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Reading: SMILE – Supporting multi-morbidity self-care through Integration, Learning and eHealth


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SMILE – Supporting multi-morbidity self-care through Integration, Learning and eHealth


Mary Burke

Caredoc, Ireland, IE
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Remote monitoring devices and nurse triage assessment and monitoring can reduce health related costs and improve health for at-risk populations. Monitoring devices including blood pressure monitors, blood sugar monitors, oxygen monitors, weighing scales, activity monitors were allocated to participants of this study. 

Remote nurse triage support of adults with multiple chronic conditions, self-managing their conditions at home using wearable technology. Participants electronically record their healthcare data at home as appropriate to their heath condition. Participants alerts are monitored daily by the telephone triage nurse. 


The aim is to empower participants with knowledge to take ownership of their potentially debilitating conditions, to learn to manage their symptoms better and improve their overall quality of life.

The project is for people over 18 with two or more conditions of Diabetes, COPD, CHF and heart disease. Monitoring devices were allocated to participants based on their requirements. Participants record their healthcare data at home and submit the readings from devices to a specifically designed software program. 

Sláintecare funded project. October 2019 – June 2021.

155 participants were identified in total to take part in the project. Participants were identified through local hospitals and GP surgeries. 106 received technology and nurse support. 30 received nurse support. 19 were not eligible.

Outcomes to date

Target - 50% of participants to improve their self-management and medication compliance

•           All participants are engaging with the triage nurses

•           Self-managing their care

•           Knowledge and education improved

•           90% of patients who have been equipped with the monitoring technology are engage daily or every second day

            10% engaging at least once every 5 days

•           All patients are currently compliant with their medication

Target – 20% increase in stabilisation of patient condition among participants measured by clinical symptoms and vital signs

•           92% of stabilisation of their condition 

Target - 20% reduction in unscheduled care episodes among participants measured by reduction in number of visits to GP and Emergency Departments by SMILE participants

•           35.5% of patients have a documented reduction in unscheduled care episodes and have reduced their visits to Emergency Department

Participant experiences

P05: 24 courses of antibiotics in 2017, none prescribed in 2020 since joining the SMILE program.  No hospital admissions this year, and no unscheduled attendance to GP since start of the project.

P30: Admission rate of 3 or 4 times a year for the past number of years.  No admissions since start of SMILE program.

This project is scalable and transferable across all health sectors social, primary and acute.

Qualitative lessons learned

-           Gentle reminder tools motivate participants

-           Sharing excitement with achievements is an important aspect of the program and highlights the benefits of continuous monitoring

-           Directing participants to the appropriate health professional leads to appropriate attendances at GPs and hospital.

How to Cite: Burke M. SMILE – Supporting multi-morbidity self-care through Integration, Learning and eHealth. International Journal of Integrated Care. 2022;22(S1):194. DOI:
Published on 08 Apr 2022.


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