Who is eligible for the Remote Care Monitoring program?
General eligibility criteria:
- 60+ years of age
- Valid OHIP coverage
- Clinical Frailty Score of 5, 6, or 7
- Stable housing
- At least one community-based escalation point (e.g., caseworker, care coordinator, family member, friend) to support non-urgent concerns
- Diagnosed with 3 or more chronic conditions and
- Had an encounter with urgent/emergent care in the past month related to one of the chronic conditions (e.g., emergency department visit, urgent care clinic, etc.) or urgent need identified following a visit from a community provider (e.g. Ontario Health atHome care coordinator, caseworker, etc.)
Device-Specific Considerations
SOS/Falls/GPS Locating Pendant (OdysseyGo) Pendant
- Not suitable for individuals with cardiac implantation devices (e.g., pacemakers) due to cellular/magnetic interference.
- Other RCM devices are unaffected by such devices.
Medication Dispensing Device
Best suited for clients whose non-compliance stems from forgetfulness. Additional criteria:
- Willingness and insight to take routine medications
- Ability to respond to prompts from the device (e.g., lights, alarms)
- Community escalation support for troubleshooting or wellness checks
- Not suitable for clients with a history of overdose
- Safe home environment (e.g., no pest infestations)
- Someone must be home to receive regular medication cartridge deliveries (every 1–4 weeks)
- Home must have safe, accessible entryways for delivery
- Medications must be assessed and approved by Toronto Grace Health Centre’s pharmacist
Note: The device cannot accommodate:
- As-needed medications
- Liquid medications
- Medications requiring special preparation (e.g., crushing)
Program Administration
The RCM program is operated by Toronto Grace Health Centre (TGHC) in collaboration with GRT Health, the program’s technology provider.
Referrals
Who can refer:
Healthcare professionals or formal service providers (e.g., hospitals, Ontario Health at Home, police services, community paramedics, primary care, etc.)
How to refer:
Submit the completed RCM referral form. Referrers will receive confirmation and eligibility updates from the RCM Intake Team. Medication dispensing referrals will also be reviewed by TGHC pharmacists.
What happens after referral submission?
- Confirmation of referral submission is sent automatically.
- Intake team reviews client eligibility.
- For medication devices, pharmacists confirm suitability.
- RCM team may follow up with referrers for clarification.
- If eligible, RCM team will contact the client/family to schedule set-up.
Is there a cost to the client?
- Devices are provided at no cost to the client.
- Medication costs are the client’s responsibility, though they may be covered under the Ontario Drug Plan or third-party insurance.
Program Duration
The RCM program is time-limited, with length of stay ranging from 6 months to 1 year (maximum). The RCM program is not offered indefinitely. At discharge, the client’s circle of care can be notified. In addition, clients have the option of continuing the service for a fee. The remote monitoring technologies are property of Toronto Grace Health Centre and must be returned to the RCM program upon discharge.
All clients who are enrolled are subject to the following discharge criteria:
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- There have been no “true”/intended alerts from the monitoring devices (e.g. a fall, request for emergency assistance, missed medication dose, etc.) after 6 consecutive months.
- There is inconsistent usage/adherence to the monitoring devices (e.g. not charging the OdysseyGo pendant). This can result in a discharge within 1 month of enrollment, or sooner.
- Client experiences a long-stay hospitalization (~3+ weeks)
- Client relocates to a facility where the RCM program is not offered:
- Long-Term Care (LTC) facility (i.e. nursing home)
- Retirement home
- Palliative care unit/hospice
- Any other institutional setting
At Discharge
The client’s circle of care will be notified. Clients may choose to continue services privately (for a fee) and are eligible for re-referral pending reassessment.
Device Return
Clients must contact us at general line (647) 660-8233 or rcmteam@torontograce.org to proceed with device return. RCM will supply all clients with a return package, once confirmed. The RCM devices are property of Toronto Grace Health Centre and must be returned.
Ambulance Services
If emergency medical services are activated via the Call Centre and ambulance transport is required, clients are responsible for associated costs.
Alert Management
Alerts are routed to the 24/7 Remote Care Monitoring Call Centre and, where applicable, to informal supports (e.g., family).
- Call Centre staff triage alerts to distinguish emergencies from false alarms.
- Alerts do not go directly to 911 — responses are based on pre-established client protocols.
Who provides support for non-English speaking clients?
The RCM program offers interpretation services for our multi-linguistic communities. Please contact our team at 647-660-8233 or via email at rcmteam@torontograce.org for further information.