This program empowers individuals to take an active role in managing conditions that lead to hospital admission, Chronic Obstructive Pulmonary Disease and Congestive Heart Failure. The program has easy to use equipment to measure key biometrics (e.g. weight, blood pressure, blood glucose and blood oxygen) so that patients can monitor their conditions at home and answer questions concerning their symptoms each day. The Remote Care Monitoring Team monitors patient’s biometric data and responds back to them with a helpful management plan and ongoing coaching and education as needed.
The local collaborative model has these 3 community partners: Community Paramedic Program, Primary Care, and Home and Community Care Services. The partners work together, maximizing the capabilities of their team members and providing long term sustainability that will ultimately benefit the patient as they manage their condition together.