TELE HEALTH AND SECURITY AND PRIVACY MEASURES

Tele Health And Security And Privacy Measures

RESULTS AND ANALYSIS

Telehealth equipment is used as a tool in the management of long-term conditions in the community to proactively monitor patients and respond promptly to indicators of acute exacerbations. 'Vital signs' monitoring is believed to reduce hospital admissions and uses equipment in patients' homes to identify trends and alert when preset parameters are breached .

Users are trained to operate a machine which measures physiological indices such as blood pressure, oxygen saturations, pulse, spirometry, temperature, ECG and blood glucose readings each day in their home. In addition, users can enter subjective information into a touch screen, such as their responses to relevant symptom questionnaires and their latest weight. Data collected from a telehealth machine are sent via a telephone line to an Internet portal which can be accessed by health care professionals (such as community matrons, GPs and hospital consultants). The data may not be available immediately for review and therefore does not function as an emergency monitor. However, alarms can be elicited when abnormalities are detected. For example, persistent tachycardia or hypoxia could trigger a telephone call or home visit from a community matron. Responses to alarms are protocol-driven and should be planned in advance in consultation with the patient. Earlier intervention might reduce pressure on acute services and allow patients to avoid hospital admission.

Data collected can be used to provide a more accurate picture of disease status over a long period and may save time for clinicians, who can review the information before seeing the patient. Healthcare professionals can then spend more time discussing the patient's concerns and proposed changes to their management. Potential savings in clinician time may enable greater access to specialist care.

Telehealth can also be used in the shorter term as a diagnostic tool to gain objective evidence of paroxysmal pathology. Patients with a previously undiagnosed condition can have their vital signs recorded when symptomatic, which may be enlightening. Patients with COPD may undergo a noninvasive assessment for long term oxygen therapy in their own home using telehealth to provide an accurate picture of their requirements during everyday activities. Another application for telehealth is the support of patients discharged from hospital following an acute illness when they may require a limited period of monitoring in conjunction with intermediate care. Using telehealth may allow improved planning around end-of-life concerns, given that trends predicting terminal decline can be identified. The decision to stop monitoring and even remove the machine should be discussed in advance with the user.

One goal of telehealth is to improve quality of life for patients by empowering them to 'self-manage' their condition. Users must be willing and able to participate in this service for it to be beneficial. They must accept training on using the equipment and subsequent 'refresher' courses to check their ability to avoid common pitfalls occurring. For example, incorrect positioning of a sphygmomanometer cuff produces inaccurate results and cold hands generate falsely low oxygen saturation ...