Facilitating Hospital-at-home Therapy through Advanced Remote Patient Monitoring
Joseph Antony Cafazzo, Peter E. Picton, Jack Lam, Peter G. Rossos, Anthony Easty, Kevin J. Leonard, Christopher T. Chan · Medinfo 2007: Proceedings of the 12th World Congress on Health (Medical) Informatics; Building Sustainable Health Systems · 2007
Resource shortages in the healthcare system has called into question its sustainability and has generated interest in alternative forms of service delivery. Delivering of complex services in the home at a lower cost and with improved outcomes has proven to be elusive. In this study, we discuss the development of a comprehensive remote patient monitoring system that facilitates self-care of nocturnal hemodialysis patients, a complex hospital-at-home therapy. An ethnographic analysis was undertaken, determining the barriers to adoption and design criteria for a system that would facilitate mediated patient self-care for a complex therapy. These data were then used to inform the development of a remote patient monitoring system. In our pilot testing, patients developed a dependency on the system, when it was expected to be needed only for their transitional phase. Patient accountability was increased through the use of the system when it was found that patients did not always dialyze as frequently as they reported. The development of a blood disconnect monitor proved to be a critical component of the system. The resultant system provided an increased level of comfort and reduced anxiety for patients, and for family caregivers in particular.