Hospitalizations and other negative health events are detrimental to seniors’ health and costly to the healthcare system. Proactive health monitoring may help seniors avoid negative health events and remain safely in their homes for longer. Many seniors do not have the skills, knowledge, or technology to regularly monitor their health at their own at home. Without regular, proactive health monitoring, we cannot identify seniors at risk of negative health outcomes (like hospitalizations) before such events occur. Having trained home support workers (caregivers) use their skills and technology to monitor seniors’ health makes proactive health monitoring more accessible to seniors receiving home care. In this project, trained caregivers use technology to proactively monitor seniors’ health for risk factors that could predict hospitalizations or other negative health outcomes. Seniors’ complete regular health assessments with their caregivers. Caregivers enter the results into a mobile app for analysis. The assessments involve physical health (like weight and blood pressure) and cognitive/mental health (like word recall and quality of life). All equipment is provided in a kit that is stored in the senior’s home. We anticipate that seniors will appreciate regularly checking on their health. Caregivers will benefit from learning new skills and having a new way to positively impact the seniors they care for. We anticipate showing that it is practical to have trained caregivers use technology (secure mobile app) to monitor the health of seniors receiving home care. We also aim to investigate if trends in seniors’ health can predict negative health events, like hospitalizations.

1. • Associate Director | Institute of Biomedical Engineering, UNB
• Associate Professor | Electrical and Computer Engineering
• Director | Health Technologies Laboratory
• Adjunct Professor | Dalhousie Medical School NB
Feb 23, 2022 | Erik Scheme, PhD, PEng
Technology-enabled Proactive
Community-Based Health
Assessments

2. Expertise:
 Data Science
 Machine Learning & AI
 Signal Processing and Control
 Human Machine Interfaces
 Internet of Things
Applications:
 Diagnostics & Prediction
 Digital Health
 Aging in Place
 Rehabilitation
 Biometrics
Research Themes: The Design, Translation, and Impact of Technology on
Human Health, Movement, and Happiness
Erik Scheme, PhD, PEng

3. Costs:
+$100M
2016
20%
2023
25%
% of New Brunswickers
with 3+ Chronic Conditions
New Brunswickers are
among the UNHEALTHIEST
in the country
Have at least one
Chronic Condition
62-77%
$1,266
$2,866
$5,232
PER PERSON
PER YEAR
2X 4X
0
Chronic
Conditions
1 or 2
Conditions
3+
Conditions
From: GNB & New Brunswick Health Council
The Need

4. Scared and alone
 Drowning in an epidemic of chronic
disease, and fear and loneliness rival the
worst among them
 Informal caregiver sector that is ready to
break
 No ability to plan for changes in state (level
of care)
How can we provide care?
How can we enable more effective community
supports for aging in place?
show we

5. An ill-suited, inefficient system
 Overwhelmed and reactive
 Poor access, client experience
 Increasing costs
 Difficult to plan Lack of Context
Chronic need, Acute
Response
Subjective Assessment
Ounce of Prevention,
Pound of Cure
What’s Missing?

6. Why Not Technology?
Concern Cost
Complexity

7. Proactive Health & Wellness
 Principal Investigator:
Dr. Erik Scheme (Engineering)
 Collaborators:
Dr. Emily Read (Nursing)
Dr. Pamela Jarret (Horizon)
Dr. Inder Chopra (IBME)
Dr. Dawn MacIsaac (ECE/CS)
Dr. Natalia Stakhanova (Usask, CS)
Dr. Scott Bateman (CS)
Dr. Suprio Ray (CS)
Use Regular Health Monitoring to Promote Human Connections
… and enable proactive planning and intervention
The PITCH Team
With support from

8. 6
API
1
2 3
Administration
Outreach Personnel Medical Professional
Proactive
Engaged
Oversight
Escalation
Data Repository
& Analytics Engine
Context Trends
Circle of Care
Personalized
4
Facilitator/Provider
Actionable Data
Customization
Modular Toolkits
Health System
Process Improvement
Intervention
5
Population Data
Planning
The PITCH Model

9. PITCH Toolkits
Customizable Based on Client, Organizational, or System Needs
Diabetes
Glucose Test, Waist Circumference
Congestive Heart Failure
Heart Rate, Symptoms
Mental Health
Self-Perceived Mental Health Assessment
Cardiovascular Disease
Health History, Cholesterol, HDL, LDL, Triglycerides
Hypertension
Blood Pressure
Obesity
Weight, BMI, Percent Body Fat, Nutrition
Dementia
Mini COG, MOCA
* Examples
Social Determinants
Care team, outings, visitors
COPD
Spirometry, Oxygen Saturation
Medication
Prescription, adherence, changes
Frailty & Mobility
Timed up and go, 6M Walk test

10. Proactive Health & Wellness
 A simple-to-use mobile interface for collecting
routine health assessments.
PITCH. automates and streamlines
assessment workflows, enables quality
interactions between seniors and those who
care for them.
 A secure and private platform powered by the
VeroSource Framework (VSF)
The PITCH Platform
PITCH. Assessments

11. Proactive Health & Wellness
 The PITCH Analytics Engine automates
the analysis of acute and longitudinal data,
highlighting anomalies and emerging
trends to inform preventative action
• Tunable alert settings
• Personalized insights
• Adaptive machine learning
The PITCH Platform
PITCH. Analytics

12. Proactive Health & Wellness
PITCH. Sharing
 PITCH Sharing organizes and presents
health & wellness data in a way that's easy
to understand and provides quick and easy
data sharing with friends and loved ones.
 Trigger customized alerts with tunable
settings
 Engage and connect the circle of care
The PITCH Platform

13. 13
 Validate the feasibility of using PITCH. Assessments (named
Wellness Check) to conduct regular health assessments in the
community
Wellness Check is available on
Android and iOS
 Leverage regular visits from Kindred’s personal support workers
and established network of clients
• Train caregivers to use the platform and conduct health and
wellness assessments
• Complete needs assessment and user acceptance testing
• Understand factors that may predict changes in a senior’s ability to
stay at home
• Perform a retrospective analysis of assessments to identify whether
state changes could have been predicted
Health Seniors Pilot Program

14. 14
Health Seniors Pilot Program
 Trained almost 200 Kindred personal support workers
from across the province
• PITCH Platform
• Blood Pressure, Weight, Walk Test
• SF-36, Mini COG
• Notables
 Assessed over 100 users weekly over 8+ months
 Interruptions initially due to COVID, but Kindred pivoted
and quickly returned to sustained service and
assessments
 Integration with Kindred Salesforce platform

15. Early Feedback
“One of the best feelings was being thanked by his
nurses and doctors as they believed the WCI to be a
great motivator in this client's situation. I am looking
forward to recruiting more clients for this project in the
future!”
- Personal Support Worker
Health Seniors Pilot Program
 Noted improvement in communication with clients,
senior engagement and motivation
 Anecdotal benefits reported by support workers,
Kindred, and circle of care
“It’s comforting to check-in regularly
and see you’re on an even basis, no
ups or downs.”
- Client Participant
“When you don’t know you worry;
being able to check is comforting.”
- Client Participant

16. Qualitative Analysis
Emerging themes:
1. Improved access to medical assessments (especially during the pandemic)
2. A motivator for further action
3. Importance of mental health discussions
4. Reassurance/Reduced Anxiety
5. Improved Caregiver satisfaction/Sense of Purpose
Health Seniors Pilot Program
 Conducted Interviews with clients, caregivers and management
 Transcription complete, and ongoing thematic analysis of recordings

17. Quantitative Analysis
Health Seniors Pilot Program
Analyses ongoing
 Vs. control group
 Pre- vs post
 Outliers & trends
 Vs. Notables

18. Quantitative Analysis
Health Seniors Pilot Program
Analyses ongoing
 Vs. control group,
 Pre- vs post
 Outliers & trends
 Vs. Notables

19. Health Seniors Pilot Program
Earlier assessment
Last assessment before hospitalization
Earlier assessment
Last assessment before hospitalization

20. Mental Wellness – Population Summary
SF36 – Perceived Role Limitations due to Emotional State
Red
Orange
Yellow
Green
Circuit Breake
Covid
Phase
Ability
to
complete
daily
roles
(higher
is
better)
Health Seniors Pilot Program

21. Physical Wellness – Population Summary
SF36 – Perceived Role Limitations due to Physical State
Ability
to
complete
daily
roles
(higher
is
better)
Red
Orange
Yellow
Green
Circuit Breake
Covid
Phase
Health Seniors Pilot Program

22. PITCH. What’s Next?
 Application for HSPP Round 3, with CIRA and York Care Centre to scale size and function
 Evaluate the different needs and impacts across 3 levels of care
• Nursing Home
• Assisted Living
• Community
 Demonstrate PITCH data sharing capabilities by including clients’ circles of care
• Not included during HSPP Round 1
 Explore Opportunities for Commercialization and Continue to Scale
• Additional use cases and Integration models
• Augment virtual care, support decision making
• Build ML-based prediction models

23. Independent, audited data custodian
NB Digital ID and Circle of Care
Securing and Linking
VSF GaaS
VSF DaaS
PITCH
Offer to PSW students for training
Offer
for
Free
• Dept. of Health
• Dept. of Social Development
• Program and Policy Analytics
Dept. of Health is already a subscriber
Joint DoH & SD subscription
DataLocker ensures that data is secure
and isolated by facility and follows
partner data governance agreements
VSF DaaS DataLocker
• Personal Support Workers
• Long Term Care Facilities
• In Home Care
Families
State-of-the-Art Analytics and AI Research
PITCH. What’s Next?

24. escheme@unb.ca
Feb 23, 2022 | Erik Scheme, PhD, PEng
Thank you!
… and everyone involved in the HSPP
program
@escheme
Thank you to Aaron Tabor and Janelle Aikens for their help in preparing this talk!