SMILE – Supporting multi-morbidity self-care through Integration, Learning and eHealth
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From: Department of Health
- Published on: 19 October 2020
- Last updated on: 19 October 2020
Caredoc, in partnership with NetwellCASALA at Dundalk IT and the Trinity Centre for Practice and Healthcare Innovation (TCPHI) at Trinity College Dublin are delivering the SMILE project funded by Sláintecare.
SMILE is a new, innovative service to enable Irish citizens to proactively self-manage their health and well-being from home supported by a digital platform and nurse-led remote assessment and triage. Participants with two or more conditions including diabetes, COPD, chronic heart failure, and heart disease will use a selection of healthcare devices based on their needs to monitor their health and wellbeing. Using the ‘ProACT’ digital health platform, developed by researchers in NetwellCASALA at Dundalk IT and the TCPHI at Trinity College Dublin, participants can monitor their data (captured by their devices) and receive education about their conditions through their ProACT app. Alerts are monitored daily and participants are supported by an experienced telephone triage nurse.
One of the aims of the Sláintecare Integration Fund is to test and scale innovative new ways of providing care that will allow people to avoid attending hospital, and to receive the care they need as close to home as possible. This project aims to prevent a deterioration in participant conditions, empower them to engage with their own health within the community setting and to avoid hospital admissions.
Monitoring devices including blood pressure monitors, blood sugar monitors, oxygen monitors, weighing scales, and activity monitors are allocated to participants based on their requirements. Participants record their healthcare data at home and submit the readings from devices to a specifically designed software program. Participant alerts are monitored daily by the telephone triage nurse.
Remote nurse triage has been introduced to support the older adults with multiple conditions, self-manage at home using their wearable technology. Care is delivered in a more appropriate way as participants are monitored and empowered to maintain their health and well-being and directed to the appropriate clinician (e.g. nurse specialist, GP etc) before their condition deteriorates or if there are any abnormal readings. Using gentle reminder motivational tools about medication management and understanding the importance of diet and exercise in their health management has increased the quality of life for participants.
Case Studies:
One SMILE participant had 24 courses of antibiotics in 2017 but since joining the SMILE program, they have had no antibiotics prescribed in 2020. They have also had no hospital admissions this year, and no unscheduled attendance to GP since start of the project.
Another participant has had 3 or 4 hospital admissions a year for the past number of years. They have had no admissions since start of SMILE program.
Another participant was very unwell at the start of the program with COPD and numerous unscheduled visits to GP for infections. Since they started the program, they have had no chest infections in 6 months and no unscheduled GP visits.
The feedback from participants has been very positive.
“SMILE has made me realise the importance of looking after myself. It has motivated me to comply with my medications and I am very grateful for the Nurses calling me and giving me advice and listening’ said one participant”.
Another told us
“I had numerous calls and advice from the SMILE team about my elevated pulse and blood pressure. I went to my GP and was referred for full cardiac work up. I had an angio as one of my arteries was 90% blocked. I am very grateful to have been part of the SMILE project. Only for you girls, you saved my life I will be forever grateful”