Provincial Respiratory Outreach Program in the Province of British Columbia, Canada

1. Provincial Respiratory Outreach Program in the Province of British Columbia, Canada Submitted by Name: Esther Khor, Manager of Respiratory Therapy Affiliation: BC Association for Individualized Technology and Supports for People with Disabilities National association (if exists): Location: Vancouver, BC, Canada E-mail address for contact: EKhor@bcits.org; Anthony_Chan@bcit.ca

2. Country Estimates in Brief Global CE / HTM Success Stories

3. Country's Health Technology ProgramKey Success Story • The BC Association for Individualized Technology and Supports for People with Disabilities (BCITS, a non-profit organization) runs a home ventilation program - the Provincial Respiratory Outreach Program (PROP) • PROP allows individuals depending on respiratory support to live independently in the community. • It provides total technology management to its clients including medical care, training, equipment, supplies, and maintenance. Global CE / HTM Success Stories

4. Country's Health Technology ProgramKey Success Story • Users of the program have various diagnoses such as spinal cord injuries, post-polio, amyotrophic lateral sclerosis and other neuromuscular diseases. • PROP is a successful “client-directed” health care model with respiratory therapists providing education for the users and their care givers. Users (or their care givers) are responsible for replacing, cleaning and ordering their respiratory supplies. Mechanical ventilators, BiPAPs and suction units are part of the equipment pool. These are maintained and supported by biomedical engineering staff. Global CE / HTM Success Stories

5. Country's Health Technology ProgramKey Success Story • All these factors contribute to running PROP effective and lean. PROP allocates C$2,500 (C$1 = US$0.75) for each tracheostomy user per year. This cost is low compared to similar patients in facilities and hospitals. Including capital equipment replacement, the PROP program costs approximately C$3.5 million a year; on average about C$6,400 per patient per year. A single hospital patient-day can easily cost over a thousand dollars in BC, Canada. Global CE / HTM Success Stories

6. Country's Health Technology ProgramNext Steps for Success Story • A funding formula based on the number of clients was established in 2014 with all health authorities in the province of British Columbia. The number of PROP clients is growing at a rate of about 20% per year. • BCITS is looking at expanding PROP’s services to more patients who are not meeting the current medical inclusion criteria. Global CE / HTM Success Stories

7. Conclusions and Action Plan • Gone are the days of “institutional care”, where people with disabilities are given little choice in their lifestyle. PROP successfully keeps over 500 people with disabilities out of acute care institutions allowing them to live independently in the community with better quality of life, and at a small fraction of conventional institutional cost. • The success of PROP is an excellent example of systematic technology management embracing users, healthcare providers, and biomedical engineering. Global CE / HTM Success Stories