Home Telehealth for COPD Patients in Spain - ATA conference Austin ePoster (April 2013)


Published on

Published in: Health & Medicine, Business
  • Be the first to comment

  • Be the first to like this

No Downloads
Total views
On SlideShare
From Embeds
Number of Embeds
Embeds 0
No embeds

No notes for slide

Home Telehealth for COPD Patients in Spain - ATA conference Austin ePoster (April 2013)

  1. 1. A Managed Home Telehealth Service for Severe COPD Patients in Spain Ofer Atzmon, B.Sc., VP Business Development and Marketing1, Cristina Gómez Suárez, PhD2, Business Development Manager, Europe 1Aerotel Medical Systems, Holon, Israel, 2Linde Healthcare, Madrid, Spain. ePoster ATA Annual Meeting, Austin, Texas, May 2013
  2. 2. Introduction and Objectives • A new service for monitoring of severe Chronic Obstructive Pulmonary Disease (COPD) patients at home using telehealth technology was introduced by Linde Healthcare in Spain. • A study was conducted in order to establish the efficacy of the service, measured as the reduction in (a) the number of hospitalizations; (b) the length of hospital stays; and (c) number of Accident & Emergency (A&E) visits, due to COPD exacerbations. ATA 2013 2
  3. 3. Materials and Methods (1) ATA 2013 3 • The study was a randomized controlled trial including two groups, a group receiving conventional care and another home telehealth, with 30 patients in each. • The trial was performed by the Pneumology Department from the Hospital Universitario La Princesa (Madrid, Spain) and coordinated with four local Primary Care Centers (Goya, Montesa, Lagasca y Castelló). • Telehealth equipment and software was provided by Aerotel Medical Systems (Holon, Israel). • Home service, technical assistance and specialized telehealth clinical call center (CCC) was provided by Linde Healthcare (Madrid, Spain). • Patients included in the trial suffered severe COPD (GOLD stage IV) and where on home oxygen therapy. • Additionally, they had experienced at least an exacerbation episode that leaded to hospitalization in the year prior to inclusion in the trial.
  4. 4. Materials and Methods (2) ATA 2013 4 • Vital signs like blood pressure, heart rate, blood oxygen saturation where monitored on a daily basis and peak-flow weekly. Monitored data was received, and the CCC performed daily follow-up and triage (fig. 1). • Emphasis was made on designing an intuitive and easy to use system, as well as on adequate preparations and training of both patients and caregivers prior to the start of the service. • The clinical response was the result of a coordinated effort between the various stakeholders, with a “traffic light” like triage system being used (fig. 2). • The CCC resolved all non-adherence and technical issues, and clinical alerts activated by any alterations out of range after these baseline values had been verified with a clinical questionnaire. • When confirmed, clinical alerts were escalated to the clinical responsible who initiated an immediate evaluation and response.
  5. 5. Materials and Methods (3) ATA 2013 5Fig. 2: Triage Process Fig. 1: Telehealth Service Platform
  6. 6. Results (1) ATA 2013 6 • All of the patients included in the trial where polymedicated and suffered from different comorbidities (table 1). • Among the home telehealth group, 21 patients reported to have a caregiver with a moderate average care burden (Zarit test average score of 48.08). • The number of A&E visits, hospital admissions, length of stay, ICU admissions and exits were registered for both conventional care and home telehealth groups during a period of 7 months (fig. 3). • The clinical response pathway after evaluation of clinical alerts upon severity (fig. 4) was either: – a telephone recommendation or a home care visit by the clinical responsible for mild severity, and a priority appointment at the respiratory department, or – suggestion for A&E visit for very severe alerts • The acceptance of the home telehealth service was high among the patients, with an average score of 8.95 in a scale of 10.
  7. 7. Results (2) ATA 2013 7 Fig 3: Hospital resources usage for both Home Telehealth and Conventional Care groups.
  8. 8. Results (3) ATA 2013 8 Table 1: Clinical characteristics at baseline Parameter Home Telehealth Conventional Care p-value FEV1 37.76 37.1 0.46 BODEX 5.43 5.63 0.20 CAT 17.69 17.32 0.85 Previous hospitalizations (COPD exacerbation) 1.72 1.80 0.59 Respiratory acidosis 0.17 0.1 0.108 100% stage D according to GOLD 2011: severe patients with comorbidities Fig 4: Clinical response pathway
  9. 9. Conclusions ATA 2013 9 • The Home Telehealth group did considerably reduce the number of A&E visits (p 0.001), the number of hospital admissions (p 0.015) and the length of hospital stay (p 0.018) as compared with the Control Group. • Home Telehealth Services are effective in the follow-up of patients with severe COPD, optimizing care and associated costs, and starting care at the patient’s home when possible. • Patients adapted well to the telehealth service, were highly satisfied with the service and no withdrawals were observed due to difficulty in the use of the telehealth equipment.