Transitioning Medication-Related Home Visits to a Cognitively Accessible Digital Intervention in Home Care: A Practice Innovation Pilot

Background: Medication adherence among older adults with cognitive impairment is a major challenge in home care and often results in frequent in-person visits for reminders or medication administration. While digital reminder tools show promise, evidence supporting their integration into routine home care practice remains limited. In publicly funded home care services, medication-related visits are resourceintensive and increasingly difficult to sustain amid workforce constraints, making the identification of safe and scalable alternatives a growing priority. Methods: A quality improvement pilot project was conducted within a publicly funded home care program in Quebec, Canada. A smart clock was implemented to deliver cognitively accessible medication reminders and enable remote confirmation of intake. The technology was integrated into existing clinical workflows through nursing assessment, structured installation, user and caregiver training, and ongoing monitoring. Descriptive quantitative measures assessed device use, substitution of in-home visits, user experience and safety, and a preliminary break-even cost analysis. Results: Forty-eight older adults received the smart clock. Thirty-five participants (72.9%) were considered successful, defined as maintaining accurate medication intake. Use of the smart clock was associated with 6,276 avoided medication-related home visits across the pilot and time savings of 39.6 minutes of home care staff time per device per day. No major medicationrelated safety events were observed. Conclusion: This pilot suggests that a clinically integrated, cognitively accessible digital intervention can support the safe substitution of medicationrelated home visits. Findings highlight the importance of interdisciplinary collaboration and implementation practices in developing sustainable technology-enabled home care models.