Revolutionizing Aging at Home through Virtual Care

Using voice technology to connect seniors with a virtual nursing community response service

Lead Organization: SE Health (Saint Elizabeth Health Care)

Program Name: Ring of Support (RoS)

Area of Care: Independent living, Mild cognitive impairment (MCI), Early-stage dementia, Senior isolation and loneliness

Health Care Partners:This study project is funded by the Centre for Aging + Brain Health Innovation under its I2P2 program. SE Health, through its SE Research Centre, has received funding to complete the user experience testing of the technology.



  • Mitigate for loss of memory and cognitive function in seniors by using a smart-notification system to improve medication adherence, participation in activities of daily living, and appointment attendance
  • Equip caregivers with the right knowledge and supports to avoid caregiver stress/burnout
  • Provide real-time monitoring to notify caregivers and health care providers of abnormal behaviour (ex. medication non-adherence, feeling low during check-ins, missing check-ins), allowing for timely intervention that supports seniors to live safely in the community, thereby reducing demand on costly long-term care resources


RoS monitors, identifies risk, pre-empts preventable medical events, and ultimately allows for timely interventions for the sustainable long-term health management of our aging population.

RoS supports individuals to age in the comfort of their own home as independently as possible, and provides the necessary supports to caregivers.

  • Seniors: Have access to medication, event, and appointment reminders; are monitored through morning and evening wellness check-ins; and have access to in-person support through SE Health’s community response team, using the Amazon Echo (Alexa) device and Interactive Voice Response (IVR) calls
  • Caregivers: Receive remote-monitoring updates about the senior via a dashboard to track trends over time as well as adaptive mental/caregiving strategy supports via SMS
  • Nursing Staff: SE Health’s community response team monitors program escalations (missed check-ins, medication non-adherence) and can respond to assist over the phone or to deploy a personal support worker or nurse to the senior’s home

Technology Type:
The RoS program leverages a voice-enabled virtual assistant to engage users for check-ins, event reminders and medication reminders.


The Ring of Support research project is a usability study, where users are engaging with both the Alexa device and IVR calls. Early results demonstrate the potential RoS has to support individuals in the comfort of their own home, while keeping their caregivers and care providers in the loop.

Data is currently being gathered and will be released when the study is completed in February 2020.

Some early user testimonials:

  • “They give you answers and ask you how you are feeling, they are interested in you and ask if you want a nurse to call you, so they were giving you good information”
  • “My neighbour is paralyzed and this would be great for her to be informed who is coming in and out of her home”
  • “Love to be reminded at night for medications”

Change Required to Support the Model

SE Health’s community response team was leveraged to support this model. Currently the model draws on the support of 20 virtual nurses on the community response team who are available to respond to the escalation calls.Note: these virtual nurses are not solely looking after RoS but are performing their other regular duties as well. The virtual nurse team can then dispatch a personal support worker or nurse who are currently on duty in the Central East LHIN closest to the client home, if needed.

Adoption Rate

The user experience evaluation of RoS is currently being conducted with 50 to 60 older adults – a mix of SE Health home care clients and non-SE Health clients in the Central East LHIN.

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