Mobile care services take the care to the patient

Text: Kreetta Haaslahti, Photos: Julia Hannula

When working at the Satakunta Central Hospital Emergency Room, the Chief Physician Katriina Lähteenmäki realised something. There were too many patients seeking treatment from the Emergency Room without real need for emergency services or any gain from their visit. This was a burden to the Emergency Room and especially elderly patients were transported around for no reason. There must be a better way to do this, Lähteenmäki thought and set to work straight away.

In the spring of 2014, Lähteenmäki took up work with the Basic Services of the City of Pori, and the introduction of the mobile care services system she had developed began. In a couple of years, the services have become established in the operational area of the Basic Services in the Pori region, and in late 2016 they employed one specialist, two GPs and four nurses alongside Chief Physician Lähteenmäki. 

Lääkäri Jenni Merimaa ja sairaanhoitaja Mari Kujansuu © Julia Hannula

Doctor Jenni Merimaa and nurse Mari Kujansuu work together face to face, but also with the help of wireless connections in the mobile care services offered by the Basic Services of Pori.

Professional orientation of the services

The mobile care services are professionally oriented: a social or healthcare professional contacts a mobile doctor as soon as a problem is detected for which a doctor’s view is needed in the course of the same day. The goal of the services is to avoid unnecessary visits to the Emergency Room by taking urgent examinations and care to the patients in sheltered housing and institutions of care, and in so doing to listen to the patient and respect their autonomy and opinion.
“If a nursing professional wonders if a patient should be taken to the Emergency Room for a doctor’s examination, it is possible to telephone a mobile doctor first. The doctor makes an assessment and a home visit, if necessary. This means avoiding unnecessary patient transfers,” explains Chief Physician Katriina Lähteenmäki.

Sairaanhoitaja Mari Kujansuu © Julia Hannula

Nurse Mari Kujansuu packs the equipment in a rucksack and drives off for a home-visit with a patient.

It can be easier for the patient to function in a familiar environment.
“A lot of the times, elderly or disabled people have to wait for a long time at the Emergency Room. An unfamiliar place with unfamiliar people can be tiresome and confusing, especially for elderly people suffering from dementia. As a part of the mobile care services, a patient is treated at home if possible or transferred directly to a department at the local hospital.”

Help from a video connection

In 2016, a video connection has been tested as a part of the mobile care services with nurses contacting doctors from patient homes using a connection on a tablet computer.
“The video connection can be helpful in assessing changes in skin, breathing, neurological symptoms and speech.” 

Mobiililääkäri Marjo Santavirta © Julia Hannula

Nurse Raija Laakso (on the tablet screen) in a video conference with mobile doctor Marjo Santavirta.

The nurses have completed the necessary checks and examinations requested by the doctor, and it has been possible in most of the cases to make a diagnosis with the help of a video connection.
“The patients and their families have been very happy with the trial. It has been made easy for the patient to receive help from a doctor. This way, it has been possible to create an alternative to a visit to a health centre or Emergency Room for elderly patients or those in poor health.

Mobiililääkäri © Julia Hannula

This is how a contact request from a nurse appears on the screen of the mobile doctor’s tablet device.

Doctor’s services enabled by a video connection could be offered for faster and more efficient treatment especially in remote areas. This could generate significant savings in the use of resources and time.
“The video call option has been found very useful and practical among patients, nurses and doctors alike.”

The decision has already been made to continue the use of the nine tablets that were received for the trial at the Pori Basic Services.
“The opportunity to make video calls should be introduced more widely to professionals in home care services and care units in the Basic Services operating in the Pori region; the matter has been discussed, but no decisions have been made yet,” Lähteenmäki comments.

Välineet sujuvoittavat mobiilitoimintaa © Julia Hannula

Equipment that helps mobile operations run smoothly: mobile phones, tablet computers and equipment carried in a rucksack that help the nurse to carry out the necessary checks and examinations requested by the doctor at the home visit.

Tablets received from the HYVÄKSI project

The introduction of tablets is a part of the HYVÄKSI Project (Innovation Network of Welfare Technology) coordinated in cooperation with Prizztech Oy and the Satakunta University of Applied Sciences. This project helps professionals in social services and health care to receive new information and user experiences of the opportunities offered by new technology and get a chance to test how they work in practice.

Bringing the customer experience into focus in product development and testing will help to design technology that meets user needs and is easy and agreeable to use. Target groups include the elderly, people with disabilities, dementia patients and disabled people as well as the families of the aforementioned groups and nursing professionals. The HYVÄKSI project is ongoing from 1/11/2014 to 30/09/2017 and it is funded by the Regional Council of Satakunta (ERDF), municipalities in the Pori region (Pori, Harjavalta, Kokemäki, Pomarkku and Ulvila), and the Satakunta University of Applied Sciences.