Social Care Alarms and more moving from analog to digital

Social Care Alarms and more moving from analog to digital

Pär Kindstrand I have worked for the municipality since 1986 Assistant nurse for homecare services, in city and rural areas Works with social care alarms since 2006 Full-time Alarm Coordinator since 2011 Responsible for all social care alarms working without interruption in private homes Including special alarms: Door alarms, epilepsy alarms, motion detectors, floor mat alarms etc Integrated care, digital home health care Implemented GPS-alarms and remote visits via camera 2017

Agenda Organisation Start of digitalisation Procurement Pros and cons SCAIP standard Current situation Lessons learned Watch out for! Success factors What s coming Obstacles

20 regions/countys (health care) 290 municipalities (social care)

Forests and lakes! 91 000 inhabitants 66 000 in the urban centre 1 720 social care alarms

Organisation Home care service 2 alarm coordinators 20 service groups 15-30 assistive nurses /care staff per service group 3-5 alarm managers per service group Tasks alarm managers Installation and removal Keys safe-keeping Function control Home care service group Tasks alarm coordinator Register the alarms at the alarm receiving center (Tunstall) Register service at the municipality broadband network (Wexnet) Service/warehousing Back up for problem searching Special alarms and solutions Home care service group Alarm coordinator 2,5 position Home care service group Home care service group

Start of digitalisation In 2008 an increasing number of inhabitants stopped using plain old telephone service (POTS/PSTN) Houses were built without POTS, only with fiber Some elderly social care alarm users stopped using POTS and contracted mobile service exclusively The State owned telephone company initiated a nation-wide replacement of POTS/PSTN towards mobile solutions The municipality started having problems in providing services since analogue tone signaling alarms did not function well with broadband services Started testing IP-alarms with Group NEAT

Progress of digitalisation In 2010 our municipally-owned broadband network company Wexnet showed an interest in connecting social care alarms Wexnet reaches today approx. 22 000 households in the region The initial tests showed good and stable connections for social care alarms We can connect the social care alarm even when the user does not have an internet service The municipality has its own Social care alarm service with Wexnet Easy and quick activation, ready in 3 minutes

New procurement In 2011 Växjö did a new procurement A big step towards digitalisation New supplier Doro (Caretech) 350 digital alarms installed of totally 1400 Alarms can be connected both via fixed broadband (ETH) and over GSM/GPRS We lease the alarms with ready to use suited roaming SIM card (8.50 /month) We decided to concentrate in putting the digital social care alarm in the municipal broadband network GSM became backup

Pros and cons of digital social alarms Real-time functionality check Reprogramming and upgrading remotely Some problems can be solved remotely Municipality and contracted suppliers has control of (almost) the whole chain Reduced risk due to thunder storms It could be a bumpy ride to do the transition (Sweden had a lot of lessons learned, also the companies! It was a very bumpy ride in 2008) Might require a higher technical knowledge among the installers/handlers Still in development; there are some upgrading going on

SCAIP- Social Care Alarm Internet Protocol An open protocol for the communication between carephone and alarm recieving centre Standardisation work conducted by: Swedish public sector European/global companies: Doro (Caretech), Tunstall, Group NEAT etc. Swedish/European testing and certification organisation: SP Suited for fixed broadband (ETH) and GSM/GPRS Suited for UK and global market Swedish standard approved April 2014, becoming an industry standard in Europe and globally Deployed in Växjö late 2014 (GSM) and mid 2015 (ETH)

Växjö municipality Total approx. 1 720 social care alarms October 2017 Approx. 1 340 GSM SCAIP Approx. 380 Broadb. SCAIP Wexnet

Sweden total Total approx. 231 000 social care alarms January 2017 Approx. 150 000 GSM SCAIP Approx. 5000 Broadb. SCAIP Approx. 5000 Unknown Approx. 71 000 Analog

Lessons learned At the begining, poor mobile connections, but it is much improved now; New improved antennas on the alarms Better coverage from the telecom suppliers Manufacturers now supply social care alarm units with roaming SIM cards Local authority/ municipality must be responsible for the communication!

Lessons learned Difficult for the installation crew to find network connection outlet Distance between network outlet and electricity outlet Secure the cable.

Lessons learned Difficult for the installation crew to find right network outlet

Monitoring and management Useful to be able to remote-check operability in different ways (heartbeat/ping/testalarm) I-Care Online for: Programming Reprogramming Status check Upgrading Logging

Watch out for! Analog tone signaling alarms in the digital networks: GSM and fixed broadband Procuring alarm units and telecommunication separately Procuring different parts of the alarm-chain from different suppliers Bad roaming solutions Not fully digital alarm reciever platforms Bad device management and monitoring solutions Cheap unsafe solutions that bring extra expenses in the end Not listening or not cooperating with the organisation s own technical knowledge base Forgetting the organisation s own human knowledge

Success factors Roaming SIM cards as integral part of the carephone leasing SCAIP Good device management and monitoring systems Collaboration with urban/rural/national broadband provider Maintain a central organisation that is knowlegeable in technique and service, as well as handling alarm monitoring.

What digital tech is on the rise in Sweden? Digital social alarms : about 75% implemented Also.

Sensors / passive alarms Door alarms / position alarms Motion sensors Bed /chair alarms Epilepsy alarms Floor / mat alarms Fall alarms Passive alarms Smoke / fire alarms ( to personnel) Share of municipalities that use this technique in : Ordinary homes: 86% Special homes for elderly: 97% Homes for disabled: 87%

Care planning via image communication Share of municipalities that use this technique in : Ordinary homes: 59% Special homes for elderly: 51% Homes for disabled: 47%

Access to wifi, internet and tablets Share of municipalities that use this technique in : Special homes for elderly: 61% Homes for disabled: 59%

GPS-alarm Share of municipalities that use this technique in : Ordinary homes: 52% Special homes for elderly: 47% (about 500 in operation total)

Electronic locks Share of municipalities that use this technique in : Ordinary homes: 48%

Remote visits via camera Share of municipalities that use this technique in : Ordinary homes: 37% Special homes for elderly: 11% Homes for disabled: 8% (about 500 in operation total)

Digital reminders Share of municipalities that use this technique in : Ordinary homes: 26% Special homes for elderly: 20% Homes for disabled: 25%

Mobile documentation Share of municipalities that use this technique in : Ordinary homes: about 25%

Problems for municipalities to implement new technique It s complicated and comprehensive Not enough resources to make it happen fast Not enough support from regions or government Need support in law, ethics and procurement Too many suppliers that don t use standards Technical problems at the implementation cause loss of confidence Lack of integration between systems (You have to enter same info multiple times) Sometimes suppliers can t meet the demand for mobile solutions Not enough infrastructure in some rural areas There is a desire to rather procuring a platform to connect different solutions to.

Thank You! Par.Kindstrand@vaxjo.se