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J. Cordeiro

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    OS21 - Advancing Telehealth: The Next Wave of Opportunities (ID 33)

    • Event: e-Health 2018 Virtual Meeting
    • Type: Oral Session
    • Track: Clinical Delivery
    • Presentations: 1
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      OS21.04 - Supporting COPD Patients with Home Telemonitoring: Insights from TEC4Home (ID 479)

      J. Cordeiro, Digital Emergency Medicine, Uninversity of British Columbia; Vancouver/CA

      • Abstract
      • Slides

      Purpose/Objectives: Chronic Obstructive Pulmonary Disease (COPD) is a major cause of morbidity and mortality that decreases patient quality-of-life and increases health system utilization due to frequent emergency department (ED) visits and hospitalizations. Supporting patients either before or after an exacerbation can optimize health outcomes. TEC4Home COPD is an evaluation to determine how home health monitoring (HHM) technology can better support patients with COPD at home, after leaving the hospital or clinic. The aim of TEC4Home COPD is to improve patient outcomes and quality-of-life, while also reducing ED readmissions and hospitalizations.

      Methodology/Approach: In TEC4Home COPD patients, either in acute exacerbation or in stable condition, are provided with home telemonitoring. Participants are recruited from emergency departments, in-patient units, and out-patient clinics. Once enrolled, the HHM equipment – a tablet, BP monitor, pulse oximeter, weight scale, and pedometer – is delivered to the participant’s home. Participants are asked to submit their measurements every weekday, for 60 days. A monitoring nurse reviews the data and follows up with the patient and/or primary care provider when necessary. After 60 days, the patient is discharged from the service, and equipment is retrieved. To assess impact and outcomes, participants are asked to complete an enrollment (pre-) and completion (post-) survey. The surveys are comprised of various validated scales including the Veterans Rand 12 Item Health Survey; the Clinical COPD Questionnaire; the COPD Self-Efficacy Scale; a healthcare utilization survey; and the System and Use Survey. Surveys assess overall health and disease-specific quality of life, self-efficacy, healthcare utilization, and comfort with technology. Patient biometric data from the 60-day monitoring period is also analyzed to assess changes to the patient’s health outcomes (e.g., change in symptom severity). Follow-up surveys with the monitoring nurses are conducted to assess provider experience and feedback on the monitoring process, communication with patients and other healthcare providers, and to collect recommendations for improvements to the technology and service. Other providers a part of a patient participant’s circle of care (e.g., family doctor, respirologist, etc.) are invited to provide insight into the impact of home telemonitoring on their patient care. Hospital administrative data is used to assess utilization and cost outcomes.

      Finding/Results: Enrollment is open until February 2018. Results and recommendations from the benefits evaluation will be shared at the eHealth conference. This study will contribute unique insights into home telemonitoring by: 1. Determining the efficacy of monitoring to help patients in exacerbations recover and to help stable patients avoid deterioration; 2. Comparing those in stable condition versus those recovering from exacerbations to identify similarities and differences in the use of home telemonitoring for COPD management; 3. Applying the triple aim framework to understand how home telemonitoring impacts patient experience, health outcomes, and costs in both groups of COPD patients.

      Conclusion/Implications/Recommendations: This evaluation of home telemonitoring for the care of both COPD patients recovering from exacerbations and those in stable condition will generate insights into how best to deploy home telemonitoring in accordance with patients’ specific needs. This work is submitted on behalf of the TEC4Home Healthcare Innovation Community.

      140 Character Summary: Better COPD outcomes: The benefits of home monitoring for enhanced patient quality-of-life, self-management & reduced healthcare utilization.

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