations looking at mobilising operations or services should start small, keep it simple, understand what they want to achieve, put the end user at the centre, and make it easy to use and deploy.
When it comes to implementing the strategy, Silver Chain’s Burt says mobilising a workforce is a daunting experience and the key is to introduce it gently with a lot of super users who have a voice in the business.
The aim is to wow but not overwhelm them by slowly bringing in one feature after another, after which they will spread the positivity and benefits of the productivity gain, he says.
“If you then continuously innovate and give new features and reassure them that the company is being proactive – that IT is being proactive – they see the benefits. It builds a lot of trust but with that you do have to educate. If you don’t put that education in the training then you can lose them early on.”
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