Mary is 80 and lives alone in rural Leitrim. Independent and determined, she manages rheumatoid arthritis, frailty and recurring falls. Like many older people in remote areas, accessing specialist care can mean long journeys.
This winter, it meant something different.
Mary is an active patient with the Sligo /Leitrim Integrated Care Programme for Older Persons (ICPOP). Two weeks before Christmas, the team carried out a Comprehensive Geriatric Assessment (CGA) in her home, the gold standard in older person care, identifying her needs and agreeing a coordinated plan, including a tailored home exercise programme.
On December 30th, when a Therapy Assistant, Maggie Moran, arrived for a scheduled visit, she found Mary in extreme pain. Mary later admitted her next step would have been to call an ambulance.
Instead, the team activated crisis care using the Attend Anywhere video platform.
Within minutes, a Clinical Nurse Specialist linked in virtually, connecting directly with rheumatology colleagues. Mary was assessed in real time from her own sitting room. A flare-up of rheumatoid arthritis was suspected. Steroids and regular paracetamol were commenced immediately, and her case was flagged for consultant review.
The pain settled shortly after treatment began. Within days, she resumed her exercise plan.
“It was fantastic,” Mary said afterwards. “It was reassuring to see and talk to the clinicians online. I didn’t feel alone.”
Melissa Currid, Operational Lead with Sligo/Leitrim ICPOP, says geography makes innovation essential.
“Our catchment covers almost 115,000 people, including very remote areas. Attend Anywhere allows us to bring specialist input directly into patients’ homes. We use it for domiciliary visits, crisis care, follow-up reviews and multidisciplinary collaboration. It means the right clinician can join the appointment without delay.”
A therapy assistant remains physically present in the home during the online consultation, ensuring safe assessment and strong clinical governance, while the clinician joins in virtually.
Community paramedics are also beginning to play an increasing role in joining up care. Through established pathways, it is planned that community paramedics will assess patients at home and link directly with ICPOP teams via Attend Anywhere or secure messaging, agreeing safe management plans without default hospital transfer. This integrated model ensures older people receive the right care, in the right place, at the right time.
Speaking at a recent HSE Virtual Care in the Community workshop, National Clinical Advisor and Group Lead for Older Persons, Dr Emer Ahern believes technology must always serve clinical safety.
“We are looking at technology through a lens of how it can deliver safer care for older people. Older people want to be included in decisions about their health and want better access to coordinated care closer to home. Digitisation supports that communication and integration.
“There is increasing evidence that virtual care improves post-discharge follow-up, increases accessibility for people who are homebound or living in rural areas, and delivers high satisfaction rates among older adults. The evidence shows that a hybrid model combining virtual and in-person care delivers the best outcomes and is cost-effective for the health service.”
Mary’s case is a clear example of right care at the right time and in the right place. Without rapid virtual specialist input, she likely would have attended the Emergency Department during one of the busiest weeks of the year. Instead, she received timely treatment and remained safely at home.
The HSE is committed to improving healthcare for older people through the HSE’s Enhanced Community Care Programme, a key pillar of Sláintecare, and embedded in the priorities of the HSE Corporate Plan 2025 – 2027.