Dispatching and Management Center for Optimizing Home Care
Integrated Services
Virginia Săndulescu
, Sorin Pușcoci
, Monica Petre
, Sorin Soviany
Mirabela Chirvașă
and Alexandru Gîrlea
National Communications Studies and Research Institute (INSCC Bucharest), Bucharest, Romania
QuickWeb Info, Romania
Keywords: Home Care, Home Care Services Provider, Integrated Services, Teleassistance, Assisted Living.
Abstract: The paper summarizes the design specifications for a complex ICT platform for optimizing home care
integrated services. It is based on the work involved in implementing the project with the same title
“Dispatching and Management Center for Optimizing Home Care Integrated Services”. The project aims to
create a network of centers that offer services to home care service providers (HCPs). The centers in the
network should optimize the activity of the home care service providers and support them in offering quality
standardized services through the usage of a complex platform that optimizes most of the activities involved
in offering home care services. The proposed system does not focus on the home care system, but
concentrates on the software and hardware components that will allow a home care services provider to
perform in a very efficient way. It may be compared to an ERP (Enterprise Resource Planning) system
customized and dedicated to HCPs. As far as we know, there is no such system implementation currently on
the market. The main beneficiaries are the home care service providers along with their end-users (elders,
chronic patients or people who need ambulatory treatment), who will ultimately receive better services.
Population aging is a growing problem that needs to
be addressed. The 2018 Ageing Report (European
Commission, 2018) shows projections of age-related
expenditure on the basis of a new population
projection by Eurostat. The report shows that the
category of people aged 65 and over will become a
much larger share, rising from 19% (2016) to 29%
(2070) of the population, those age 80 and over will
also become more numerous rising from 5% (2016)
to 13% (2070). This is projected to happen while the
active share of the population will become
substantially smaller, declining from 65% (2016) to
56% (2070). The old-age dependency ratio (people
aged 65 and above relative to those aged 15-64) in
the EU is projected to increase by 21.6 pps., from
29.6% in 2016 to 51.2% in 2070. The EU would go
from having 3.3 working-age people for every
person aged over 65 years to only two working-age
persons. Most of this increase is being driven by the
very old-age dependency ratio (people aged 85 and
above relative to those aged 15-64) which is rising
by 14 pps (8.3% to 22.3%). This leads to new
challenges in providing assistance for aging people
in maintaining an independent living, preferably at
home. Solutions are sought in using ICT support for
delivering care services at home to those that need it
(due to age/ non-age-related problems).
Offering medical and social care services at
home may be accomplished by the means of an
integrated home care system aimed towards people
with a high dependency degree or with low mobility
for maintaining their autonomy and increasing their
quality of life.
Home care services should be available and
affordable for all the elderly and contribute to their
wellbeing, in their living environment. The purpose
of these services is to allow the main beneficiaries to
live in their own homes as independent as possible,
while maintaining their safety and enjoying social
activities. The elderly should be able to choose the
timing and the types of support services they wish to
In the presented context, the paper describes the
work involved in implementing the project with the
same title “Dispatching and Management Center
for Optimizing Home Care Integrated Services”. The
project aims to create multiple partnerships for
knowledge transfer in order to develop the ICT
andulescu, V., Pus
coci, S., Petre, M., Soviany, S., Chirvas
a, M. and Gîrlea, A.
Dispatching and Management Center for Optimizing Home Care Integrated Services.
DOI: 10.5220/0007743902550261
In Proceedings of the 5th International Conference on Information and Communication Technologies for Ageing Well and e-Health (ICT4AWE 2019), pages 255-261
ISBN: 978-989-758-368-1
2019 by SCITEPRESS – Science and Technology Publications, Lda. All rights reserved
support necessary for the implementation of multiple
Dispatching and Management Centers for
optimizing home care integrated Services (referred
to as CDMS), as a support for offering medical and
social services at home. A CDMS is designed to be a
platform operated by a service provider for multiple
Home Care Providers (HCP).
HCPs represent a field of activity with an
increasing demand in the current years in Romania
and also in Europe. Considering the increasing
number of old people in Romania and the fact that
the medical system struggles to handle the long-term
hospitalization of people suffering from chronic
affections, the role of home care services providers
increases. HCPs may offer social and/ or medical
services. Offering medical and social services at
home can be optimized by using a support platform
based on ICT integrated in a CDMS.
A CDMS may bring significant improvements in
the management of technical, human and economic
resources of an HCP as the project aims to solve the
technical and organizational matters involved in the
development and implementation of HCPs.
The project proposes a platform that facilitates
and optimizes the integrated (medical and social)
services offered by home care providers. Figure 1
shows a quick overview of the proposed services to
be offered by HCPs through the usage of a CDMS
platform, ranging from medical/ palliative care,
daily basic services (like toileting, aid in preparing
and consuming food, etc.), services for independent
living (e.g. shopping, cleaning, bill payment, etc.),
home adaptation to specific needs that the user may
have (accessibility adaptations for low mobility or
for different impairments), socialization services.
The paper describes the design specifications of
the CDMS platform, as developed by the project’s
team, which comprises engineers, as well as medical
personnel, after multiple research meetings with
direct beneficiaries (representatives of three HCPs).
A market study related to the HCPs in Romania
paved the way for the funding application for the
current project, and the first results of the project
comprised a number of studies concerning the
possibilities of improving the functioning of an
There are multiple already-on-the-market
platforms or research implementations for home care
ICT solutions: software and/ or hardware platforms.
In the traditional approach, these platforms usually
only implement layer 3 the “smart home”
consisting of the components installed at the
monitored subject’s home and, possibly a
supervising level that gathers data acquired from
multiple home care systems and manages different
situations. The proposed system does not focus on
the 3
layer, or on the home care system, but
concentrates on the 1
layer of figure 2 the
software and hardware components that allow an
HCP to offer home care services in a very efficient
way. It may be compared to an ERP (Enterprise
Resource Planning) system customized and
dedicated to HCPs. As far as we know, there is no
such system implementation currently on the market.
A CDMS is an entity that offers services to an HCP,
in order to optimize and simplify the delivery of care
services at home, by offering technical support at
hardware and software level. A CDMS is designed
to offer software modules that allow for an easier
management/ deployment of different home care
services and to minimize the required hardware so
that an HCP can optimize most of its operation.
The services offered by an HCP are grouped in
three categories:
- Medical Services: comprising all the health care
delivered at home aid in following prescribed
medication, monitoring physiological parameters,
palliative care, aid in performing recommended
physical exercises, etc.;
- Social Services: various services for assistance
with the daily activities or for maintaining an
independent living like dressing, help in feeding or
Figure 1: Medical andocial services at home.
ICT4AWE 2019 - 5th International Conference on Information and Communication Technologies for Ageing Well and e-Health
Figure 2: General architecture of the CDMS platform.
doing the hygiene activities, shopping, house
cleaning, etc.;
- Socio-medical Services: mixt services from the
above categories.
An HCP may choose to deliver one or more of
these types of services and a CDMS will offer
personalized services to an HCP, as per request. A
CDMS is designed to offer the following support
services to an HCP:
- Human Resources Management: management
of the employees delivering home care services and
of the employees performing administrative/
managerial tasks: management of the employees list,
management of the home care services delivered by
each home carer, the patients list and the work
schedule assigned to each home carer, etc.
- Patients Management: managing the data for
every patient identification data, medical data, data
about the assigned caregivers, of the desired/
received services, cost data, etc.;
- Inventory Management: managing the
inventory of products used in home care services:
automatic/ manual inventory management, creating
alerts when inventory reaches specific thresholds,
generating reports about used inventory, etc.;
- Dispatching Services: Two types of dispatchers
are envisaged: the management dispatcher offering
technical support for each HCP this level manages
the health status of the hardware equipment used,
maintaining logs regarding the functioning of all the
components of the system; the teleassistance/
telemonitoring dispatcher: This component offers
the possibility for each HCP to organize its own
telemonitoring dispatcher with minimum investment
and has the main purpose of monitoring the data
acquired from the teleassistance/ telemonitoring
systems supervised by each HCP;
- Reporting Services: This component will
support each HCP in generating reports, statistics on
different activities, costs, information regarding
personnel, etc.
- Remote Monitoring/ Assistance Services: This
component will allow an HCP to offer the following
services: physiological parameters monitoring; the
detection and management of dangerous/ abnormal
situations at home.
The proposed platform has a layered architecture as
provided in figure 2:
layer 1: the actual dispatching and management
This layer consists mainly of web applications to
be accessed by the employees and the clients of the
health care providers and the needed hardware
equipment to run these applications: server
A dispatching and management center is
designed to provide services to multiple home care
layer 2: the hardware and software components
that each home care provider must use at their main
As the purpose of this entire platform is to ease
the burden on the home care providers, at this level
there are very few requirements. The personnel of
the home care providers only need to use terminals
to access the web apps running at the higher level.
These terminals don't need powerful specifications
(neither concerning computing power nor storage),
Dispatching and Management Center for Optimizing Home Care Integrated Services
as they can be implemented using any type of
terminal with Internet connectivity capable of
running a modern browser.
Two mobile applications are also implemented at
this level:
- a mobile app for managing the supplies used in
home care activities;
- a mobile app for aiding the nursing staff during
field visits at the patients’ homes.
layer 3: the hardware and software components
required in each patient's home.
Each patient and his informal caregivers
(relatives, close friends, etc.) may access a web
portal using an Internet-enabled terminal. The
patients may also use a dedicated mobile app that
offers information about the services they are
receiving and allows them to make requests.
Also at this level, devices for remote monitoring
and assistance may be deployed: medicine
reminders, medicine dispensers, physiological and
environmental sensors for activity recognition and
for health status assessment, panic buttons, etc.
The software components of the platform are
presented in figure 3.
The main components are the web applications
running at the CDMS center as most of the
functionalities offered to HCPs are implemented as
web applications. The management dispatcher is
also running at the server level.
4.1 The Management Dispatcher
The management dispatcher offers technical support
for the HCPs that it serves. It may be accessed by
HCPs through a web portal.
All hardware is monitored and the resulting logs
(information on health status of/ errors raised by each
component of the system, etc.) are kept at this level.
4.2 HCPs Containers
Each HCP will access the CDMS servers only
through the web apps. Each HCP has a dedicated
software container that runs the required web apps
and keeps the related database up to date.
This design approach (each HCP may only access
its own container on the server) has multiple benefits:
it allows for the implementation of a strong security
policy and it also allows for a modular
implementation. A new HCP that joins the platform
only needs a new container. Also, this approach
allows for a clear delimitation between the data of
Figure 3: Software components of the CDMS platform.
ICT4AWE 2019 - 5th International Conference on Information and Communication Technologies for Ageing Well and e-Health
each HCP client, so there is no concern about unfair
competition. Each database may only be accessed
through the web apps from the same container.
The web apps available for every HCP are
described in the following paragraphs.
4.2.1 Web Portal for HCP (Administrative
The administrative web portal for HCPs is designed
to offer the following functionalities:
Employees Management
This functionality allows the HCP to manage
the human resource, to schedule field visits for the
nursing staff and offers a centralized view of the
activities performed by each employee. It allows the
following activities:
- manage employees list;
- schedule activities for the nursing staff
(schedule the home visits);
- automatically estimate work hours performed
by each of the nursing staff and the associated
monetary retribution;
- generate reports regarding the field activity of
the nursing staff.
Clients Management
This section allows an HCP to access and
organize the medical files of their clients and the
field visits required/ requested for/ by their clients.
This module must allow the HCP to:
- manage clients information:
- manage the general and medical
information of the clients
- manage the information of their clients
informal caregivers
- manage requests/ feedback from clients
- generate reports on the provided services to a
client/ group of clients
- send messages to clients (response to feedback/
additional requirements form or informing
clients on news like: schedule changes, nurse
change, etc.).
Inventory Management
The inventory management component is
designed as an integrated system for managing the
supplies needed for the home care activities. This
module must allow HCPs employees to:
- manage the supply records for different
products (syringes, band aids, etc.)
- generate alerts (manual alerts - generated by
employees or automated alerts - system
generated) when supply levels reach certain
predetermined values.
- generate reports concerning the current levels of
supplies, used materials in certain time
intervals, for certain procedures or different
custom reports.
- generate predictions/ estimations concerning the
required supplied levels for certain time
intervals/ procedures, etc.
HCP Management
This module allows the HCP to:
- manage the offer of services: create subscription
methods, create packages of services, etc.
- create reports concerning the functioning and
the information collected by any of the modules
presented above.
4.2.2 Web Portal for the Nursing Staff
The main purpose of this web portal is to offer the
nursing staff support during their field visits.
The main support for a nurse will be the mobile
app installed on a mobile device that is required
during field visits. The web portal doubles some of
the functionalities offered through the mobile app.
4.2.3 Web Portal for Doctors
The web portal for doctors is an application used for
the management of the patients’ medical charts.
In order to access the applications the doctor has
to be authorized by the HCP or by the client/ patient.
Authorized medics may:
- view the medical history of the patient;
- view the performed/ scheduled procedures;
- view the prescribed/ followed medication;
- view the recorded physiological data along with
context information;
- recommend medical procedures or medication;
- recommend a visit to/ from a doctor.
4.2.4 Web Portal for Clients
The web portal for clients (patients and their
informal caregivers) is designed to offer the
following functionalities:
display complete medical file;
view the data collected in the system;
manage the services offered by the HCP: the
client may opt for additional services (on top of
the services recommended by a medic or the
services included in his home care package);
manage doctors: the client may allow a doctor
to access his personal file;
manage list of informal caregivers (users
interested in the wellbeing of the patient like
relatives, close friends, etc.) and their access to
the clients medical file;
Dispatching and Management Center for Optimizing Home Care Integrated Services
manage general information about his account;
initiate communications with employees of the
HCP/ send feedback to HCP.
4.2.5 Remote Monitoring/ Assistance
The remote monitoring/ assistance dispatcher is an
optional module, as, for the moment, not many
HCPs offer remote monitoring/ assistance services.
The designed functionalities for this module are:
Management of data from remote monitoring
Management of medical alarms (e.g. when a
value of a certain physiological parameter is
outside predefined normal values, usage of a
panic button, etc.);
Management of alarms from home environment
monitoring devices;
Management of technical alarms (e.g. a remote
device stopped communicating, a device sends
corrupted data, etc.)
4.3 Supply Management Software
(Installed at a HCP)
The supply management software installed at an
HCP is designed as a mobile application for
smartphones/ tablets that will allow users (HCP
employees) to record supplies in their own database
in an easy manner, by scanning the bar codes from
the products using the camera integrated in the
mobile device. The bar code identification number
may also be manually inputted using the mobile app
or directly in the web portal for HCP management.
4.4 Mobile Apps for the Nursing Staff
Each of the nurses performing home visits will use a
mobile device (smartphone/ tablet) with an Android
app installed that gives assistance in performing the
activities during visits.
By using the mobile application, the nursing
staff can remotely access, during visits, certain
information related to visited clients (contact
information, requested procedures to be performed,
The functionalities of this app are related to:
management of assigned clients:
- access clients general information (name,
contact information);
- access clients medical information;
- send messages to clients (responses to feedback/
additional requirements or send messages like
changes in schedule).
Management of the scheduled appointments
- access the list of procedures requested by /
recommended for the clients;
- record information on each performed
procedure: type of activity, date and hour,
additional observations, supplies used;
Management of the remote monitoring/
assistance devices deployed in the homes of the
visited clients:
- program the devices with certain parameters,
like: the schedule for taking medications, the
schedule for monitoring physical parameters,
alarm levels, etc.
- collect information for the devices (read
measurements performed by the devices and
send them for storage to a superior level of the
4.5 Software for Remote
Monitoring/ Assistance for Clients
The software installed in the homes of the clients
will communicate with the remote monitoring
component from the CDMS server.
The designed functionalities are:
monitoring vital/ different health parameters at
predefined time intervals or continuously;
detect dangerous situations/ events, signal them
and trigger the procedures for effectively
manage the alarms;
remote communication functionalities: send
acquired measurements to the CDMS server for
monitor health status of hardware components
and log hardware and software functioning
parameters and anomalies.
The presented platform offers multiple benefits for
an HCP:
simplify the starting procedures in becoming an
HCP by:
- minimizing the necessary hardware and
offering a list of minimal equipment needed
along with their technical specifications;
- supporting the HCP in offering complex
services: medical, social services and
teleassistance/ telemedicine services;
simplify the running procedures of an HCP by:
ICT4AWE 2019 - 5th International Conference on Information and Communication Technologies for Ageing Well and e-Health
- optimizing the administrative management
- optimizing the home care activities of the
nursing staff;
- optimizing the communication processes
between the administrative staff, medical and
nursing staff and clients.
The end beneficiaries of the project are the end-
users: elders, chronic patients or people who need
ambulatory treatment who may get a variety of
services from an HCP. As the activity of an HCP is
optimized it is expected that the prices for services
for the end-users to be minimized while maintaining
or increasing the quality of service.
The development of the presented platform is a
work in progress, as the related project will end in
September 2020. In the current development phase,
the implementation of the proposed platform, based
on the presented specification is ongoing, having
already reached the phase of experimental platform.
In the next phase, the experimental platform will be
used to implement a pilot CDMS that will connect a
number of HCPs, each with its own clients. The
experimental results of the platform will be
presented in following papers.
This work was partially funded from the European
Development Fund through the Operational
Programme Competitiveness 2014-2020, project no.
P_40_251, Dispatching and Management Center for
Optimizing Home Care Integrated Services.
European Commission, 2018. The 2018 Ageing report
Economic and Budgetary Projections for the EU
Member States (2016-2070)
Dispatching and Management Center for Optimizing Home Care Integrated Services