Health and social care services to living rooms


Eksote discusses Health and social care services for an ageing population…

Eksote’s new models of mobile care and integrated service system.     

The ER in Your Livingroom project delivers new model of service, where paramedical nurses in cooperation with other professions don’t just treat acute events, but enable citizen to live and function better at home.

South Karelia Social and Health Care District (Eksote) provides health services, family and social welfare services, and services for senior citizens that promote health and everyday wellbeing and functioning.

Ageing population and urbanization is causing additional challenges to the rural areas. At the same time specialized level medical care is nationally centralized to fewer hospitals and inpatient places are reduced. The role and significance of decentralized social and health services outside the hospitals has increased. Evaluation of patients must take place 24/7 in order to avoid unnecessary hospitalizing of patients. Also hospitals are able to discharge patients sooner through mobilized services and lite service options, without compromising patient safety and sense of security. New service models and resource types are required in the changing environment.

Eksote responds to this challenge with a project called, “ER in Your Living Room”. The main objective is to create integrate, customer-oriented service processes, rationally combine professions and provide digital, user-based services that will increase productivity and effectiveness. Various service models have already been implemented with good results.

Over forty per cent of all the interventions in Eksote’s ambulance service are evaluated and treated at the scene. Almost all staff members are paramedic nurses. This has enabled much broader use of paramedics in the patient’s chain of services. In March 2016 new mobile paramedical evaluation and care unit was launched that is the first of its kind in Finland. The unit provides flexible evaluation of patients including need analysis of care and other services. Paramedic nurses are able to do procedures, medications, examinations and advanced point of care based on a physician consultation, general guidelines and wider variety of point of care diagnostics. The professionals are additionally trained to the acute hospital areas and intensive home nursing procedures. Starting at September the unit will be able to provide also social care services and reserve a doctor’s appointment. Consulted physician can write an electronic prescription that patients can get straight from a pharmacy. During the first four operating months (March-June 2016) the new unit had 708 missions which have saved at least 70 000 euros if compared to the previous service model.

To manage service processes outside the hospitals all professionals must have the identical real-time patient information system, identical situational awareness and knowledge of service system’s resources and service delivery options. All professionals must have information and knowledge that ensures value provision to the processes and patients. Information must be at hand quickly and collectively making evaluation and estimation of situations more comprehensive.

In Eksote, all these requirements are combined into the role of special coordinator which will be integrated with the ambulance service situation room. With the help of the coordinator human resources outside the hospital can be managed and fitted to the needs of the clients. The coordinator role also improves the utilization of different professionals making the service delivery more efficient. The coordinator can also monitor home safety technology, bio signals and other devices placed in the home of clients.

By developing activities and services constantly Eksote is able to optimize discharge of patients 24/7. Nightly medical infusions can be provided through mobile unit and the bio signals of discharged patients can be monitored remotely, so that possible complications may be intercepted, identified and treated immediately. In addition patients can be reached anytime through video connections by professionals and relatives.

At the same time patients and relative caregivers are raised to the center of the service processes by giving them more freedom of choice and responsibility of their own care. By keeping them also situationally aware about activities and needs the flow of relevant information improves the quality of services. The goal is to involve patients and relatives to participate and to reduce unnecessary concern. As a result of this improvement the contacts to the system in different stages of the patient’s service chain will eventually diminish.

Every encounter, regardless of service channel, demands comprehensive information, evaluation, coordination and cooperation. Also other services are provided with the same ideology such as multi-professional home rehabilitation, coordinated medication management and preventive work of dieticians. The healthcare service structure changes from centralized and “inter hospital” to decentralized, preventive and customer oriented. The aim is to comprehensively evaluate the need of services, to understand also overall effects of nutrition, medications and for example loneliness, to extensively take care of customer’s needs. Organization’s structure and procedures are developed so that they able the combined service processes. Resources are used seamlessly and coordinated wisely to have our citizens live and function better at home.

You are Welcome to visit us in South Karelia so please feel welcome to respond to this article!


South Karelia Social and Health Care District

ER in Your Livingroom, mobile health care services, decentralized service options, ambulance, paramedic, multi professional

Katri Länsivuori

Project manager

South Karelia Social and Health Care District

Tel: +358406511706

Henri Karppinen

Expert advisor

Saimaa University of Applied Sciences

Tel: +358406313800

Merja Tepponen

Chief Development Officer, Doc Sci.

South Karelia Social and Health Care District

Tel: +358400655197


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