Telehomecare

INTRODUCTION: In this research project, a group of heart patients were transferred from traditional hospital settings to home hospitalisation across sectors. The project involved patients with heart failure and arrhythmia. AIM: The aim was to understand the experiences and attitudes of patients and their spouses/partners with regard to the application of telehomecare technology as an option within home hospitalisation. METHODS: A phenomenological hermeneutic approach was used to collect and interpret the findings and data...

OBJECTIVE: To examine the feasibility and efficacy of integrating home health monitoring into a primary care setting. DESIGN: A mixed method was used for this pilot study. It included in-depth interviews, focus groups, and surveys. SETTING: A semirural family health network in eastern Ontario comprising 8 physicians and 5 nurses caring for approximately 10 000 patients. PARTICIPANTS: Purposeful sample of 22 patients chosen from the experimental group of 120 patients 50 years old or older in a larger randomized controlled trial (N = 240)...

Examining the benefits of nursing interventions through research significantly contributes to both professional nursing and quality healthcare, yet few benefits of home healthcare have been rigorously studied. Research challenges and lessons learned during a clinical trial of heart failure patients receiving home health nursing services are presented with recommendations.

Telemedicine in homecare--also known as telehomecare (THC) or electronic home healthcare--uses telecommunication and videoconferencing technologies to enable a healthcare provider at the clinical site to communicate with patients in their home. Such an interaction is called a "virtual visit". Numerous applications are utilising commercially available monitoring devices and the internet to enable home-based disease management and monitoring. Prior to the implementation of telehomecare applications, one needs to address issues of accessible design, privacy and confidentiality of medical data, and reimbursement...

PURPOSE: The purpose of this study was to explore and identify inter-organisational and inter-professional controversies that emerge when telehomecare technology is implemented across healthcare sectors. THEORY: A combined inter-organisational and inter-professional perspective constitutes the conceptual framework for this study. METHODS: The case study approach was applied as the overall methodology of the study. A triangulation of data collection techniques was used in order to provide multiple sources of evidence for exploring and identifying controversies (documents, participant observation, qualitative interviews, focus group interviews)...

PURPOSE: To explore how the implementation of the concept 'Home hospitalisation of heart patients' by means of telehomecare technology influences the integration of clinical tasks across healthcare sectors. THEORY: Inter-organisational theory. METHODS: The case study approach was applied. Triangulations of data collection techniques were used: documentary materials, participant observation, qualitative and focus group interviews. RESULTS: The clinical decision-making and task solving became multidisciplinary and integrated with the implementation of telehomecare and, therefore, complex in terms of the prescription and adjustment of patient medicine...

Although the usefulness of telehomecare has been recognized, and all technologies required are readily available, expectations for its widespread adoption have not been realized. This paper presents the development of a portable telehomecare monitoring system (PTMS). What sets this work apart from most other systems is the focus on a highly decentralized monitoring model and the portable nature of the system. We believe that this is the approach that is needed to make such systems economically viable and acceptable to the end-users...

Home care services are growing up in the past years. Contemplating the patient/family pair, it represents a solution to the medical problems of the modern life. With the social trends, the senior population has been increasing in the last years. However, as living is more stressful than ever, there are more cases of chronic diseases. The difficulties of transport in the big cities and the scarcity of hospital streambeds turn the home care an attractive solution. However, its routines can be switched by telemedicine...

Telemedicine is the use of technology to provide healthcare over a distance. Telehomecare, a form of telemedicine based in the patient's home, is a communication and clinical information system that enables the interaction of voice, video, and health-related data using ordinary telephone lines. Most home care agencies are adopting telehomecare to assist with the care of the growing population of chronically ill adults. This article presents a summary and critique of the published empirical evidence about the effects of telehomecare on older adult patients with chronic illness...

Over the last decades, development of home care services is an important component of ongoing health care systems reforms. However, their full integration into hospital or primary care services is still progressing slowly. It appears that telehomecare (THC) could help create networks of services between hospital and primary care providers. Even though their potential to increase access to services and improve quality of care and health outcomes is recognized, their widespread adoption has not yet been achieved...

The use of telehomecare has the potential to facilitate access to healthcare services for vulnerable populations. However, evidence on the implications of telehomecare on various aspects related to patients, healthcare professionals, organizations, and healthcare systems is still limited. Assessing the various effects of telehomecare for these different groups of stakeholders is thus an essential step to ensure future integration of this technology into mainstream healthcare services. A synthesis of lessons learned from the evaluation of three telehomecare experimentations targeting specific vulnerable groups is proposed...

Neurological disorders, such as Alzheimer's disease, Parkinson's disease and stroke recovery, strike an estimated 50 million Americans each year, costing billions of dollars in medical expenses each year, not to mention the countless personal losses and the immeasurable emotional impact on families and patients that such diseases inflict. Due to the complex nature of neurological diseases, the treatment of these diseases often requires two types of care: neurological care and mental health care.

A cost-minimization analysis was performed on a telehomecare program for patients with a chronic obstructive pulmonary disease (COPD). The research was quasi-experimental and included a control group. We compared the effects and costs of care provided to a group of 19 patients under a telehomecare program to a comparable group of 10 patients receiving regular home care without telemonitoring. Our results clearly indicate that there were fewer home visits by nurses and hospitalizations for patients in the experimental group...

No abstract text is available yet for this article.

Changing societal demographics, increasing complexity in healthcare knowledge, and increasing nursing shortages have led healthcare strategists to call for a redesign of the healthcare system. Embedded within most redesign recommendations is the increased use of technology to make nursing practice more efficient. However, information technology (IT) has the potential to go beyond simple efficiency increases. If IT is perceived truly as a part of the redesign of healthcare delivery rather than simply the automation of existing processes, then it can change nursing processes within institutions and furthermore change the point-of-care between nurses and patients...

All industrial societies are ageing. This has profound socio-economic and health sector implications. Innovative services based on Information Society Technologies (IST), like telehomecare are regarded as promising avenues to follow both to allow (national) health systems to cope with these challenges and to improve the quality of life of chronically ill and frail older citizens. The aim of the TEN-HMS project is to convincingly prove that telemonitoring of congestive heart failure (CHF) patients at home can improve medical outcome for these patients as well as their quality of life and the efficiency of healthcare delivery processes...

For telehealth to become an accepted component of rehabilitation, a scientific base verifying that telehealth improves outcomes must be developed. A conceptual framework based on theory and empirical findings is necessary for this area of inquiry to flourish. Most academic curricula possess such an educational pillar, which serves to help prepare professionals to practice in the new arena, and scholars to perform quality research. Currently, the authors are involved in developing areas of the biomedical engineering and nursing curricula at Marquette University to address key areas of telerehabilitation...

The aim of this study was to demonstrate that telehomecare linking homebound patients with their home health-care nurses over the plain old telephone system (POTS) provides high-quality, clinically useful, and patient satisfactory interactions. Congestive heart failure, chronic obstructive pulmonary disease, and chronic wound-care patients receiving skilled home nursing care were randomized into control (standard home health care, HHC) and two intervention (standard care plus video conferencing/Internet access; the above plus physiological monitoring) groups...

Numerous pilot studies have demonstrated that telehomecare technology may improve client outcomes through timely intervention and health crises prevention, thereby reducing return visits to hospitals and physician offices. Although the potential of telehomecare to increase access to services and improve quality of care and health outcomes is recognized, expectations for its widespread adoption have not been realized. Factors affecting diffusion of innovations include, among other things, perceptions of the technology, organizational characteristics, and communication...

The delivery of health care is often segmented into sectors. In Canada, hospital care has traditionally been distinct from community care, and thus the transition of patients across sectors has been challenging. This paper focuses on the systematic development of an integrated model of care for children, for the purpose of smoothing the transition from hospital to home. The new service model uses emerging telecommunications technology to link hospital care providers to patients at home and is termed "telehomecare" (THC)...