Telehomecare

Heart failure (HF) afflicts nearly 6 million Americans and the prevalence continues to rise as the population ages. Hospital use for HF is high and about half of readmissions are believed to be preventable. Promoting self care through telehomecare is an emerging strategy for managing chronic illness. Hospitalized heart failure patients were randomly assigned at discharge to receive usual home care or telehomecare, nurse visits and daily use of monitoring devices such as blood pressure cuffs, scales, glucometers, and pulse oximetry to monitor their symptoms...

Clinical management of refractory heart failure remains challenging, with a high rate of rehospitalizations despite advances in medical and device therapy. Care can be provided in person, via telehomecare (by telephone), or telemonitoring, which involves wireless technology for remote follow-up. Telemonitoring wirelessly transmits parameters such as weight, heart rate, or blood pressure for review by health-care professionals. Cardiac implantable devices (defibrillators and cardiac resynchronization therapy) also transmit continually interrogated physiological data, such as heart rate variability or intrathoracic impedance, which may be of value to predict patients at greater risk of hospitalization for heart failure...

Telecardiology is the use of telemedicine for remote cardiological monitoring and healing. The international shift from traditional healthcare to electronic healthcare and the various telecardiology solutions available worldwide motivated our efforts to design and develop the e-Herophilus platform implementing a strategy to improve the quality and reliability of telecardiology in Greece. Our primary goal was to develop a national standard to consider the needs of rural, urban and telehomecare cardiological services provision ranging from children to adults and the elderly...

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This study's objective was to determine and to explain the potential substitution effects of a nurse-led video teleconsultation service for homecare clients. To that end the largest program in the Netherlands up till 2009 was analyzed. This program's aim was to realize partly substitution of homecare visits by telecare for carefully selected clients. The study was multi-method. Each video contact was registered, and a sample was described on forms during an 8- month period starting half a year after implementation...

AIMS: We studied the effect of Telehomecare (THC) in a group of Cystic Fibrosis (CF) patients, with the aim to early recognize the relapses of pulmonary infections. Data obtained with Vivisol (OXYTEL) instrumentation were collected from 2001 to 2005. MATERIALS AND METHODS: The study has involved 17 patients (11 f, 6 m) affected by CF, treated with THC, in addition to the usual therapeutic protocol, for an average period of 29.6 months +/- 13.5. The mean age for THC enrollment was 15...

Being able to act remotely in our homes could be very useful in providing various services such as surveillance and remote interventions, which are key features for telehomecare applications. In addition to navigation and environmental challenges that a telepresence robot would face in home settings, the system requires an appropriate teleoperation interface for safe and efficient usage by novice users. This paper describes the design criteria and characterizes visualization and control modalities of user interfaces with a real robot...

OBJECTIVES: To provide a systematic review of home telemonitoring for respiratory conditions and to present evidence on its effects in relation to data quality, patient medical condition, utilization of health services, feasibility and use, and economic viability. STUDY DESIGN: Systematic review of the literature to identify peer-reviewed articles that reported effects of home telemonitoring for patients with respiratory conditions. METHODS: A literature search was conducted on Cochrane and MEDLINE (1966-2007) databases using the following keywords: pulmonary, respiratory, asthma, lung, telemonitoring, telecare, telehealth, telehomecare, and home monitoring...

This study aimed to understand how different types of knowledge have influenced the decision making process regarding the implementation of telehomecare in the organization of regional healthcare services in the Province of Quebec (Canada). A case study was conducted in order to explore how scientific evidence was integrated in the decision-making processes regarding the implementation of a telehomecare system in the Gaspésie-Magdalene Islands Health Region. A total of 14 semistructured interviews were completed with key organizational decision makers (regional managers, organization managers, healthcare professionals, and technological managers)...

The purpose of this study was to evaluate the effects of a telehomecare intervention implemented in an oncology and palliative care unit in Quebec, Canada. As part of the intervention, nurses working within the oncology and palliative care program were given a tablet PC to use during patients' home visits and capture data related to the patient's encounter. Outcomes of interest were nurses' satisfaction with the software application, perceived quality of care, and individual and group productivity. With regard to productivity, we hypothesized that this system use would increase (1) the number of patients treated by all the nurses involved in the program, (2) the average number of home visits made by a nurse per shift, and (3) the percentage of time nurses spent providing direct care to patients...

Telehomecare is considered one of the most successful applications of telehealth. However, despite increasing evidence of telehomecare benefits, the diffusion of these services is still limited. Decision-makers need strong evidence in order to expand the development of telehomecare to various populations, regions, and health conditions. The objective of this review is to provide a basis for decision-making by identifying common indicators from the literature on telehomecare. A comprehensive review of the literature on the cost-effectiveness of telehomecare was conducted in specialized bibliographic databases...

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Telehomecare usage requires that patients, home-helpers and nurses interact as a group using remote communication technology. Group interaction produces many levels of social variance that contribute to outcomes. It is unknown how social variances in remote interaction influence outcomes. Social Relations Model (SRM) approach is currently used to analyze individual, relational and group influences on family outcomes. SRM applied to telehomecare groups contributes to better understanding of the influence of remote relationships on patient outcomes...

The purpose of this randomized field study was to determine the effects of telehomecare on hospitalization, emergency department (ED) use, mortality, and symptoms related to sodium and fluid intake, medication use, and physical activity. The sample consists of 284 patients with heart failure. The authors used logistic regression to study the effects of telehomecare on health services utilization and mortality and a general linear model to analyze changes in self-reported symptoms. On average, patients in the telehomecare groups had a lower probability of hospitalizations and ED visits than did patients in the control group...

PURPOSE: This paper explores the constituents of and challenges related to the innovation of technology-based services in the long-term homecare sector. METHODS: This research used purposeful extreme case sampling, a mixed methods approach to research that included focus groups and interviews, to learn from the experiences of an innovative telehomecare project. The paper uses a framework that integrates service management; information systems innovation and medical informatics theory...

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Telenursing was instituted as an effective mode for providing care to patients geographically distant from healthcare providers. Using telecommunications and information technology, nursing care is provided remotely to individuals. Nurses recognize the value of telecare and telehomecare as essential components of telenursing that give patients easy access to high-quality care and eliminate costs and difficulties associated with travel to healthcare facilities. Patient satisfaction with telenursing is related to prompt quality care from professional nurses...

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Hand rehabilitation requires continuous and frequent monitoring of the functionality in order to assess therapy and/or refine it. In order to contain costs for the rehabilitation program, a telehomecare rehabilitation system is suitable. The purpose of this paper was to describe the setup and configuration of a homecare device for telemonitoring/telerehabilitation of patients who underwent hand transplant. The telehomecare device allows the assessment of dynamics and kinematics of hand function by integrating dedicated software in two components...

BACKGROUND: Epidemiological shifts, financial pressures and changing policy priorities in healthcare initiate reflections on innovative ways to deliver care. Technologies offer opportunities to change health services delivery. One of the emerging fields is telehomecare-applications. Yet, these applications are not always adapted to the user needs and characteristics of the homecare setting, resulting in "system failure". OBJECTIVES: We describe a generic methodological model to incorporate user perspectives in the design and development process of e-health systems...