Blended Care with a Focus on Wellbeing and Social Connection

This is the second blog post in a series about cutting edge elder care in the Netherlands. In the first blog post of the series, I introduced the innovators that I will be profiling in greater depth in this series. In this blog post, we take a closer look at FocusCura.

Innovation is combining knowledge from different fields to solve a pressing problem. This is exactly what the eHealth entrepreneur Dr. Daan Dohmen is doing in Holland with his software applications in elder care. FocusCura is no longer a startup company.

More than one hundred thousand clients use FocusCura software applications (apps), automated pill dispensers, and safety alarms in their homes. Sixty nine percent of users report that they feel more independent by using the apps. Around forty four percent of users indicate that they have fewer healthcare problems overall after starting to use the apps.

Dr. Dohmen can show a reduction in the number of hospital readmissions for the users of his software apps. This is a quite remarkable achievement. If this result can be replicated in other countries, such as in Sweden, we may be looking at a revolutionary innovation in the field of elder care. To those of us who are interested in medical technology, this is of key importance, since the FocusCura VideoCareApp has been validated for use in the healthcare space, and the HomeMonitoringApp has been classified as a medical product with a European CE mark.

I traveled to Utrecht to meet with Dr. Dohmen and to understand his view on homecare and aging in place. I had the opportunity to sit down and discuss his care philosophy for a couple of hours and pick his brain about the adoption of technology from a sociological and psychological standpoint, topics that have interested him for years.

Dr. Dohmen is a former elder care nurse assistant who has pursued further studies in the field of eHealth and technology adoption. He has successfully combined his interest in elder care with his passion for technology by developing smart innovations and software apps that support people who want to continue living at home independently as they age.

FocusCura sells its software apps to homecare providers, general practitioners, and other healthcare professionals or insurance companies. You can go and download the apps or, if you need help, the FocusCura team will help you install the apps on your tablet. You can then use these apps at home.

The VideoCareApp connects you to a round the clock Medical Service Center provided by FocusCura partner MSC. You will receive a direct video link to your district nurse. You will be able to book appointments and reach out to your district nurse. Users can add other healthcare professionals, such as occupational therapists or conversational therapists, to the video conferencing app to produce a tailor made contact network through the tablet.

Besides connecting with homecare, the app can also be used to connect users with their general practitioners. The app can set up video conferencing tools so you can share information with an entire group of healthcare professionals involved in your care. You can add a number of services to the app that will help you manage independent living at home. For instance, users add a link to their pharmacist and connect with family members through the VideoCareApp.

FocusCura does not deliver healthcare services itself. The company creates and maintains the patient’s network through the software apps. In a country like Sweden, where extensive care coordination between multiple healthcare professionals, spanning both local municipality and the larger regional county council, this type of video conferencing tool has the potential to improve care coordination. The VideoCareApp can allow a range of healthcare professionals to exchange information smoothly. At the same time, the app provides instantaneous feedback and involves patients in their own care.

It would be interesting to see how public and private organizations in Sweden start to adopt these software apps and how researchers and academics could develop methodologies to evaluate these types of apps in elder care. Every other sector is introducing technology. Surely, elder care will also use more and more technology in the future.

FocusCura studies how its CE marked medical software applications benefit its users. For example, the company is looking at an independence score, which is a metric that captures how independent users of these apps feel.

FocusCura asks users whether they would recommend the video conferencing tool to their friends and neighbors. More than half reported that they would. In short, the FocusCura video conferencing app shows some very promising patient reported outcomes, along with reduced readmissions to hospital.

In the future, I would like to learn more about how nurses, doctors, and homecare professionals experience working with the video conferencing tools. I would like to learn more about how this could work in other countries, such as in Sweden, where care coordination is a central concern to many healthcare professionals working in the homecare sector.

The second software app that FocusCura has developed is a home health monitoring app for a number of different conditions. Users receive a prescription from the doctor for this app. You download the app and enter a code listed on your prescription. The app is preprogrammed with a care program for you to follow with the help of the app. The app itself has received a CE mark and can be used with different programs for different patient groups, such as people with Parkinson’s disease, chronic obstructive pulmonary disease, hypertension, gestational diabetes, and heart failure.

The company has developed these care programs in collaboration with medical doctors and has even partnered with the University Medical Center of Utrecht. In Utrecht, FocusCura is also helping the medical center to finance a doctoral student’s research on the use of monitoring to create a safe path from intensive care unit to home, following trauma.

Once you start using the app, you receive instructions every day about how to manage your condition. These instructions may ask you to weigh yourself, measure your blood pressure, document this information, and send it to your nurse or general practitioner. Some days, the patient may be asked to complete a number of tasks. On other days, the patient may be asked to complete a different set of tasks. The app is connected to a number of devices, such as a blood pressure meter, glucose meter, and Bluetooth scales.

Algorithms will analyze your health status based on the data you send. A yellow alarm will be sent to your general practitioner or to the FocusCura answering service if your health may be considered in danger. A red alarm will be handled directly by the Medical Service Center or forwarded to your doctor if your health is considered in serious danger and in need of immediate attention. All doctors and specialists have direct access to a patient dashboard, which also can be connected to the electronic medical record. Check out this video where you can see these tools in action. You can see this and other videos on the FocusCura YouTube channel.

Since the application collects patient data and conducts a risk assessment based on this data, the application must obtain a CE mark from the European authorities, and it must do so in the medical product category. The fact that the app processes the data and distinguishes between a yellow alert and a red alert, in other words, a patient’s risk, we are witnessing something quite remarkable that can help doctors and nurses do their jobs better.

This type of smart data processing and presentation is what I would like to see more of in the future of healthcare. Healthcare is a data intensive sector. We need all the help we can get to process and present this data in intelligent ways so that healthcare professionals will be able to help patients in the best ways.

It is also interesting to note that Holland has partly solved one of the key issues that we struggle with here in Sweden: how to integrate patient reported data with official electronic medical records. As we introduce software applications and move toward collecting more and more data through our wearables, we may end up drowning in our own data. Healthcare professionals will struggle to sift through all the layers of data if we do not learn how to present this data intelligently and efficiently.

It is difficult to assure the quality of self reported data like the data collected through the FocusCura app. This is not an argument to stop collecting data from patients through home health monitoring apps. I think Sweden can learn from Holland and flag patient reported data in the electronic medical records. Healthcare professionals will then know to use this data with some caution since patients at home may misreport certain aspects of their health conditions.

What impressed me most with FocusCura is that the company looks at the use of technology through a triangular viewpoint, with each corner of the triangle mattering just as much as the others. One aspect of the use of technology is to improve the wellness and wellbeing of the users. FocusCura does this by encouraging users to connect with their peers and their family members, for example, by playing bingo every Wednesday night with the tablet.

The second aspect concerns the quality of homecare. FocusCura tries to understand how their apps can improve the quality of homecare, free up time for staff members to help individuals, while at the same time encourage autonomy and independent living through remote assistance via the tablet and the video conferencing tool. Some users want to conduct their daily activities on their own but are afraid to do so without someone on the other side of the video call who can support them remotely and come to their home if they need help.

The third part relates to the medical aspect of aging in place. FocusCura recognizes the importance of providing immediate feedback to individuals who use the apps. You always have access to your own data. You can work with your healthcare team to set up individual targets. You can compare your progress with others managing the same disease. You can easily access a wide range of information about your disease through the app. Most importantly, when you add personal healthcare data in the validated care program, you receive instantaneous feedback on your own values.

These design details offer incentives to individuals to adopt the technology. FocusCura has understood that if we want to introduce these types of home health monitoring apps, we also need to make sure that patients reap the benefits of their use immediately. Many previous studies have revealed that individuals are not that concerned about their heart rate or weight. What matters to most people is feeling safe, secure, and supported in their everyday activities.

FocusCura apps and products can teach us a lot about how to think about the adoption of technology in the elder care sector and the need to provide instantaneous feedback to users. Technology is not the end; it is merely a means to increase the quality and accessibility of healthcare. It is a very powerful means. If we do not carefully study how technology impacts people, motivates patients, and influences healthcare workers, we cannot reap the benefits. FocusCura has certainly opened my eyes to what innovation in medical technology can mean for the future of elder care. I hope that I will have the opportunity to study this further.