Wellness Checks

"Are you okay?" "Have any problems occurred in the last 24 hours that you feel need attention today?" "Are there any issues around your home that could cause problems for you today?"

These questions are being asked around town — by a computer. Wellness Check programs such as Guardian Calling by Reverse 911, C.A.R.E. by DCC and Command Caller by Voice Technologies, usually integrated into Emergency Notification Systems, monitor local residents to ensure they do not require assistance from emergency personnel. Residents sign up for the program with local public safety departments, typically police and fire, to be called daily or even multiple times in the same day by the computerized system. When the resident is called, he responds to the scenario that was created in the ENS. If no reply or an incorrect response is received, the resident’s caregiver is notified and asked if he can respond. If the caregiver is not available, emergency personnel is dispatched.

Implementation and call flow varies among municipalities. In Upper Arlington, Ohio, the Kind Call Program (utilizing C.A.R.E.) has a coordinator who interacts with the community to enroll residents in the program, often by attending senior health fairs and communicating with police and fire personnel.

The program in Birmingham, Ala., currently has 2,500 residents enrolled and the numbers continue to grow. According to Mark Henderson, senior communications technician for the city of Birmingham, new names are entered into the system every Wednesday following the city council meetings. Regardless of which system is being used, all of the program administrators indicate the response from participants is overwhelmingly favorable. Birmingham’s system includes several scenarios that were designed based on feedback from residents, including scenarios for the elderly, disabled, domestic violence victims and other victims of crime. Henderson finds the product especially beneficial when used by residents with cognitive disabilities.

"When the system unexpectedly went down temporarily, people cried," said Henderson. "Doctors even called."

While the programs are implemented to save lives, there is no avoiding ROI. Wellness checks decrease reliance on 911 and minimize the number of police and fire units that are dispatched. Henderson states the cost for dispatching a unit in Birmingham is $750, estimating the city saves at least $20,000 a year by using C.A.R.E.

Kevin McCarthy, vice president of Reverse 911, adds that the Guardian Calling feature of Reverse 911 is often used by facilities that are open all night or at high risk of crime, such as convenience stores and guard shacks. Command Caller, based on VBVoice, does not have a module specific to wellness checks.

However, Paul Wilson, vice president of Voice Technologies, states that the open architecture of the system makes wellness check scenarios possible. "The system is primarily used to get the word out quickly to a lot of people," said Wilson. "But it can do other, very targeted tasks, (including wellness checks)."

Similarly, the Canadian government recently explored implementing Command Caller to enforce home quarantine of SARS patients. While the system was never needed due to the resolution of the epidemic, the system was to include voice printing to ensure the targeted individual is responding to the prompts.

Voice Technologies uses ScanSoft and Fonix TTS and typically uses Nuance as the speech recognition platform.

The ramifications of wellness checks are broad. Utilization can provide peace of mind to family members while allowing enrollees to exercise more independence. But while Guardian Calling is a popular module in the Reverse 911 system, McCarthy estimates there are about 100 units currently in use.

Jamie Hoskins, product manager at DCC, reports similar numbers. While DCC has approximately 900 Communicators (the base product for C.A.R.E.) in use internationally, Hoskins believes there may be only 50 clients currently taking advantage of C.A.R.E.

Dina Garcia, a commissioner for the Los Angeles City Commission on Disabilities and a System Change Advocate for the Westside Center for Independent Living, herself disabled, had never heard of wellness checks. Upon being questioned as to the value of these programs, she responded, "Awesome," adding it is a priceless tool in responding to homebound residents whose caretakers arrive late, or not at all. A client once told me her attendant was unreliable, and on one occasion did not show up for three days. This client was left in bed, unable to move, let alone drink, use the restroom, or call for help, resulting in dehydration and bedsores. Had she been enrolled in a wellness check program, assistance would have arrived before her health had been compromised. To ascertain whether a wellness check program is available in your area, contact your local public safety departments.

Robin Springer is the president of Computer Talk ( www.comptalk.com ), a consulting firm specializing in the design and implementation of speech recognition and other hands-free technology services. She can be reached at (888) 999-9161 or contactus@comptalk.com.

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