Information Technology Reference
In-Depth Information
and each caregiver in the TAO system becomes
the subject of an electronic record which provides
quantitative and qualitative information on care
delivered and received, as well as the impact of
these interventions on the care recipient.
The data entered into the TAO, along with the
specific alerts that triggered the caregiver's ac-
tions, are analyzed by the second component of
the EBETA, a specialized software package. This
software automatically maintains, indexes, links,
updates and displays the information and prepares
the third component, the Interactive Care Evalu-
ation Tool (ICET), that automatically produces a
series of web pages. These pages summarize the
condition of each of the individuals being moni-
tored and includes: 1) a daily synopsis of all
problems, care delivered and health outcomes; 2)
trend charts on any alert, care action and/or health
outcome for any designated time period; 3) a
narrative of the total care delivered by all caregiv-
ers; and 4) a list of all issues to which caregivers
need to pay special attention. The pages of the
ICET provide comparable information on each
monitored individual, both within a single care
provision location and across locations. As a
consequence, this information can be used to
evaluate the effectiveness of the caregiving in
order to achieve better practice, as well as by
researchers to undertake comparative assessments
of different Telehomecare applications in two
stages: the first in the United States; and the sec-
ond in Europe.
tion, twenty-nine frail older adult clients from
the Queens Borough had QuietCare
®
installed
in their residences. Fifteen of the clients resided
in low-income housing and fourteen resided in
high-rise apartments.
The care protocol developed specifically for
the study provided a set of systematic rules for
responding to both urgent (red) and non-urgent
(yellow) alerts. Urgent alerts included, late wake-
up—the individual being monitored not getting out
of bed by one hour later than normal—and falls.
Non-urgent alerts included changes in overnight
toileting, changes in meal preparation and decline
in overall activity. Urgent alerts were simultane-
ously sent to an ADT call center and to designated
staff and family. The study protocol required that
the ADT dispatcher contact the client and/or the
appropriate responder to take immediate action.
Designated responders were staff, family members
of the clients and in cases when neither staff nor
family members could be reached, e.g., on week-
ends, emergency response services. Non-urgent
alerts were sent via email to the staff, as well as
designated family members. The study protocol
required that each staff member check her email
each work day by 10:00 am and when alert no-
tices were received, navigate to the QuietCare
®
website to access detailed information on the
alert(s). After taking the appropriate care action
in response to the alert, e.g., phoning the client in
cases of an alert indicating that the client had not
gotten out of bed, the staff member accessed the
TAO website, entered the care actions taken and
any outcomes that were the result of these actions.
The EBETA software automatically indexed and
linked the entered data and prepared an electronic
record. The participating social workers reviewed
these care records at periodic staff meetings and
discussed how they were using them to better
understand relatively subtle changes in behavior
or health conditions of the client and deliver more
appropriate and timely care.
The second study was undertaken in London
during late 2006 and the first half of 2007. The
APPLICATION OF EBETA
The first study to employ the EBETA methodol-
ogy described above was conducted in New York
City during 2006. Our research partner was a
not-for-profit care organization that provides a
comprehensive network of social service, senior
housing and home care services to over 20,000
aging, frail and “at-risk” clients in the five Bor-
oughs of New York. For the six month evalua-
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