The Yellow Lunchbox Saves Lives

In Belgium, the Yellow Lunchbox helps health and social care providers address the needs of elderly people living on their own. With elderly patients typically under the care of multiple providers, the Yellow Lunchbox serves as a focal point for their health data. It contains a document with critical health and wellness information and is kept at home in the refrigerator, while a sticker on the front door alerts visitors to its presence. With each visit to the home by social services or healthcare workers, the Yellow Lunchbox is taken out and its contents reviewed and updated before it’s returned to the refrigerator.

Currently, about 100,000 seniors living independent lives, but still needing some assistance, have the Yellow Lunchbox in the refrigerator. The Lunchbox is easy to use, and anyone with a pen can update the contents. What’s not to like about that?

The Yellow Lunchbox suffers from the access flaw common to most analog solutions – the Lunchbox isn’t always with the patient. In these cases, critical information such as the use of a blood thinner or a serious nut allergy may not be readily available to care providers when needed. An elderly woman living in the Auderghem municipality near Brussels described one such scenario.

“My husband and I went to the bingo hall, about 9 kilometers from home,” she said. “He’s 93, and while we were there, he had a serious problem. Luckily, I was with him, because the Yellow Lunchbox was at home and the doctors needed to know that he’s on Heparin [a blood thinner]. If I hadn’t been there and they tried to operate on him, there’s a good chance I would have lost him.”

Jean Claude Vitoux, president of the Auderghem municipality’s Public Center for Social Action (CPAS), is keenly attuned to the needs of the elderly in his jurisdiction. “The nurses, doctors, and community service providers, meal delivery people, and others who come into these homes are incredibly busy. Sometimes they forget to update the Lunchbox, and important information may only come to light when a problem arises later.”

Vitoux also noted that in Belgium patient data is still scattered among different care providers and regions. “We’ve sent spaceships to Mars, so I think we should be able to solve these types of problems here. We can do better than a yellow lunchbox.”

At the municipality’s urging, InterSystems and two independent software development organizations teamed up to produce an enhanced, digital Yellow Lunchbox app. Four developers using InterSystems IRIS for Health® data platform and their development languages of choice – in this case Python and Java – completed the project in less than 3.5 months. The system includes InterSystems IRIS for Health interoperability capabilities for data sharing and is hosted in the cloud. With GDPR-compliant security, and patient consent, the system can access hospital and other health records to populate the digital Yellow Lunchbox content.

Now, instead of a Yellow Lunchbox in the refrigerator users have a tablet computer at home with a clean and simple interface geared toward the elderly. When the patient is away from home, the same information is available to them via the cloud in the Yellow Lunchbox app on their mobile phones, and for providers on their own devices. Authorized care givers and family members can update Yellow Lunchbox content, as well as view it. InterSystems IRIS for Health interoperability capabilities ensure that new data is communicated back to source systems.

The app can also present questionnaires to assess well-being, so care givers and family can address the social aspects of health, as well. In an emergency, the app’s “break the glass” feature allows care providers without pre-authorization to access potentially lifesaving data.

With InterSystems IRIS for Health already providing interoperability and managing health data in one half of the hospitals in Belgium, using it for the digital Yellow Lunchbox project was a natural choice. The result has been more power for patients, families, and providers to communicate across time and place for better care coordination, increased safety, and peace of mind. “This project is a step toward making sure that everyone has access to the same, complete information for each patient,” said Vitoux. “It’s especially important for our elderly population, who tend to have complex care needs.”