Providing the best possible care to at-risk Australians
There is an emerging trend for care agencies to supply non-monitored personal alarms to their clients as opposed to monitored health alarms. Generally, this can be put down to the cost of monitored health alarms in comparison to non-monitored alarms, however, this decision raises several concerns regarding the safety of at-risk Australians and the effectiveness of emergency responses.
What is the difference between monitored and non-monitored health alarms?
Where a monitored health alarm sends medical alerts directly to a professionally trained emergency operator in an emergency, non-monitored alarms call or text pre-programmed contacts and display the user’s location on a Google map on their smartphone.
The key difference between these two medical alarm types lies in the level of response and immediacy. With a monitored alarm, users are connected 24/7 to emergency services, allowing immediate emergency response. Non-monitored medical alarms primarily depend on the availability of an emergency contact, as well as the extent of their knowledge regarding the correct actions to take. While non-monitored alarms perform calls and texts to family members, friends and caregivers, there is no guarantee that these notifications will be seen or answered immediately. This can cause a delay in receiving help and emergency assistance, potentially leading to further complications.
Limitations of Non-Monitored Medical Alarms
Non-monitored medical alarms do not offer the same level of assurance or quality of emergency response compared to professionally monitored alarms. Rather, the emergency response is dependent on the availability of the pre-programmed emergency contact to take any emergency calls or texts, and their ability to respond. In many cases they may be busy at work, taking other calls, unable to respond due to distance, or their mobile phone may be switched off or not in a mobile service area.
Also, modern telecommunications networks do not guarantee the delivery of text messages, and text messages may suffer very long delays during periods of network congestion.
Can non-monitored alarms contact emergency services directly?
It is PERSLs understanding that if the 000 emergency service is listed as a pre-programmed responder for a non-monitored medical alert device, and there is no voice contact with the user, there is no way to determine if the call is a genuine emergency. This means the alarm activation will not be given a high priority by ambulance services, or may not be otherwise acted upon. It is also PERSLs understanding that ambulance services may not be able to retrieve the GPS location from the text messages.
With a 24/7 monitored service, every emergency call is answered by a professionally trained operator, they will have access to the user’s information, medical history, and location. The operator will attempt to speak to the person needing assistance to determine the nature of the emergency and will give reassurance that help is at hand. A significant number of alarm calls are non-emergency calls or false alarms, and the ability of the operator to determine the nature of the emergency very often avoids an unnecessary ambulance call-out.
If an ambulance is required, the operator will pass the client’s details, including any relevant medical information, to the Emergency Services Operator and ensure the appropriate priority. If voice contact with the client is not possible the operator will follow a procedure previously agreed with the client or the client’s representative.
Australian Standard AS4607
AS4607:1999 is the Australian Standard for the provision of Centrally Monitored Medical Alarms. It specifies the minimum Standards for alarm equipment, alarm installation, and alarm monitoring services. As largely an outcomes-driven standard it is relevant to all new-generation medical alarms operating over the mobile phone service that call into a Central Monitoring Service.
Alarm centres complying with AS4607 record detailed information on all alarm events, and can make this information available within the terms of their privacy policy. Conversely, there is no Australian Standard for the provision of non-professionally monitored medical alarms. (Generic EMC, Safety, telecommunications and radiocommunications Standards only relate to the electrical safety and the technical characteristics of the equipment).
There is also little ability to measure the outcomes or cost-effectiveness of providing non-monitored medical alarms.
Organisations that arrange or fund these systems on behalf of their clients should be wary of using any systems that do not comply with recognised Australian Standards. Funding, recommending, or arranging non-standards-compliant systems may legally expose the organisation when hardware or systems fail.
Benefits of a Monitored Medical Alarm
There are a number of benefits associated with personal alarms, one of the greatest being the peace of mind they offer to users and their friends, families, and carers. Personal safety for those who are at risk is crucial, and a monitored alarm system provides an extra layer of security and safety.
There are a range of flexible options available, including wrist or neck-worn pendants, some with fall detection, as well as mobile and watch personal alarms, all are able to quickly connect the user to a 24/7 monitoring centre. This allows for faster responses to emergency situations, tailored to the needs of the individual.
Monitoring services have extensive redundancy in both equipment and telecommunications paths, thus avoiding single-point failure and ensuring backup communications mechanisms are available in almost every situation.
Additionally, monitoring companies automatically test each medical alarm on a very regular basis to ensure the equipment is operating correctly. Clients are also encouraged to make manual test calls, and the monitoring service will follow up with the client if a manual test call has not been received as expected. This ensures the client knows how to use the alarm system in an emergency, and gives greater reassurance that help is close by should they need it.
These capabilities go well beyond simple monitoring and alerting and set the monitored medical alarm industry participants well apart from non-monitored alarm alternatives, resulting in significantly better care for their clients.
Many of PERSL’s member monitoring services add further services such as the ability to share critical information with emergency services including health and home access details and also provide valuable feedback to family and care providers to ensure continuity of care. This information can be critical to prompt and better health outcomes.
Summary
The reliability and quality of medical alarm provision can only be assured if all medical alarms use a 24/7 professional medical alarm monitoring centre.
Providing professionally monitored medical alarms assures that all clients receive the same quality of equipment and services and that all emergency events will be handled with the same high degree of professionalism and effectiveness. A monitored personal medical alarm also promotes independent living and peace of mind for users and those around them.
Conversely, the provision of non-monitored medical alarms will result in disparate outcomes through contacting only emergency contacts, who may not be available or know what to do, and could also result in a higher number of unnecessary ambulance call-outs.
As the peer industry association in this field, PERSL recommends the use of systems that adhere to AS4607. PERSL members also adhere to high standards for quality services and ethical conduct.
The Personal Emergency Response Services Limited (PERSL) is the Australian peak body representing manufacturers, suppliers, monitoring services and consumers of 24/7 monitored Medical Alarms and Personal Response Services (PRS). We estimate there are circa. 300,000 aged and at-risk Australians using professionally monitored medical alarms, both in their own homes and in residential aged-care facilities.
In making this submission the medical alarm industry seeks to ensure the highest possible level of service, standards, access, and equity in the delivery of Personal Response Services in Australia.