Chumbler N et al. 2004 "The association of home-telehealth use and care coordination with improvement of functional and cognitive functioning in frail elderly men."
Reference
Chumbler N, Mann W, Wu S, et al. The association of home-telehealth use and care coordination with improvement of functional and cognitive functioning in frail elderly men. Telemed J E Health 2004;10(2):129-137.
Abstract
"This study compared health-related outcomes, during a 1-year period, for two groups of frail elders-one that received care coordination via distance monitoring (home-telehealth) and one that received no intervention. A case-control design was employed. The home telehealth intervention group was made up of 111 male veterans who were enrolled in a Veterans Health Administration project. The control group consisted of 115 men who were referred from either senior service agencies or hospital rehabilitation programs, but did not receive home-telehealth. Subjects in both groups had primary diagnoses of hypertension, diabetes, respiratory disease, or heart disease. The two groups were similar in terms of age, race, marital status, and independence in instrumental activities of daily living (IADL) at baseline. A paired t-test was used to study the before-after (baseline to 12-month follow-up) improvements in the outcome measures within each group. Regression models were used to compare the outcome improvements between the two groups. Over 1 year, the intervention group improved 2.2 points more in IADL, 14.4 points more in [functional independence measure] FIM motor scores, and 2.7 points more in FIM cognitive scores than the control group (p < 0.0001). This evidence supports the use of a specific home-telehealth strategy for care coordination to improve functional independence in non-institutionalized veterans with chronic disease. A randomized controlled trial should be employed to confirm these findings."
Objective
"To compare health-related outcomes, during a 1-year period, for two groups of frail elders-one that received care coordination via distance monitoring (home-telehealth) and one [group] that received no intervention."
Tools Used
Type Clinic
Primary care
Size
Large
Geography
Rural
Type of Health IT
Telemedicine
Type of Health IT Functions
The telemedicine system included (1) a handheld in-home messaging device, (2) monitoring technology with two-way audio-video allowing for bio data, and (3) a videophone.
Workflow-Related Findings
The adherence rate was 94 percent.
"Virtually all (98%) of the respondents indicated that the technology was easy to use, whereas 95% felt that the technology made them feel more secure. More than 9 out of 10 (92%) reported that the technology was helpful in managing their chronic conditions."
Study Design
Randomized controlled trial (RCT)
Study Participants
The study participants included 226 Veterans Administration (VA) patients: 111 male veterans (intervention group) and 115 men (control group). Only 58 of the 111 subjects in the experimental group provided data. Study groups included a control group and an experimental group using (1) home messaging devices, (2) telemonitors, and (3) two-way videophones.