The Telematic Management of Insulin-Dependent Diabetes Mellitus project, funded by the European Union, implemented and evaluated a distributed computer-based system for the management of insulin-dependent diabetes mellitus. The system was evaluated in a nonrandomized, longitudinal study, and the findings indicated that web-based systems using clinical practice guidelines, patient registries, and performance feedback have the potential to improve the rate of routine testing among patients with diabetes. Support System to support the provision of routine care to patients with diabetes (Baker et al., 2001). Similarly, the Center for Health Services Research’s Henry Ford Health System in Detroit developed the web-based Diabetes Care Management McKay, exploring the development and feasibility of a web tool for diabetes self-management that emphasized personalized goal setting, feedback, and social support (McKay et al., 1998) found that patients were satisfied with the system and appreciated the social support and the availability of information. As diabetes has in many cases an asymptomatic nature, the time frame between sustained hyperglycemia and observable complications can be extended, thus making a long-term program of secondary prevention an essential part of appropriate diabetes care and a suitable domain for technology-based diabetes management applications. The data sets (including the spirometry readings) are transmitted to health care providers.Īnother example involves diabetes. The system is operated by the patient or an informal caregiver (including family members or friends) and involves web-based questionnaires and the operation of a spirometer to assess lung capacity. This section is organized by the disease or condition addressed by the application.įor asthma management, an example of Internet utilization is the home asthma telemonitoring system (Finkelstein, O’Connor, and Friedmann, 2001), which provides patients with continuous individualized help in the daily routine of asthma self-care and coping and alerts health care providers if specific conditions or patterns emerge. Telehealth applications offer a platform to support disease management for home care patients diagnosed with chronic conditions and their families. TELEHEALTH APPLICATIONS FOR HOME- BASED DISEASE MANAGEMENT Telehealth applications for home-based disease management (that link patients and their families to their health care providers) The following taxonomy captures the multiple levels of IT function and functionality in the context of home care:Īctive monitoring and management (requiring end-user involvement and participation) Information technology can be introduced in home care in a multitude of ways. Such a transition may be possible due to the active involvement of patients in the management of their disease using home monitoring devices and software, the access to information and online communities, and the use of personal health records maintained by patients themselves. Many anticipate that IT platforms may lead to patient empowerment and a transition from a passive role, in which the patient is the recipient of care services, to an active role, in which the patient is informed, has choices, and is involved in the decision-making process. The use of IT can lead to a fundamental redesign of home care processes based on the use and integration of electronic communication at all levels. Advances in telecommunications, web solutions, and social networking tools have the potential to support health care delivery and education. It is a general premise that information technology (IT) can address these challenges and enhance home health care services. Home health care faces several challenges, such as funding limitations, large geographic distances that make such resources often more costly for rural patients, and issues of clinical workforce distribution that impose access barriers to these services. Information Technology and Systems in Home Health Care
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