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Patient-Centered Internet Applications

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  • 0:00 Benefits of Being Connected
  • 0:38 Patient-Centered…
  • 4:16 Challenges with…
  • 5:06 Lesson Summary
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Lesson Transcript
Instructor: Patricia Jankowski

Patricia is an experienced registered nurse who has worked in various acute care areas as well as in legal nurse consulting. She also has a BSChE.

The world of healthcare has become more complex during recent years. To keep pace with the change, the Internet is playing a role in empowering patients to manage and monitor their own health conditions. This lesson is about patient-centered Internet applications.

Benefits of Being Connected

John Doe, a patient who has had asthma since he was a child, is feeling very tired and doesn't quite know why. It seems like he's breathing okay today, but he just can't seem to get anything done. Even climbing the stairs up to the bedroom seems difficult. So, he decides to do a spirometry self-test, using his home asthma telemonitoring system. Much to his surprise, he discovers that his readings show some obstruction, so he uses the fast-acting inhaler that his doctor prescribed for him, and within minutes, he feels like himself again. He's very glad he did not have to go to the emergency room.

Patient-Centered Internet Applications

In past years, patients played a passive role in the healthcare system, letting their doctors make most of the decisions about their care. They went into the office for testing and then simply waited for results. But in this age of computers and information technology, patients can now play a more active role in their own healthcare and in the prevention of complications of chronic diseases. They can be more in charge of their own healthcare by using patient-centered Internet applications.

Patient-Centered Internet Applications Empower Patients
Image of computer mouse

Patient-centered applications are information technology tools that support patient education and enhance communication between patients, families, and healthcare providers. They also promote prevention and wellness. They are especially important in the management of chronic diseases that require regular monitoring and care. They can be designed to support self-care without the intervention of a provider, or they can involve provider intervention.

Let's look now at some types of patient-centered Internet applications.

Self-Care Information Technology Systems

Self-care information technology systems are designed to help patients follow clinical action plans to manage their diseases. In these systems, the patient is in charge of his own self-care and monitoring, although information may be sent electronically to a physician or healthcare practitioner at intervals.

An example of this is HAT, or home asthma telemonitoring, like the system that John Doe used in the introductory example. Some studies have shown that patients often have difficulty following an action plan for asthma management on their own. For this reason, the HAT system was developed and then later evaluated in a study performed in 2001 by Finkelstein, O'Connor, and Friedmann, which is outlined in PubMed.gov. The HAT system allows the exchange of information between patient and clinician in the home setting so that potentially dangerous situations can be recognized early and intervention can take place.

Evaluation of the lung function testing that patients did at home with the HAT system showed that it was comparable to that done by professionals at the doctor's office. Further studies showed that even those patients who did not have computer experience were still able to use the HAT system successfully. Preliminary results of evaluation of HAT also showed that it increased patient compliance with the treatment regimen.

Virtual Visit and Video Conferencing

The virtual visit is a way in which patients can see a doctor anytime - 24 hours a day, seven days a week - as long as they have access to a computer. Virtual visits are appropriate for common problems that do not require ongoing care, such as colds, allergies, diarrhea, or similar issues. Companies like TeleDoc and MDLive allow the patient to see a doctor via webcam for a fee. Virtual visits are offered by some health insurance plans and are less expensive than a visit to an urgent care center or emergency room. While they cannot replace a face-to-face doctor visit, they provide a convenient way for patients to get quick help with minor health issues.

Video conferencing systems between patients and providers are also used in home care settings. Results of the Kaiser Permanente Tele-Home Health Research Project were published in the January 2001 issue of Archives of Family Medicine. In this study, patients who were newly diagnosed with various health conditions requiring home care were placed in both control groups with no intervention and intervention groups who had access to a video system that allowed the patients to interact with nurses in real time. The system also included equipment for assessing relevant parameters such as vital signs. The study showed that the video conferencing was effective, well-received by patients, saved money, and did not compromise the quality of care.

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