3 examples of success in personal Internet support & telecare: Consumer-centric highlights of a systematic review of e-Hea...
The review <ul><li>Late 2008 literature review of evaluated implementations of “eHealth technologies” </li></ul><ul><li>Id...
Overall results of review process 50 of these articles concerned ‘consumer’ systems
Consumer system types Not a lot of evidence of benefit yet, but seeing use Type Description Messaging Consumer communicate...
Good success rates <ul><li>Improved chronic disease outcomes: </li></ul><ul><li>11 of 15  education / self-management syst...
3 outstanding examples <ul><li>Puff City asthma management </li></ul><ul><li>Carelink insulin pump with data upload </li><...
Puff City <ul><li>Focuses on 3 core behaviours </li></ul><ul><ul><li>Controller medication adherence </li></ul></ul><ul><u...
Puff City <ul><li>4 consecutive educational computer sessions </li></ul><ul><ul><li>normative </li></ul></ul><ul><ul><li>i...
Puff City <ul><li>Significant reduction in symptoms & hospitalisation for urban, African-American high school students </l...
Carelink <ul><li>Internet-based insulin pump monitoring system </li></ul><ul><li>Rural and urban children </li></ul><ul><l...
<ul><li>Home monitoring trial evaluation </li></ul><ul><li>Symptomatic heart failure or angina patients </li></ul><ul><li>...
<ul><li>Significantly reduced re-admission rates & length of stay for angina patients </li></ul><ul><li>Improved quality o...
Limitations <ul><li>Did NOT find ALL evaluated systems </li></ul><ul><li>This was a review of ‘e-Health’ in general – didn...
Where to from here? <ul><li>Move the known successes to new contexts </li></ul><ul><li>Take maximum advantage of the innov...
Questions <ul><li>Jim Warren </li></ul><ul><ul><li>[email_address] </li></ul></ul><ul><li>Get the full report from the Min...
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Three Examples of Success in Personal Internet Support and Telecare

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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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Three Examples of Success in Personal Internet Support and Telecare

  1. 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. 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 & telecare </li></ul>
  3. 3. Overall results of review process 50 of these articles concerned ‘consumer’ systems
  4. 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. 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. 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. 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. 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. 9. Puff City <ul><li>Significant reduction in symptoms & hospitalisation for urban, African-American high school students </li></ul>
  10. 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. 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. 12. <ul><li>Significantly reduced re-admission rates & 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. 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. 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. 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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