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Research Article| Volume 129, P1-5, November 2019

A novel approach to integrated care using mobile technology within home services. The ADMR pilot study

      Highlights

      • Social workers can participate in the health system by using a system that gives well-being alerts but not any medical information.
      • Serious medical alerts were raised by social workers.
      • Social alerts were also raised.

      Abstract

      Background

      The care model for supporting elderly people living independently at home relies on the informal and formal assistance of caregivers. Information and communication technology (ICT) offers new approaches for informal care services for this group.

      Methods

      A longitudinal observational pilot study was carried out in home services in France. Employees of the ADMR home services followed 130 elderly people living at home and who were no more than moderately impaired. A single visual analogue scale (VAS) was used on a smartphone to assess global health every time a person was visited. An alert system was devised to inform the elderly person and/or a responsible person of any deterioration in health status. All medical and social events were recorded throughout the 9-month study.

      Results

      138 people were enrolled and 106 were evaluated. 37 alerts were observed. 21 were confirmed and 16 were false positives. Only employees untrained in the use of the system generated false positive alerts. Six severe medical alerts were observed, including one cancer undetected by the physician, one hospitalization for diabetes, one hospitalization which led to death 6 months later and one hospitalization which resulted in follow-up care.

      Conclusions

      Social workers can participate in the health system with all the ethical criteria of medicine. To our knowledge, this is the first ICT-based alert system that has been found to produce severe medical alerts by employees of home services.

      Abbreviations:

      ADMR (Aide à domicile en milieu rural), CARSAT (Caisse d’Assurance Retraite et Santé au travail), GDPR (General Data Protection Regulation), ICT (Information Communication Technology), VAS (visual analogue scale)

      Keywords

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      References

        • Sandberg L.
        • Nilsson I.
        • Rosenberg L.
        • Borell L.
        • Bostrom A.M.
        Home care services for older clients with and without cognitive impairment in Sweden.
        Health Soc. Care Community. 2018;
      1. Adequate Social Protection for Long-Term Care Needs in an Ageing Society LeUheeesmj.
        2014
        • Bergstrom A.L.
        • Hanson E.
        An integrative review of information and communication technology based support interventions for carers of home dwelling older people.
        Technol. Disabil. 2018; 29: 1-14
        • Nogues M.
        • Laune D.
        • Paccard D.
        • Coupet A.L.
        • Millot-Keurinck J.
        • Bototo N.
        • et al.
        Integrated platform for home services using new products and services for senior citizens Call CNAV-CARSAT 2015.
        Geriatr. Psychol. Neuropsychiatr. Vieil. 2017; 15: 5-12
        • Oubaya N.
        • Mahmoudi R.
        • Jolly D.
        • Zulfiqar A.A.
        • Quignard E.
        • Cunin C.
        • et al.
        Screening for frailty in elderly subjects living at home: validation of the Modified Short Emergency Geriatric Assessment (SEGAm) instrument.
        J. Nutr. Health Aging. 2014; 18: 757-764
        • Bousquet J.
        • Bewick M.
        • Arnavielhe S.
        • Mathieu-Dupas E.
        • Murray R.
        • Bedbrook A.
        • et al.
        Work productivity in rhinitis using cell phones: the MASK pilot study.
        Allergy. 2017; 72: 1475-1484
        • Caimmi D.
        • Baiz N.
        • Tanno L.K.
        • Demoly P.
        • Arnavielhe S.
        • Murray R.
        • et al.
        Validation of the MASK-rhinitis visual analogue scale on smartphone screens to assess allergic rhinitis control.
        Clin. Exp. Allergy. 2017; 47: 1526-1533
        • Bousquet J.
        • Devillier P.
        • Anto J.M.
        • Bewick M.
        • Haahtela T.
        • Arnavielhe S.
        • et al.
        Daily allergic multimorbidity in rhinitis using mobile technology: a novel concept of the MASK study.
        Allergy. 2018; 73: 1622-1631
        • Bousquet J.
        • Devillier P.
        • Arnavielhe S.
        • Bedbrook A.
        • Alexis-Alexandre G.
        • van Eerd M.
        • et al.
        Treatment of allergic rhinitis using mobile technology with real-world data: the MASK observational pilot study.
        Allergy. 2018; 73: 1763-1774
        • Bedard A.
        • Basagana X.
        • Anto J.M.
        • Garcia-Aymerich J.
        • Devillier P.
        • Arnavielhe S.
        • et al.
        Mobile technology offers novel insights on control and treatment of allergic rhinitis. The MASK study.
        J. Allergy Clin. Immunol. 2019; 144: 135-143
        • Menditto E.
        • Costa E.
        • Midao L.
        • Bosnic-Anticevich S.
        • Novellino E.
        • Bialek S.
        • et al.
        Adherence to treatment in allergic rhinitis using mobile technology. The MASK Study.
        Clin. Exp. Allergy. 2019; 49: 442-460
        • Article 4 EU GDPR
        « Definitions ». EU general data protection regulation.
        (/679) GDPR), 2016
      2. Directive 2002/58/EC of the European Parliament and of the Council of 12 July 2002 concerning the processing of personal data and the protection of privacy in the electronic communications sector (directive on privacy and electronic communications).
        Off. J. Eur. Communities. 2002; L 201
      3. Directive 2009/136/EC of The European Parliament and of the Council of 25 November 2009 amending Directive 2002/22/EC on universal service and users’ rights relating to electronic communications networks and services, Directive 2002/58/EC concerning the processing of personal data and the protection of privacy in the electronic communications sector and Regulation (EC) No 2006/2004 on cooperation between national authorities responsible for the enforcement of consumer protection laws.
        Off. J. Eur. Union. 2009; L 337
        • Bousquet J.
        • Arnavielhe S.
        • Bedbrook A.
        • Bewick M.
        • Laune D.
        • Mathieu-Dupas E.
        • et al.
        MASK 2017: ARIA digitally-enabled, integrated, person-centred care for rhinitis and asthma multimorbidity using real-world-evidence.
        Clin. Transl. Allergy. 2018; 8: 45
        • Bousquet J.
        • Bedbrook A.
        • Czarlewski W.
        • Onorato G.L.
        • Arnavielhe S.
        • Laune D.
        • et al.
        Guidance to 2018 good practice: ARIA digitally-enabled, integrated, person-centred care for rhinitis and asthma.
        Clin. Transl. Allergy. 2019; 9: 16
        • Levitt D.
        New strategies and innovations to engage seniors in eldercare.
        Healthc. Manage. Forum. 2018; 31: 142-146
        • Lyn M.J.
        • Johnson F.S.
        Just for us: in-home care for frail elderly and disabled individuals with low incomes.
        N. C. Med. J. 2011; 72: 205-206
        • Mortenson W.B.
        • Sixsmith A.
        • Beringer R.
        No place like home? Surveillance and what home means in old age.
        Can. J. Aging. 2016; 35: 103-114