Digital supervision is often cited as a key solution to demographic and capacity challenges in health and social care services. At the same time, there has been considerable uncertainty for several years regarding the actual benefits this technology provides in practice.
One key reason is simple:
Many municipalities lack a clear baseline: a systematic description of how the services actually functioned before the technology was implemented.
Without such a baseline, the debate over benefits quickly becomes theoretical. It becomes difficult to know what has actually changed—and why.
That is why we at Tellu, in collaboration with two municipal services, have conducted a baseline, implementation, and benefit realization study of digital supervision in nursing homes and assisted living facilities. The goal has been to start where the services actually are—in everyday life, at night, in the rooms, and within the workflow.
What do we mean by “baseline”?
The baseline describes how the service operates before digital supervision is implemented.
Not how people think it works, but how it is actually practiced.
In this study, the baseline included, among other things:
how nightly rounds are conducted in practice
how often staff enter the rooms
what triggers supervision (routine vs. incident)
staff’s perceived sense of safety
sleep and restlessness among residents
how falls and other incidents are detected
how alarms are handled and prioritized
This provides a fact-based picture of current operations and a necessary basis for comparison when evaluating changes at a later date.
Two services—different frameworks, many shared challenges
The study includes:
one nursing home with several dozen rooms
assisted living facilities consisting of several separate buildings with different resident profiles
Although the frameworks differ, the baseline reveals several commonalities.
Nightly rounds are a key feature of the service
At the nursing home, three scheduled nightly rounds are conducted for all residents, regardless of whether specific incidents have occurred.
Depending on the duration of each check (including documentation), these rounds account for a significant portion of the total nightly work hours.
Nightly rounds are also conducted in assisted living facilities, but here both the need for them and the time spent vary greatly from one building to another and from one night to the next. The night shift covers several separate residences simultaneously, which means that some buildings may be without a physical presence for parts of the night while staff are handling tasks elsewhere.
Sleep, Distress, and a Challenging Dilemma
A clear finding from the baseline study is that physical nighttime visits are often perceived as disruptive.
Doors opening, lights, and noise wake many residents. Several staff members describe light and fragmented sleep among residents, and in some cases, increased restlessness following rounds. This applies to both nursing homes and assisted living facilities.
At the same time, staff face a care dilemma:
How can they ensure safety without causing more disturbance than necessary?
This is a key factor behind why digital monitoring is being considered—not primarily for efficiency, but to enable more targeted and non-intrusive monitoring.
Falls and Real-Time Detection
Another consistent finding in the baseline study is that falls are not always detected in real time.
In the baseline study, incidents in nursing homes were often detected by chance—through cries for help, during rounds, or upon finding someone on the floor—without definitive knowledge of the exact time or sequence of events.
In assisted living facilities, detection occurs via safety alarms, cries for help, chance, or during the next round of checks.
This means that the duration of immobility following a fall is unknown in many cases, and that staff must deal with uncertainty regarding what actually happened—and when.
Alarm Flow and Collaboration at Night
Both services describe technological solutions with limited decision support at the point of incident:
the same alarm sound regardless of severity
a fragmented alert chain
lack of prioritization and colleague notification
In practice, this leads to more searching, shouting, and uncertain coordination, especially when multiple incidents occur simultaneously.
Why this matters for realizing benefits
When digital supervision is later implemented, it’s easy to point to “time savings” or “increased safety.”
But without a baseline, you don’t know:
what has actually been replaced
what has been improved
and what has merely changed form
The baseline makes it possible to:
distinguish between assumptions and actual changes
understand which benefits are realistic
and document both the positive and challenging aspects of implementation
It provides a more honest and useful basis for decision-making—for leaders, employees, and family members alike.
The Way Forward
This study also follows the services during and after the implementation of digital supervision.
Future publications will address, among other things:
experiences with planned and incident-based digital monitoring
alarm quality, calibration, and the learning curve
perceived changes in workflow and safety
which benefits actually endure over time
All with the same starting point:
Reality first. Technology second.
You’ll hear more about this study at Tellu Forum ’26—The Art of Normalizing Welfare Technology, on May 5 at the National Museum. Secure your tickets here, or by clicking on the image below.