Telemedicine Experience for Chronic Care in COPD

Abstract

Abstract-Information and telecommunication technologies are called to play a major role in the changes that healthcare systems have to face to cope with chronic disease. This paper reports a telemedicine experience for the home care of chronic patients suffering from chronic obstructive pulmonary disease (COPD) and an integrated system designed to carry out this experience. To determine the impact on health, the chronic care telemedicine system was used during one year (2002) with 157 COPD patients in a clinical experiment; endpoints were readmissions and mortality. Patients in the intervention group were followed up at their homes and could contact the care team at any time through the call center. The care team shared a unique electronic chronic patient record (ECPR) accessible through the web-based patient management module or the home visit units. Results suggest that integrated home telemedicine services can support health professionals caring for patients with chronic disease, and improve their health. We have found that simple telemedicine services (ubiquitous access to ECPR, ECPR shared by care team, accessibility to case manager, problem reporting integrated in ECPR) can increase the number of patients that were not readmitted (51% intervention, 33% control), are acceptable to professionals, and involve low installation and exploitation costs. Further research is needed to determine the role of telemonitoring and televisit services for this kind of patients.

Telehealthcare for chronic obstructive pulmonary disease: Cochrane Review and meta-analysis

“…Following review of titles and abstracts, full text of 48 reports were obtained for appraisal of relevance and quality. Finally, 10 trials were selected, [12][13][14][15][16][17][18][19][20][21] published in 12 reports [12][13][14][15][16][17][18][19][20][21][22][23] ( Figure 1) studying a total of 1004 patients.…”

“…Description of studies A summary of the key characteristics of all 10 trials is given in Table 1. 12-21 Some of the studies 14,16,17,20 relied on videoconferencing or telephone communication to set up 'virtual consultations', sometimes in addition to face-to-face consultations. Key outcomes of emergency department visits and hospitalisations were studied across most studies, but only those four studies which investigated a period of 12 months contributed to meta-analysis.…”

The Empirical Foundations of Telemedicine Interventions for Chronic Disease Management

“…The authors found that the integration of telemedicine with case management ''increased the number of patients who were not readmitted (51% intervention versus 33% control), is acceptable to professionals, and involves low installation and exploitation [utilization] costs.'' 127 The following two studies had samples fewer than our suggested standard of 150 cases. Nonetheless, they are included here because of some unique features.…”

“…'' 126 In 2006, an RCT (n = 157) conducted in Spain investigated the effects of an integrated telemedicine system on hospital re-admission rates and mortality. 127 The telemedicine service consisted of a call center, an application server, and an educational server, all connected to the patients' homes. The application server included three different applications: a Web-based Patient Management Module, a telemonitoring module, and a home visit server.…”

Tele-monitoring of ventilator-dependent patients: a European Respiratory Society Statement

“…There are different technologies and timings for data collection, ranging from digital videophone systems, alone [25] or coupled with other systems [26] to weekly transmission of ventilator data through modems, weekly phone interviews by nurses coupled with oximetry download through modems [34,[46][47][48], daily oximetry readings [46][47][48], customised or commercial multifunctional devices [34,35,49]. For severe COPD patients with CRF tele-spirometry may help in the monitoring of lung function and complement the information in the VDIs [34].…”