Lessons out of Chaos - Human-Computer Interaction and Innovation in Handheld, Mobile and Wearable Technologies - page 131

study encompassed two separate care models:
sheltered housing; and centralized care manage-
ment for community dwelling elderly. A total of 56
individuals were included in the study: 21 living
in sheltered housing and 35 living within the com-
munity. Once again, a specialized care protocol
was developed that provided rules for responding
to urgent and non-urgent alerts. In the sheltered
housing location, all alerts, regardless of time of
day or day of week, were sent to a centralized
nursing station that dispatched appropriate care
to the client. For the community dwelling clients,
urgent alerts were sent to staff at a dispatch center
who notified emergency services. Non-urgent
alerts were sent via email to care managers and to
family members. The care managers either took
actions themselves or, when needed, contacted a
specialist to take the most appropriate actions, e.g.,
nutritionist if the alert concerned meal preparation.
The protocol also required that the care manager
review all actions provided by other carers, discuss
the actions taken and health outcomes with all car-
ers and family members and modify the client's
overall care plan when required. After the care
action was taken, the care manager accessed the
TAO website and entered the care actions taken
and any outcomes that were the result of these ac-
tions. It was also the care managers' responsibility
to enter TAOs for all urgent alerts that were sent
to the dispatch center. In the sheltered housing
setting, designated individuals were responsible
for accessing the TAO website and entering all of
the relevant information. As in the United States,
the EBETA software automatically indexed and
linked the entered data and prepared an electronic
record that was made available to selected carers
at both locations.
The third study that employed the EBETA
methodology was undertaken in Limburg Prov-
ince beginning in late 2007. The first stage of
this study was a small pilot that ran fOR six
months during 2007-2008 and brought together
a research institute, an emergency call center,
and two care providers—a comprehensive home

care organization and a residential care facility.
A total of 25 frail and cognitively impaired older
adults were selected by the staffs of the two care
organizations: twelve of whom lived in the com-
munity and thirteen resided in the residential care
facility. The second and much larger component
began in the fall of 2008 and included, in addi-
tion to the organizations participating in the pilot,
two care organizations that provided services to
people throughout the northern region of Limburg
Province. There are presently over 100 frail elderly
individuals, all of whom live within the community
and receive a wide range of care and services in
their own residences, participating in the study.
For both the pilot and the larger study, the
care/research protocol developed provided a
set of systematic responses to urgent (red) and
non-urgent (yellow) alerts. When the QuietCare ®
system generated an urgent alert, a telephone call
was placed to the around-the-clock emergency call
center. The dispatcher, who received the phone
call, would proceed by checking the QuietCare ®
website in order to obtain details about the alert,
and then, following the protocol, contact the des-
ignated responder so that the appropriate action
could be taken. Designated responders could be
staff, family members or neighbors, or depend-
ing on the seriousness of the alert, the ambulance
service. Non-urgent alerts were sent via email to
the designated staff person who then used this
information to take appropriate care actions.
In the pilot study, once the appropriate action
was completed, by either the dispatcher at the
emergency call center or a staff member at the
care organizations, that individual accessed the
Dutch language website in order to enter the care
action(s) and health outcomes. Similarly to the
other locations, the EBETA software automatically
indexed and linked the entered data and prepared
an electronic record, only in this instance the ICET
was in Dutch.
Both before and during the early part of the
pilot study significant improvements, in addition
to changing from English to Dutch, were made in