Four Years of Retrospect.
Marie-Madeleine Bernard, M.D., Mathias Fruhwirth, P.Eng., Ottawa (ON)

Over the last decade more convincing evidence has emerged which indicates that isolation leads to increased morbidity and mortality. This becomes a major concern when considering the status of frail seniors who no longer have the ability to freely commute nor to remain part of the main stream of family and community life.

The PACE 2000 International Foundation's mandate is to produce "Programs for the Autonomy and Communication for the Elderly" thereby enabling seniors to live independent in their homes. PACE 2000 provides home bound seniors with a real-time video-conferencing (VC) link to health centers and to various community organizations. This "Virtual Village" has been expanding since 1997, delivering programs in the fields of leisure, cross cultural exchanges, teen-mentoring, language immersion for students and newly landed immigrants, education, physiotherapy and medical follow up.

Two VC modules were designed by PACE 2000: A video conference-based goniometer (VCBG), as part of a hospital VC module, and a personal mode, with customized video-display set up and simplified access for frail seniors, people with disabilities and persons who have no computer experience. VCBG was created to measure range of motion (ROM) via VC, thereby facilitating rehabilitation in a home setting. The PACE 2000 VC equipment consists of a personal computer, a hardware codec, a PACE 2000 interface design, an integrated camera and microphone, and a large, easy-to-use trackball specially designed for seniors with arthiritis. The Hospital module shares the same functions as the Personal module, in addition to the use of the VCBG for clinical use. A file for each participant is created on the Hospital data base prior to testing. Once the subject is placed in the proper position, the image is captured on screen by the computer. Angle measurements are done by loading these images on-screen. Once the landmarks are identified, the PACE 2000 unit automatically measures the joint angle. Evaluations: PACE 2000 conducted 2 research projects using the VCBG, one clinical trial with tele-follow up of seniors in their homes after orthopaedic surgery and 3 surveys - in 1997 (56 participants) - winter 1998-1999 (60 participants) - 2001 (67 participants in long term VC programs), as well as evaluations of intergenerational educational programs in a virtual classroom.

The Personal module is readily accepted by frail seniors, fosters compliance to medical follow up and shows potential for multiple applications for home bound users. Intergenerational coordinators and steady VC sessions are key to the success of VC programs. PACE 2000's VCBG proves to be a highly reliable tool when taken within or between therapists.

In an aging population with increasing needs for home care and physiotherapy, simplified Video Conferencing stations for home users could become an indispensable adjunct of supportive housing for seniors and of long term care services.

E-Health 2002 Conference, April 23, 2002,
Emerging Trends in Care Delivery and Technologies.

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