CEO Ulrika Kjellberg tells Health Europa more about how the medication handling has transformed nursing home and residential care in Sweden.
Appva’s fully digital Medication and Care Support System takes the hassle out of medication handling. In 2012, Swedish company Appva launched a paperless, intuitive digital application called the Medication and Care Support System (MCSS) designed to help municipal care providers record and manage their medication handling. Today, the innovative and award-winning eMAR solution is used daily by 70,000 customers across Sweden and has been proven to reduce both employee stress and medication errors.
Now, Appva has launched a cutting-edge AI tool set to revolutionise elderly care by further streamlining and automating time-consuming and laborious administrative tasks.
Health Europa spoke with Appva CEO Ulrika Kjellberg to learn more about how the MCSS has transformed the paper-driven process of medication handling into a fully digital, hassle-free operation, and Appva’s plans for the future.
Where did the idea behind the MCSS come from?
What I think is so great about our business is that the idea behind the solution was not driven by us but by the users themselves. My background is in the telecoms industry, but I was contacted at the beginning of 2011 by a nursing home, who asked me if I could help them to transform their manual, paper-driven documentation system into a digital, mobile one.
To give you some background, the population in Sweden – like in Europe and indeed globally – is ageing, and many elderly people are having to deal with multiple chronic diseases at once. As a result, medication handling is becoming increasingly complex. It is no longer simply a matter of taking medication twice a day, it must be taken in the right way, prepared and mixed in the right way, and so on. This creates a lot of additional administrative work for nurses and other medical professionals.
The nursing home told me that they work with a lot of time-consuming paper documentation systems – and often have to fill these in while working very closely alongside the patient or moving between tasks, which is not very practical and leaves room for error.
From there, I began working with the nursing home to understand what they do, what their processes are, and to get a better picture of the regulatory environment around medication handling in elderly care. We started to create a prototype and after roughly eight months and multiple iterations, we arrived at something we were all happy with. That led us to establish Appva. It took us another year to turn the prototype into a commercially viable product, the MCSS, which we launched in December 2012. That same year, Appva was awarded the Potential Quality Innovation Prize in 2012 by the Institute for Quality Development in the Nordic and Baltic countries.
How is the MCSS adapted for use in elderly care?
The MCSS has been driven by user demand and so its functionality and design have been developed specifically with them in mind. It is an incredibly simple, user-friendly mobile tool.
Staffing is very critical in the elderly care sector. Nursing homes often have a lot of temporary staff who come in to work for just a couple of days or even a couple of hours, so it is very important that the MSCC is intuitive and user-friendly so that any staff member can pick up their smartphone or iPad and quickly start using the application.
What feedback have you received from users, and how has this shaped the development of the MCSS since its launch?
From the very beginning, the idea has been to reduce work-related stress and decrease medication errors, and we have seen analysis which shows that, by using our digital solution, nursing homes can actually reduce their incidents of medication errors by approximately 80-90% within just a couple of months. Given the complex process of medicating elderly patients, this is an incredible improvement.
The success of the MCSS can further be seen in the fact that one of our customers, the municipality of Torsby, was awarded an Innovation Prize for its work treating patients with behavioural and psychological symptoms of dementia. In achieving this, their work was greatly augmented by our digital solution.
Our users also much prefer the MCSS to the old paper-based system because it is much more secure. Papers can be destroyed, forgotten or lost – especially by residential care workers who travel between patients’ homes. This makes document traceability very difficult, a problem that is completely eliminated using our digital solution.
Because the MCSS requires authentication, you can also monitor who has been looking at what information and when. For the patient, our solution also negates the need for important but private and potentially embarrassing details about their health (for instance, their lavatory habits) to be visible by their bed – instead, it can be discretely stored digitally.
The feedback we have received has also helped to inform how the product has evolved. To begin with, the MCSS was very much about medication handling, but it did not take very long for our users to come to us and say: “Now we have this great tool, it is much more secure, and we can have data-based material for evaluating and improving our work, but we would like to have the same control over other tasks in our environment.”
These tasks could relate to a myriad of healthcare-related matters such as physiotherapy or nutrition. In other words, the MCSS can now document every kind of healthcare procedure an organisation provides to a patient, not just their medication. This is a very positive step as it enables the healthcare providers to have a good overview of how to plan and deliver care for each patient according to their individual needs and preferences.
We continue to receive a lot of feedback from our users, who require new features and functionalities. We estimate that our MCSS has 20 times the number of functionalities today as it had when we first launched in December 2012, and it is continuously undergoing expansive development.
Last year you launched an artificial intelligence (AI) tool to help municipalities report healthcare information to the government – can you explain more about how this will work?
In Sweden, we perform a lot of advanced healthcare in residential and nursing homes in the municipalities. The same is true globally, because it is very difficult now for hospitals to keep patients in for long periods of time. Governments have less control over the quality and efficiency of care in the municipalities than they do in the big, national hospitals, which are very closed environments.
The government therefore decided last year that they require monthly reports regarding advanced healthcare performed in the municipalities. That decision has been made with the best of intentions, but in turn has created more time-consuming administrative work for nurses.
When this government healthcare directive was first announced, we received many calls from our customers who were concerned about how they would manage to comply with the new reporting directive. The information required for reporting is already hosted in our database where we have more than 100 million records of medication handling.
The challenge was to devise a method that could effortlessly sift through the immense database and produce a monthly digital report of the medication handling. Another obstacle was that current medical record systems are not designed for this kind of advanced digital reporting.
This was also an opportunity to further expand our digital solution platform and incorporate innovative technology into our MCSS. To achieve that we developed a state-of-the-art AI tool that keeps track of all the customer’s healthcare activities and compiles a detailed report which the user needs only to briefly proofread before it is sent.
Ultimately, the aim of this AI tool is to improve sustainability in nursing homes by eliminating mundane, paper-driven administrative tasks and freeing up more time for nurses to attend to patients and help deliver better healthcare.
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Please note, this article will appear in issue 8 of Health Europa Quarterly, which is available to read now.