title: Old-and With Severe Heart Failure: Telemonitoring by Using Digital Pen Technology in Specialized Homecare: System Description, Implementation, and Early Results.
abstract: Telehealth programs for heart failure have been studied using a variety of techniques. Because currently a majority of the elderly are nonusers of computers and Internet, we developed a home telehealth system based on digital pen technology. Fourteen patients (mean age, 84 years [median, 83 years]) with severe heart failure participated in a 13-month pilot study in specialized homecare. Participants communicated patient-reported outcome measures daily using the digital pen and health diary forms, submitting a total of 3 520 reports. The reports generated a total of 632 notifications when reports indicated worsening health. Healthcare professionals reviewed reports frequently, more than 4700 times throughout the study, and acted on the information provided. Patients answered questionnaires and were observed in their home environment when using the system. Results showed that the technology was accepted by participants: patients experienced an improved contact with clinicians; they felt more compliant with healthcare professionals' advice, and they felt more secure and more involved in their own care. Via the system, the healthcare professionals detected heart failure-related deteriorations at an earlier stage, and as a consequence, none of the patients were admitted into hospital care during the study.
authors.affiliation: Author Affiliations: Department of Biomedical Engineering/Health Informatics, Linköping University (Drs Lind and Karlsson); SICS East Swedish ICT, Linköping (Dr Lind); and Department of Advanced Home Care and Department of Medicine and Health Sciences, Linköping University (Dr Carlgren), Sweden.
authors.forename: Leili
authors.initials: L
authors.lastname: Lind
authors.forename: Gunnar
authors.initials: G
authors.lastname: Carlgren
authors.forename: Daniel
authors.initials: D
authors.lastname: Karlsson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004867:Equipment Design; D006282:Health Personnel; D006333:Heart Failure / Q000628:therapy*; D006699:Home Care Services; D006801:Humans; D020407:Internet; D008490:Medical Informatics; D008499:Medical Records; D010349:Patient Compliance / Q000523:psychology; D010865:Pilot Projects; D019114:Remote Consultation / Q000295:instrumentation / Q000379:methods*; D057566:Self Report; D011795:Surveys and Questionnaires; D017216:Telemedicine / Q000379:methods*