Evaluation of the practical feasibility and acceptability of home monitoring in residential homes

Abstract

Three residential homes to the north-west of London, with their associated medical centres, were equipped with telemonitors to measure several variables, including seven-lead electrocardiogram, blood pressure, oxygen saturation, heart rate, temperature and respiration. The monitors could be operated by non-medical personnel. After recording, the data were transmitted via the Internet to a server. A total of 24 patients with a variety of chronic conditions were monitored regularly for a period of one year. Data transmission was found to be unreliable on occasions and was improved by extending the wireless network in the homes. Data access and presentation were considered acceptable, although suggestions for minor changes were made. No discernible impact on disease management, diagnosis or care was observed as a result of the monitoring. However, interviewees saw several potential benefits and patient acceptance was very good. The monitoring was found to be generally acceptable and feasibility was considered to have been largely proven.

Determinants of successful telemedicine implementations: a literature study

“…The stimulating role of leading champions who are willing and motivated to experiment with the new technology are essential in the process of creating familiarity and enthusiasm. 24,26 It is clear from the literature that different stages exist in the introduction of telemedicine interventions which might affect the process of diffusion. In general, two phases of usage of telemedicine technology are common.…”

“…However, as soon as the projects are ended, there is a lack of continued working with the telemedicine systems due to lack of financing structure. 9,12,13,17,26 This is difficult as telemedicine is a new type of healthcare delivery for which most insurance companies do not have standard tariffs. 10,14 Several studies have stated that comprehensive cost-effectiveness studies are essential in developing future financing structures.…”

“…27,41 Furthermore, the novel working practices introduced by telemedicine do not always fit with existing traditional working protocols in health care. 14,23,26,42,51 Policy and legislation…”

A H-QoS-demand personalized home physiological monitoring system over a wireless multi-hop relay network for mobile home healthcare applications

“…In order to provide proper home healthcare services and timely handle an emergency for the elderly, it is indeed necessary to monitor their physiological parameters at home over a long period of time (Alwan et al, 2006;Bratan et al, 2005;Korhonen et al, 2003;Paré et al, 2007;Roback and Herzog, 2003;Stefanov et al, 2004). Statistically, the probability that an elder person suffers from chronic diseases is relatively high, notably cardiovascular disease (CVD) (Naughton et al, 2006).…”

“…However, in indoor environments, the signal strength of access points in WLAN can be weakened by 30-90% as it passes through doors, walls and windows depending on the material and construction employed. Thus, the coverage area of WLAN will be reduced and subsequently lead to a dead spot that will cause a communication disconnection between the mobile-care device and WLAN (Bratan et al, 2005;Nicopolitidis et al, 2001;Stallings, 2004;Varshney, 2006). The patient's critical physiological information may thus be lost at that time.…”