ThaiHealth Community Care Background
Thai Health Promotion Foundation (ThaiHealth) is an autonomous government agency established by the Health Promotion Foundation Act in 2001. ThaiHealth positions itself as a catalyst, which is mentioned to inspire, motivate, coordinate, and empower individuals and organizations in all sectors for the enhancement of health capability as well as healthy society and environment to support health promotion movement in Thailand (ThaiHealth, 2016). To implement community care projects, ThaiHealth has collaborated with the National Institute for Emergency Medicine (NIEM) and community hospitals. NIEM is the institution, established under the Emergency Medical Act B.E.2551 (2008). The institution is responsible for the administrative management and coordination between relevant agencies and hospitals that support emergency medical service.
ThaiHealth promotes health promotion and projects to community hospitals regarding providing care for the elderly to create a database of elderly people. In the project of ThaiHealth, the elderly are classified into three groups based on ability and health condition including active ageing Group, self-reliant group, and disabled group. The active ageing group refers to elderly people who can live by themselves and are available to support others. The self-dependent group includes the elderly who can help themselves but are not ready to help others. The disabled group refers to the elderly who need special care, as man y of them are d isabled or b edridden.
Community volunteer caregivers are key providers to support community care based on level of collaboration and skills in elderly care. In this case, the volunteers are trained by public health providers.
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Community volunteer caregivers have an important responsibility in home visits in order to assess the condition of the elderly home. They also arrange related services such as house cleaning, food delivery, and nursing delivery. The activities of community volunteer caregivers are not limited to health work, they also share information and help the elderly obtain healthcare services by requesting medical equipment wheelchairs, walkers, walking sticks, and beds, from the sub-district health promotion hospitals, community hospitals, or sub-district administration organizations.
ThaiHealth Community Care Services
The community volunteer caregiver project started in 2003-2004 for the elderly homecare in eight provinces: Chiangmai, Phitsanulok, Phetchaburi, Su phanburi, Khon Kaen, Roi Et, Songkhla, and Surat Thani. This pilot project was initially set up with a community hospital in a su b-d istrict of each province, with an in itial target of 40 vo lun teers in each area. The implementation of this project has been carried out continuously since then. In 2013, the project was available in every district in the country, with 7,602 local administration units arranging elderly homecare volunteers in their areas. There were 51,854 volunteers to provide services to a total of 787,957 elderly people nationwide (Ministry of Social Development and Human Security 2014).
The roles and responsibilities of the community volunteer caregivers relate primarily to social welfare and elderly rights covering activities as making home visits, overseeing diets, taking care of medicines, helping with exercise, transporting to the doctor, taking the elderly to join events in the community, and assisting in adjustment of living conditions inside the home to be more suitable for the elderly. Moreover, they are required to form groups to conduct activities, provide information and knowledge to the elderly and their families. The volunteers also coordinate with authorities that provide help to the elderly. In terms of performance evaluation of the community volunteer caregivers, it is conducted by College of Population Studies of Chulalongkorn University. The results of performance evaluation reveal that the community volunteer caregivers have been able to provide social welfare benefits to the elderly at a satisfactory level (Suwanrada et al., 2014).
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In 2015, NIEM launched an application called ThaiEMS1669 to support EMS. The application is available to download on smartphones or internet based devices in both iOS and Android operating systems. The application supports administrative EMS management and coordination among relevant agencies, both from public and private sectors. It includes location tracking, personal EHR, photo, and first aid guidance. This application can be used in community care in the means that supports work of the community volunteer caregivers. Its effective use in elderly care and EMS management depends on the level of collaboration among related sectors and the ability of community volunteer caregivers to provide healthcare service.
Co-creation in eHealth Service Model for the Case of ThaiHealth Community Care
Co-creation was a criterion to explain expected values or results of interactions conducted by community volunteer caregivers and related actors in providing healthcare service. Based on the developed conceptual eHealth service model, community volunteer caregiver is considered as a caregiver who supports elderly care. The services that the caregivers provide are daily activity support and sharing knowledge to elderly patients and family members. Volunteer caregivers in community provide primary care to EMS transportation with registered health record of patients.
Figure 7.4 demonstrates co-creation paths in the adjusted eHealth service model for case of ThaiHealth community care. The model includes co-creation issues that are created and required from the collaboration of related stakeholders.
Service providers in ThaiHealth community care mainly collaborate and share technology to community hospitals and volunteers based on designed community volunteer caregiver system. It enhances quality and level of elderly care at community level based on healthcare standards and supports of people in the community. For receivers, ThaiHealth community care project promotes the ThaiEMS1669 application and collaboration between volunteer caregivers and elderly.
Mobile technology is promoted in community care system to the elderly through social communication, sharing experience, and having daily activities with the volunteers.
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Implications of eHealth service for communication and support elderly care of ThaiHealth community care can be implemented through the use of social media, EMS applications, phone calls, and personal SOS devices. Those implications are selected and used based on the ability in using technology of community hospitals, volunteer caregivers, family members, and patients.
Table 7.5 presents value co-creation in eHealth service model for elderly care in a perspective of providing healthcare service at community level in a case of ThaiHealth community care. Based on the adjusted eHealth model, co-creation is an essentially required factor in providing healthcare service at community level in perspectives of local government, EMR system, financial system, and technology support system. ThaiHealth is a community care project that enhances the overall public health system through, for example, assistance in daily activities or providing EMS. Based on level of technology acceptance and community need, ThaiHealth community care services are important for aging society as they have influence on the well-being of the elderly, family members, and society as a whole.
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Figure 7.4 eHealth service model for Elderly care: Community care by ThaiHealth
Service Providers Service Receivers
Co-creation results
- Living plan and health management - Social well-being and Life confidence - Effectivehomecare
- Proposition and solution
Elderly patients System providers
- Mobile app provider - Technical school
Financial providers - Government fund - Insurance company - Internet banking
Governments - Health Ministry - ICT Ministry - Law Ministry
Caregivers Health providers
- NIEM
- Private agent (NPO) - Community Hospitals
Family members