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Three Examples of Success in Personal Internet Support and Telecare
Three Examples of Success in Personal Internet Support and Telecare
Three Examples of Success in Personal Internet Support and Telecare
Three Examples of Success in Personal Internet Support and Telecare
Three Examples of Success in Personal Internet Support and Telecare
Three Examples of Success in Personal Internet Support and Telecare
Three Examples of Success in Personal Internet Support and Telecare
Three Examples of Success in Personal Internet Support and Telecare
Three Examples of Success in Personal Internet Support and Telecare
Three Examples of Success in Personal Internet Support and Telecare
Three Examples of Success in Personal Internet Support and Telecare
Three Examples of Success in Personal Internet Support and Telecare
Three Examples of Success in Personal Internet Support and Telecare
Three Examples of Success in Personal Internet Support and Telecare
Three Examples of Success in Personal Internet Support and Telecare
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Three Examples of Success in Personal Internet Support and Telecare

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Jim Warren …

Jim Warren
National Institute for Health Innovation, University of Auckland
www.health.auckland.ac.nz/nihi
(P04, 1/10/09, Skellerup Room, 11.13)

Published in: Health & Medicine
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  • 1. 3 examples of success in personal Internet support & telecare: Consumer-centric highlights of a systematic review of e-Health Jim Warren, Chris Paton, Karen Day, Will Reedy & Malcolm Pollock
  • 2. The review <ul><li>Late 2008 literature review of evaluated implementations of “eHealth technologies” </li></ul><ul><li>Identified 100 articles published between 2003 and early 2009 </li></ul><ul><li>Today we describe 3 of the most outstanding examples of success in consumer Internet support &amp; telecare </li></ul>
  • 3. Overall results of review process 50 of these articles concerned ‘consumer’ systems
  • 4. Consumer system types Not a lot of evidence of benefit yet, but seeing use Type Description Messaging Consumer communicates with their regular face-to-face practice (e.g., make appointment, view/query lab test) Teleconsult Consumer communicates to clinical service providers with no face-to-face relationship (‘ask the doctor’ service) Education / Self-management Consumer learning and doing for themselves Family The user is a person supporting the ill person Telemedicine The consumer is remotely monitored with some degree of participation by self and/or family Borderline E.g., service needs assessment tools
  • 5. Good success rates <ul><li>Improved chronic disease outcomes: </li></ul><ul><li>11 of 15 education / self-management systems </li></ul><ul><li>2 of 3 telemedicine (home telemonitoring) systems </li></ul>
  • 6. 3 outstanding examples <ul><li>Puff City asthma management </li></ul><ul><li>Carelink insulin pump with data upload </li></ul><ul><li>Post-Discharge monitoring for heart/angina patients </li></ul>
  • 7. Puff City <ul><li>Focuses on 3 core behaviours </li></ul><ul><ul><li>Controller medication adherence </li></ul></ul><ul><ul><li>rescue inhaler availability </li></ul></ul><ul><ul><li>smoking cessation / reduction </li></ul></ul>
  • 8. Puff City <ul><li>4 consecutive educational computer sessions </li></ul><ul><ul><li>normative </li></ul></ul><ul><ul><li>ipsative (“compared with your last session”) feedback </li></ul></ul>
  • 9. Puff City <ul><li>Significant reduction in symptoms &amp; hospitalisation for urban, African-American high school students </li></ul>
  • 10. Carelink <ul><li>Internet-based insulin pump monitoring system </li></ul><ul><li>Rural and urban children </li></ul><ul><li>Showed HbA1c reduction versus non-users </li></ul><ul><li>Users uploaded data and emailed their diabetes care provider to review the Carelink data when an upload was complete </li></ul>
  • 11. <ul><li>Home monitoring trial evaluation </li></ul><ul><li>Symptomatic heart failure or angina patients </li></ul><ul><li>3-month intervention of: </li></ul><ul><ul><li>Nurse videoconferencing </li></ul></ul><ul><ul><li>Daily transmission of weight and blood pressure </li></ul></ul><ul><ul><li>Periodic transmission of electrocardiogram (ECG) </li></ul></ul>Post-discharge heart monitoring
  • 12. <ul><li>Significantly reduced re-admission rates &amp; length of stay for angina patients </li></ul><ul><li>Improved quality of life and functional status of patients with angina and heart failure </li></ul><ul><li>Patients found the technology easy to use and expressed high levels of satisfaction </li></ul>Post-discharge heart monitoring
  • 13. Limitations <ul><li>Did NOT find ALL evaluated systems </li></ul><ul><li>This was a review of ‘e-Health’ in general – didn’t search for specific diseases </li></ul><ul><li>Measured successes are still few and thin (but compelling!) </li></ul>
  • 14. Where to from here? <ul><li>Move the known successes to new contexts </li></ul><ul><li>Take maximum advantage of the innovation </li></ul><ul><li>This is a way to break out of the limitations of present healthcare projections! </li></ul><ul><li>HOWEVER, sustained exploitation will require changes in ‘the system’ </li></ul>
  • 15. Questions <ul><li>Jim Warren </li></ul><ul><ul><li>[email_address] </li></ul></ul><ul><li>Get the full report from the Ministry </li></ul><ul><li>Look for our upcoming JMIR article </li></ul><ul><li>See ‘hive’ for further discussion </li></ul>Thank you!

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