Smart care: A telecare service for the elder in Taiwan

Abstract

Purpose: Taiwan held a 'Senior U-Care Flagship Program' with the goal of promoting the development of Telehealth care services by encouraging hospitals, medical devices manufacturers, IT vendors, and health care providers to develop telehealth care solutions for the elderly and to create feasible business models 1. This paper describes a case study of the Ming-Sheng telecare services founded by the U-care program. In order to expand the customer base, discharged patients and pregnant women have been included since 2009 2. Method: The Smart Care service, announced by the Ming-Sheng General Hospital in 2007, is a common telehealth care model in Taiwan. Figure 1 shows the service flowchart. The elderly or discharged patients can join the service on the recommendation of their doctors. Patients will be able to regularly measure vital signs at home according to the measurement prescription issued by their doctors. They then upload the measurement data and report their current health status and symptoms by home gateways or interactive voice response systems. The nursing team in the call center, which is composed of professional nurses and doctors, will phone patients in order to periodically assess patients' health status and address of their concerns. The nursing team will give suggestions and instructions to the patient or caregiver with assistance from information systems. Smart Care services serverd over 30,000 elderly and admission patients in 2009-2011. A telephone survey was created after applying Smart Care service for six-month to evaluate the effects of this research. Results & Discussion: The Ming-Sheng General Hospital experiment that developed the Smart Care service demonstrates the improvement of health status rate and saving of medical cost: (i) Improvement of health status: when 163 elderly with chronic diseases joined the smart care service in 2008, the average days in hospital fell by 21% (form 1.23 days to 0.97 days). (ii) Saving medical costs for discharged patients: During a six-month operation, days spent in the hospital fell by 12%, the medical costs decreased $151,912 USD (case number 2323, 1/2010-6/2010). The Smart Care service faces many challenges, such as willingness to pay, sustain ability, and legal restrictions. To further enhance the development of telehealth care in Taiwan, there is a need to amend the policies and regulations for the innovative service.