Healthcare@HomeTraining, following-up and treatment of

chronically ill at home

Tatjana M. Burkow et. al

The Objective of the project

Demonstrate and promote home based training and the following-up patients/chronically ill using broadband networks

Background / Motivation

• There is a potential for health improvements by doing home-based training, education, treatment and following-up

• Prevention is important• Broadband and secure systems can make

home based e-health possible • Large user groups expire technological

barriers today

The consortium• A collaboration project between

– The Norwegian Centre for Telemedicine– University Hospital of North Norway– Norut IT – Well Diagnostics

• More than 40 people involved in the project• A national grant from HØYKOM in 2005, a

program under the Research Council of Norway

Main tasks performed

• A prototype of the system made

• Educational videos produced

• Services designed and field trailed (for patients with COPD and diabetes)

• User experience evaluated (patients and health care personnel)

The System

The user interface• At home - the users TV

and a remote control (camera and headset)– In order to reach people

not familiar with the PC

• The health care personnel use their ordinary system – PC-based systems– Stand alone

videoconferencing systems

A residential eHealth gateway• A small dedicated computer• Provides a secure and reliable

communication channel between the home and the public health service– Authentication (pin-code)– Encrypted storage, message

transmission and video conferencing

• Local storage• Acquisition and visualization at

home• Open source components (Linux,

Tomcat, Firefox, Postgres, Gnomemeeting, Xine)

Functionality

- Video clips and text- based information material

- Multipart video conferencing

- Medical sensor data- Lifestyle questionnaire- Messaging with health

care personnel

COPD trials• Why COPD?

– 200.000 suffers in Norway– 600 million suffers

worldwide– 2.7 million deaths per year– The disease is increasing

rapidly in Norway and worldwide.

• Services– Group based training and

education (oxygen therapy)– Exercises– Individual following-up– Self management

Diabetes trials• Why diabetes?

– 200.000 suffers in Norway today– 200 millions worldwide– 10 billions NOK per year (in

Norway) due to late injuries– The disease is increasing rapidly

both in Norway and world wide

• Services:– Group based training and

education– Individual following-up and

consultations – Self management

Group based training• Started with an initial

meeting at the hospital for the participants

• TV-meetings at home on a weekly basis

• Part of the education on video-clips– to be watched at home

between the TV-meetings– as a basis for discussions

and education given at the TV-meetings

Individual following-up• On a weekly basis (two part video conferencing)• Personalized following-up based on daily

registration of:– Blood glucose values (wireless transmission to the

system)– O2/puls (manually filled in)– A lifestyle form (manually filled in)

Self managementThe daily registered

– Blood glucose values – O2/puls

– lifestyle form

can be used for self management

Visualization– Graphical (O2/puls Blood

glucose)– Tabular (lifestyle history)

Field trials

• Five users with COPD and five with diabetes

• Health care personnel (nurses, physiotherapist, doctor and dieticians)

• Duration 2 months

• A qualitative study / pilot with a prototype (interviews afterwards)

Conclusions• High user acceptation (both for the patients and the health

care personnel) – Services – Systems

• The patients find the user interface (the TV and the remote control) easy to use

• It is possible to use open source for eHealth solutions• The home based health services makes it possible to:

– Reach those who are not able to travel due to the distance or their illness

– Spread education and training in time

• Future work:– Further development of the technology and the services – Support for additional diseases

Questions ….