March meeting: Aging in Place Supported by Continuous Wellness Monitoring As the population ages, New Brunswick is seeing an increasing number of people who wish to age in place at home. Care for these adults increases in complexity as they age and become frailer, particularly towards the end of their lives. This project provides 24/7 support for healthy aging in place, at home, using a virtual care platform, that will allow for remote patient assessment, planning, monitoring, implementation, and evaluation. The use of a virtual-care, continuous wellness monitoring platform and associated services, is demonstrated in this project to improve many metrics of wellness, patient, and provider satisfaction, and increase the efficiency of care delivery at a lower cost. This platform can empower older adults with tools to age in place; reduce emergency room visits/rehospitalization and paramedic calls; increase the interconnectedness of seniors with friends/family, informal caregivers, and senior advocates; support and connect formal caregivers, such as social workers; and delay/reduce admission to residential facilities. Presenters: Dr. Keith Brunt and Pat Kelly

1. Aging in Place Supported
by
Continuous Wellness Monitoring
Routinify HSPP Pilot Project

2. Routinify Overview:
● Seniors want independence & need easy-to-use systems
built for them to manage health at home & connect to
virtual care & health support services.
● Healthcare system needs to be supported by automation
and digital tools that work efficiently and are patient
centered (not administrative process centered).
● Healthcare Workers need to be connected & feel
supported by technology, while maintaining professional
autonomy to care for and monitor patients.
● Primary Care Providers need a medical home for
patients to coordinate healthcare plans, schedules, data, &
assess adherence, so outcomes are met (avoiding low
acuity ER visits)
● Government needs to build a health system that ensures
patient follow-up & access-to-care is reliable, easy, more
efficient uses human resources and provides automation
to control costs, waitlists, and reduce access barriers.
● Home grown technology providers funded & built by and
for citizens require integration & opportunity to scale to
meet these needs iteratively and sustainably.

3. WellAssist
In-Home
Continuous
Wellness
Monitor
• Internet of Medical Devices
• Exercise
• Sleep
• TeleCare/Medicine
• Homecare Coordination
• Nutrition/Hydration
• Medication Compliance
• Mental Actuation
• Socialization
• Alexa / Google Assist
• Community / Government Resources

4. Healthy Seniors Pilot Program (March 2022-23):
Identified 58 Aging Seniors in their Home utilizing Valley
Health Primary Care Team and Routinify WellAssist
Platform supporting Patient self-care, provide in-home
access portal to virtual-care, support Informal Care
Providers and Formal Primary Care Team (MD, NP,
PharmD).
Each senior household was equipped with an internet
pre-connected WellAssist tablet, and associated health
monitoring devices and a digital care plan/schedule
prescribed or determined by Primary Care Team or by
specialist referral recommendation.
Care services were augmented by Routinify staff nurses
for outcome monitoring, care coordination of Visits,
Consults or Referrals (electronically or in-home, or in-
person), non-medical and preventative care,
socialization coaching, virtual care services, and periodic
health assessments or survey components guided by
MEKTU and approved under REB collected as data.

5. Results / Findings
● Detailed results available through MEKTU
○ Pilot complete.
○ Final report to be file by June 30
○ Q1 2023 results to be filed in April will be 80-90% of final results
● Technology Adoption - aging adults had no issues with the technology
○ Properly designed - Designed by/for seniors with various challenges, 3
years of feedback
○ Rationale for use - WIFM, why will this be good for you
○ Support - not tech support, but part of the daily conversation, all
participants in the CareCircle need to reverberate role
○ Habit #1 - part of daily routines, not a nag

6. Results / Findings
● Improvements in individuated Routine Behaviours
○ Sleep
○ Physical Activity
○ Med Compliance
○ Vitals monitoring
○ Nutrition
○ Socialization / Mental actuation
● Improved feelings of wellbeing
○ Confidence in ability to age in place
○ Reduction in feelings of isolation, paranoia, depression
● Increased access/utilization of community resources

7. Results / Findings
● Remote Care Workers - Routinify hired staff to provide the virtual care
services - ideally this would be taken up by existing human resources. All
were nurses and/or LCSWs augmenting “day” jobs and found the work to
most enjoyable and many nurses felt they would be willing to return to nursing
with this support or come out of retirement for this type of work.
● In-home service providers were reluctant to participate as concerned their
work was being monitored or that they would not be compensated for virtual
care services or digital care plan automation.

8. Due to a family history of diabetes, My Physicians and I have monitored my blood sugar for a long time. I
have been able to maintain control with diet alone until 2018, when I required steroid shots and the result
was uncontrolled blood sugars. I was placed on metformin. I have been able to maintain my blood sugars
with the same dose of metformin and diet.
At the beginning of this pilot I recorded under 1000 steps per day. By November I had increased to 3,000
to 4,000/day without being exhausted and my blood sugars were stable. I could not have done this without
the devices and support I was provided by this study. I could monitor my activity so I could determine the
impact on my blood sugar. Also, the reminders to rehydrate were appreciated. I should mention on
Christmas day I was able to do 7,700 steps.
I have a new lease on life – cancer free and able to walk and stand. I can now stand for 1 ½ hours,
something that was unthinkable last July. Also, I can stand straighter which helps my back and balance.
I really am grateful for the companies and researchers working together to enable seniors and diabetics
have a better quality of life. Would I participate in another study – a definite yes.

9. Next Steps
● Routinify is prepared to offer this service at scale to any location in NB.
● Routinify is prepared to provide the remote care services directly, but we will
train/equip any organization to provide the services.
● Routinify Healthcare Contact Center - behind all that you see here, is a
comprehensive healthcare CRM and care ticketing system that we use to
distribute and manage the care requests to the Remote Care Workers.

10. Remote Care Package - $400/mth
● Enroll and educate the client and their CareCircle on WellAssist and the
CareCircle
● WellAssist Continuous Wellness Monitoring kit (Tablet, PURs, beacons,
wearable)
● Onboarding Assessment with client and CareCircle
● Routinify Care Team will Oversee and Manage the Care Plan, editing the
Smart Routines as necessary or directed by guideline expectations
● Routinify Care Team will Monitor Client and Manage Data: daily health
checks/ reviewing data, data analytics and reporting.
● Routinify Care Team will manage Care Coordination: coordinate clinical
outreach to clients, care teams, CareCircle based upon client self-reporting,
changes noted in patterns of behavior, vital signs, sleep patterns (PRN) etc.