Terschuren C et al. 2007 "Implementing telemonitoring in the daily routine of a GP practice in a rural setting in northern Germany."
Reference
Terschuren C, Fendrich K, van den Berg N, et al. Implementing telemonitoring in the daily routine of a GP practice in a rural setting in northern Germany. J Telemed Telecare 2007;13(4):197-201.
Abstract
"We conducted a two-month feasibility study of telemonitoring based on home visits by a specially trained nurse to 20 elderly patients who would otherwise have been receiving monitoring home visits from their general practitioner (GP). A specially-trained community medicine nurse was instructed to report important changes in the health status of a patient during her home visits immediately via telephone. In the case of 8 patients, various telecare devices were installed by the community medicine nurse according to the patients' needs. Patients were trained to use the devices independently in their homes. Three patients received a one lead ECG meter and made 100 successful transmissions in 101 patient-days. Three patients were supplied with an electric scale and successfully transferred 72 measurements in 73 patient-days. Two patients were equipped with a teletonometry system and used the blood pressure monitor and blood glucose meter successfully. The tonometer itself was used by only one of the patients as suggested by the GP (once per week; 5 successful transmissions in 39 days). The GP reported a positive effect on her work, with time saved because of less travelling for home visits. With the back-up of the measurements obtained by the telecare devices it was possible to delegate monitoring tasks to the community medicine nurse."
Objective
"To assess the potential of a combination of telemedicine and telecare and specialized supporting home care to reduce unnecessary GP home visits in a rural area."
Type Clinic
Primary care
Size
Small and/or medium
Geography
Rural
Other Information
A community medicine nurse visited patients at home, supported by telemedicine. Two hundred of the participating GP's patients needed regular home visits.
Type of Health IT
Telemedicine
Type of Health IT Functions
The health status of patients was monitored by the specially trained community medicine nurse using the appropriate telemedicine devices. Digital measurement data were transferred to the GP's practice, and if the values exceeded a threshold, by fax.
Workflow-Related Findings
Overall, successful transmission data.
"The GP reported a positive effect on her work, and she gained time because she travelled less frequently for home visits."
"17 out of 19 remaining patients (90%) stated that they could imagine the community medicine nurse coming for routine visits assisted by telecare, thus allowing their doctor to restrict her home visits to medically necessary diagnostic checks and emergencies. Eighteen out of 19 patients (95%) felt that they would be able to enjoy a similar trusting relationship with the nurse as they had with their doctor. In general the patients reported positive scores for the nurse's work."
Study Design
Only postintervention (no control group)
Study Participants
Twenty-one patients, one GP, and one specially trained community medicine nurse participated.