How can I become a project participant? All of our participants will be sponsored by one of our project partners. If you are interested in participating in the project you would need to contact one of them. The sponsor will consult with you to determine your interest and qualifications for the project. If you and your sponsor both agree, your sponsor will recommend you as a participant. If the full project team approves that recommendation, you will then be included in the project and will be assigned a client coordinator from the sponsoring organization. The project partners that are authorized to sponsor a client include:
- North Shore Hospital and Care Center: Kimber Wraalstad – (218) 387-3260
- Sawtooth Mountain Clinic: Teresa Borak – (218) 387-2230
- Care Partners: Kay Grindland – (218) 387-3788
- Cook County Public Health and Human Services: Joni Kristenson – (218) 387-3605
- Boreal Access: Jack McDonnell – (218) 387-9471
How long will the project go on? In all likelihood the project itself will remain active through the end of 2013. We would like to install the last system no later than mid 2013. The project team would like to include some clients in the project that live in remote areas throughout the county; consequently we will have to hold off some of the installations until Arrowhead Electric Cooperative’s fiber-to-the-home broadband project is completed in those areas. There are no specified participation periods for clients. Clients will be free to end their involvement in the project whenever they wish or to continue using their systems long after the project ends.
What is the cost to get started? The cost for a client to participate is limited to the cost of a high speed internet connection, which they may already have or plan to have, and a monthly GrandCare subscription fee of $99.00. A more complete description of all of the types of costs associated with the installation and use of a home monitoring system and who pays for them is described below:
- Equipment costs: These costs include the base unit, the sensors that are selected to monitor wellness and activity concerns and the costs to install these items in the home. A typical home monitoring system installed in the home might cost in the range of $2,500.00 if purchased outright or $100 per month if leased. In the Peace of Mind Project, all of the equipment costs are covered by the project.
- Internet Service Costs: The equipment must be connected to a high speed internet connection. Today, we use a variety of techniques to connect to the internet. Some of these are fast enough, some are not. A Peace of Mind project team member can evaluate your internet connection to see if it is adequate for use with the monitoring equipment and let you know what other options might be available. The project will cover the cost of evaluating your internet connection and advising you on how you can upgrade it if necessary and possible, but the project does not cover the monthly fee that you pay to your internet service provider for your internet connection.
- GrandCare Subscription Fee: The national service provider that was selected for this project is GrandCare Systems. They provide the equipment and the online services that make it all work. Their local representative in Cook County is Boreal Access. The monthly subscription fee covers the online services as well as the ongoing system administration and support for the equipment that is installed. It is a fixed monthly fee of $99 per system. This fee does not vary, even if more than one person lives in the home and uses the system; or if multiple remote caregivers are granted some level of monitoring or communicating access to the system.
All of the above costs are associated with the monitoring system that is installed in the client home. In order for a remote caregiver to access the system, they will need a computer of their own (any standard computer will do) and their own internet connection. None of the computer equipment or internet service costs that a remote caregiver might incur are covered by the project. There are no additional GrandCare subscription fees for any remote caregivers.
The client will sign two agreements to participate in the project and to receive equipment and services from Boreal Access and GrandCare Systems. These agreements satisfy the federal Health Insurance Portability and Accountability Act (HIPPA) requirement. It must be signed by the client unless the caregiver has the power of attorney for the client in these matters, in which case the caregiver may sign those agreements. However, even if the client is the one to sign the agreements, the caregiver has the option of paying the subscription fee for the client if that is more convenient for the client.
What is the cost when the project is done? The project was designed to make it easy for a client to both continue using the GrandCare equipment and service for as long as they want, and to stop using them whenever they want, with no new or unforeseen costs. If continued use of the system is desired after the project ends, the client need only keep up their internet connection and monthly GrandCare subscription. Nothing in their service will change. If it is desired, or if it becomes necessary to terminate the service, the client or caregiver need only notify Boreal Access.
If an account is terminated or closed, the home monitoring system must be returned to Boreal Access and the terms of the current agreement will end at that time. However, we can foresee a situation where a client might travel, or be hospitalized for a period of time, but have an expectation of eventually returning home. They might not want to pay for a service that they are not using while they are away; but they might want or need those services even more when they return home. In this case, they should discuss their needs with Boreal Access to determine how best they might keep the favorable terms of the current agreement available to them.
Do insurance companies cover any of these fees that I have to pay? To the best of our knowledge, the answer is no. This is something that will evolve over time. The cost of a year’s worth of home monitoring is about the same as the cost of a one month stay in a nursing home. When home monitoring systems have been around long enough to prove that they really help people to stay in their own homes longer, the insurance companies who pay for those nursing home stays will no doubt find that paying for a home monitoring system is a bargain. Until then, this is primarily a family decision and it is primarily about the peace of mind of you and your family members. This is a question worth asking again from time to time and we will also monitor this issue for any change.
What kind of monitoring is done by this system? Monitoring falls into three categories and all of the monitoring is optional depending upon the needs and interests of client and their caregiver:
- Health or Wellness monitoring helps the client and their caregiver track such things as weight changes, blood pressure, blood glucose levels or any number of specific health related concerns.
- Activity monitoring helps to track activity levels such as changes in routine patterns of movement throughout the house, frequency of accessing such things as the kitchen or the refrigerator, problems or changes in sleep patterns or even who may be making unwelcome phone calls to the home. Activity monitors can also assist the client by automatically turning on lights when they enter dark hallways or by providing reminders to take medications.
- Safety monitoring may include alerts to the client and/or the caregiver about unsafe conditions such as stove burners left on too long, outside doors opening in the middle of the night or significant changes in wellness or activity levels.
Who gets to see what is monitored? It is assumed that the client has at least one primary caregiver, such as a family member whom they trust. The primary caregiver is given access to view all of the graphic reports of events and activity levels that have been recorded. The primary caregiver also has the ability to establish and edit rules that trigger actions, reminders, notification and alerts. The client and primary caregiver can involve as many additional caregivers as they wish for monitoring and alerting purposes with complete control over what is seen and not seen by the additional caregivers.
Because this project is intended in part to assess the value of this type of technology, both for seniors in the county and for the healthcare providers in the county, we will also grant your client coordinator access to your system. On occasion, the client coordinator will view the data that your system has collected in order to better understand what is valuable and/or what is problematic about how the system works. If the client coordinator discovers something important about the system that other members of the project team should know about, they will be free to share the minimum necessary information from your system in order to communicate that finding. However, under no circumstances would any information be shared with anyone not bound by the federal HIPPA laws.
It is also important to know that even though this system uses the internet, only those who have been specifically granted access to your data can find their way to it. This is an industrial strength computer system that effectively locks out any attempts to snoop or tamper.
Beside the fees, are there any other commitments that I need to make to be part of this project? Aside from the commitment you make to pay for your own internet connection, and the GrandCare subscription fee which you are free to cancel at any time, we have two requirements and one wish.
- The first requirement is that we ask you and your caregiver to complete a brief pre and post project survey that is designed to gauge your expectations and satisfaction with the system in order to know if it made any kind of difference in the quality of your life. The healthcare professionals are taking a similar set of surveys to gauge their reaction as well. None of the results will be attributed to any individual. The results will be compiled and reported in an anonymous fashion.
- The second requirement is that you sign the HIPPA agreement developed for this project. As stated earlier, the nature of Aging-in-Place technologies causes us to fall under and abide by the federal HIPPA guidelines for protecting your private medical information. Providing you a statement to sign is part of that requirement.
- Finally, the wish is that you might be willing at some point to share your insights about your experiences in using the system, both good and bad. If you recall, our primary purpose is to demonstrate to Cook County seniors that broadband may hold value for them. While we may be able to relate to them some of the experiences that you and others have had, none will be as valuable to Cook County seniors as those that come from one of their peers who has had first-hand experience with a system like this. If you agree to be interviewed later in the project, we would ask you a few general questions and ask if you had any interesting anecdotes to tell about your experience with the system.
I already have an emergency phone, will it continue to work? This system is not known to interfere in any way with other devices typically found in the home. Also it is not designed to replace anything currently in place in the home, be that an existing computer, telephone, home security system or life alert pendant. Each of these items has its own strengths that make it impossible for the providers of other types of items to warrant that theirs is inherently better. The decision to use one system or multiple systems, or to replace any one system with another, should only be made after careful consideration of how well each device meets your particular needs.
Will my home care nurse, or other healthcare professional, go away because I now have this machine? This system is not intended to replace your existing healthcare services. It can augment your existing services and it can be used to better coordinate and integrate your existing services, but it should not be considered as a replacement for them. We could foresee a situation in which a visiting nurse could satisfactorily check on your condition as frequently or even more frequently than they do now at much less expense than is the case now, by using these remote technologies rather than making a personal visit. But that would have to be an agreement that you and your nurse make together. A nurse only gets to monitor you remotely if you choose to allow it.
Can my primary care physician be involved in this project? We would very much welcome your physician’s involvement. We fully expect that one day physicians will use these technologies routinely to deliver some types of healthcare. If your physician has an interest in trying out this mode of interaction with you, your primary caregiver can grant access to him or her. If your physician would like to see a new type of home monitoring sensor installed for their purposes, you should contact your client coordinator to see if the project has the ability to buy that sensor for you.
As a caregiver, can I expect that you will help me monitor my loved one using this system? The project team exists to help a client and caregiver adopt the technology for their own use. The project team itself does not assume any care giving responsibility. Some clients may solicit more involvement from one of our healthcare partner organizations or perhaps a healthcare organization that is far removed from Cook County. That involvement could take place concurrent with the project and supported by the installed system. However, whatever monitoring responsibility that would exist due to that involvement would be beyond the scope and responsibility of the project team. If monitoring assistance is needed for this system to be useful for you and your loved one, it would be important to discuss that need with the sponsoring member of our project team when they consult with you about your involvement in the project.