Konferensartikel

Evaluation of a telemedical based care pathway for patients with COPD

Elin Thygesen
Faculty of Health and Sport Science, Department of Health and Nursing Science, University of Agder, Kristiansand, Norway

Carl Erik Moe
Faculty of Social Sciences, Department of Information Systems, University of Agder, Kristiansand, Norway

Ladda ner artikel

Ingår i: Proceedings from The 15th Scandinavian Conference on Health Informatics 2017 Kristiansand, Norway, August 29–30, 2017

Linköping Electronic Conference Proceedings 145:15, s. 87-92

Visa mer +

Publicerad: 2018-01-04

ISBN: 978-91-7685-364-1

ISSN: 1650-3686 (tryckt), 1650-3740 (online)

Abstract

This paper presents results from an evaluation of the care pathway for patients with COPD in the U4H project in Agder, Norway and may serve as a recommendation for future care pathways for COPD patients. Our evaluation was based on qualitative interviews and a review of key documents and research papers. The care pathway included daily videoconference follow-ups for a period of 14 days, then a reduced follow-up for at least 16 more days. It contributed to increased accessibility, increased safety, and improved clinical insight for patients with COPD. However, we recommend a care pathway with room for more flexibility depending on individual needs, on the severity of COPD, and on what level of the services the patients already have. Patients should be able to be recruited from hospitals, home care services, and GPs. Video communication should be offered. Continuity in the follow-up is important for the sense of safety. The integration between specialist health care, home services, and GPs will become even more important in future telemedicine services as the number of patients increases.

Nyckelord

Care pathway, Telemedicine, COPD

Referenser

[1] Bårdsen, L. 2015, Egenmestring av KOLS med telemedisin. En casestudie av prosjektet United4Health for å undersøke om telemedisinske løsninger påvirker pasientenes egenmestring av KOLS. Masteroppgave, Master i helse- og sosialinformatikk. Grimstad: Universitetet i Agder.

[2] Barken, T., Thygesen, E., Söderhamn, U. 2017, Unlocking the limitations: living with chronic obstructive pulmonary disease and receiving care through telemedicine – a phenomenological study. Journal of Clinical Nursing, 00, pp. 1-11 [online] Available at: https://doi.org/10.1111/jocn.13857

[3] Coleman, E. and Berenson, R. 2004, Lost in transition: challenges and opportunities for improving the quality of transitional care. Annals of Internal Medicine, pp.141(7).

[4] Creswell, J.W. 2013, Research Design: Qualitative, quantitative and mixed methods approach. UK: Sage Publications Ltd.

[5] Dagsvik, G. and Ås, I. Lokalmedisinske tjenester Knutepunkt Sørlandet - Anbefalt pasientforløp for KOLS, http://www.knutepunktsorlandet.no/Handlers/fh.as hx?MId1=10319&FilId=961 [Accessed 29 Dec. 2016]

[6] Freid, V., Bernstein, A. and Bush, M. 2012, Multiple chronic conditions among adults aged 45 and over: trends over the past 10 years. Women, pp.18-64.

[7] Gallefoss, F., Fensli, R., Ås, I., Vabo, B., Surkhe, O., Gabrielsen, C., Thygesen, E. and Ytrehus E. 2012, Protocol United4Health, v1-1, REK.

[8] Gundersen, A., Gundersen, M. and Jakobsen, V. 2016, Innovativ og varm omsorg i heletjenestene ved hjelp av kald teknologi. Masteroppgave, Master i helseinformatikk. Trondheim: NTNU.

[9] Henderson, C., Knapp, M., Fernández, J.L., Beecham, J., Hirani, S.P., Cartwright, M., Rixon, L., Beynon, M., Rogers, A., Bower, P., Doll, H., Fitzpatrick, R., Steventon, A., Bardsley, M., Hendy, J. and Newman, S. 2013, Cost effectiveness of telehealth for patients with long term conditions (Whole Systems Demonstrator telehealth questionnaire study): nested economic evaluation in a pragmatic, cluster randomised controlled trial. BMJ, 346(mar20 4), pp. f1035-f1035

[10] Hendy, J., Chrysanthaki, T., Barlow, J., Knapp, M., Rogers, A., Sanders, C., Bower, P., Bowen, R., Fitzpatrick, R., Bardsley, M. and Newman, S. 2012, An organisational analysis of the implementation of telecare and telehealth: the whole systems demonstrator. BMC Health Services Research, 12(1).

[11] Horton, K. 2008, The use of telecare for people with chronic obstructive pulmonary disease: implications for management. Journal of Nursing Management, 16(2), pp.173 – 80.

[12] Kidholm, K. 2016, D3.5 Final Evaluation report United4Health.

[13] May, C., Finch, T., Cornford, J., Exley, C., Gately, C., Kirk, S., Jenkings, K., Osbourne, J., Robinson, A., Rogers, A., Wilson, R. and Mair, F.S. 2011, Integrating telecare for chronic disease management in the community: What needs to be done? BMC Health Services Research, 11(1).

[14] Moløkken, W. 2015, Telemedisinsk oppfølging av pasienter med KOLS. En evaluering av den telemedisinske løsningen i EU-prosjektet United4health for oppfølging av KOLS-pasienter på Agder. Masteroppgave, Master i helse- og sosialinformatikk, Kristiansand: Universitetet i Agder.

[15] Morris, J., Beaumont, D. and Oliver, D. 2006, Decent health care for older people. BMJ, 332(7771), pp.1166-1168.

[16] Nielsen, R., Johannessen, A. and Omenaa, S., Bakke, P., Askildsen, J., Gulsvik, A. 2011, Excessive costs of COPD in ever-smokers. A longitudinal community study. Respiratory Medicine, 105(3), pp.485-493.

[17] Oudshoorn, N. 2016, Telecare technologies and the transformation of health care. The Netherlands: Palgrave McMillian.

[18] Paulsen, B., Romøren, T. and Grimsmo, A. 2013, A collaborative chain out of phase. International Journal Integrated Care, 13(1).

[19] Pinnock. H., Hanley, J., McCloughan, L., Todd, A., Krishan, A., Lewis, S., Stoddart, A., van der Pol, M., MacNee, W., Sheikh, A. and Pagliari C. 2013, Effectiveness of telemonitoring integrated into existing clinical services on hospital admission for exacerbation of chronic obstructive pulmonary disease: researcher blind, multicentre, randomised controlled trial. BMJ, 347(oct17 3), pp. f6070-f6070.

[20] Pols, J. 2016, Care at a distance: On the closeness of technology. Amsterdam: Amsterdam University Press.

[21] Røsstad, T., Garåsen, H., Steinsbekk, A., Sletvold, O., and Grimsmo, A. 2013, Development of a patientcentered care pathway across healthcare providers: a qualitative study. BMC Health Services Research, 13, 121.

[22] Seemungal, T. and Wedzicha, J. 2006, Integrated care: a new model for COPD management? European Respiratory Journal, 28(1), pp.4-6

[23] Smith D. 2012, Development of an end-of-life care pathway for patients with advanced heart failure in a community setting, International Journal of Palliative Nursing, 18(6), pp.295-300.

[24] Smith, S., Allwright, S. and O’Dowd, T. 2007, Effectiveness of shared care across the interface between primary and speciality care in chronic disease management. Cocrane Database Systematic Review, 3:CD004910.

[25] Stange, K. 2009, The problem of fragmentation and the need for integrative solutions. Annals of Internal Medicine, 7(2), pp.533-536.

[26] Sunde, S., Walstad, R., Bentsen, S., Lunde, S., Wangen, E., Rustøen, T. and Henriksen A. 2014, The development of an integrated care model for patients with severe or very severe chronic obstructive pulmonary disease (COPD): the COPD– Home model. Scandinavian Journal of Caring Science, 28, pp.469–477.

[27] The Ministry of Health 2006, A National Strategy for COPD 2006-2011 (Nasjonal strategi for Kols-området 2006-2011), Oslo.

[28] The Ministry of Health 2009, Report No. 47 to the Storting (2008-2009). The Coordination Reform (Samhandlingsreformen Rett behandling - på rett sted - til rett tid), Oslo.

[29] The Ministry of Health 2011, Official Norwegian Report 2011:11. 2011, Innovation in the Care Services (Innovasjon i Omsorg), Oslo.

[30] Urving, L. and Nystad, K. 2015, Prosessorienterte effekter på telemedisinske prosjekter. En case studie i Kristiansand. Masteroppgave, Master i informasjonssystemer. Kristiansand: Universitetet i Agder.

[31] Vanhaecht, K., Lodewijckx, C., Sermeus, W., Decramer, M., Deneckere, S., Leigheb, F., Boto, P., Kul, S., Seys, D. and Panella, M. 2016, Impact of a care pathway for COPD on adherence to guidelines and hospital readmission: a cluster randomized trial. International Journal of Chronic Obstructive Pulmonary Disease, 11, pp.2897-2908.

[32] Vassbø, K. 2016, Evalueringer fra Telemedisinsk sentral Kristiansand, internt notat. Kristiansand kommune.

[33] Vatnøy, T., Thygesen, E. and Dale B. 2017, Telemedicine to support coping resources in homeliving patients diagnosed with chronic obstructive pulmonary disease: patients’ experiences. Journal of Telemedicine and Telecare, 23(1), pp.126-132.

[34] Vestbo, J., Hurd, S., August, A., Jones, P., Vogelmeier, C., Anzueto, A., Barnes, P., Fabbri, L., Martinez, F., Nishimura, M., Stockley, R., Sin, D., and Rodriguez- Roisin, R. 2013, Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. American Journal of Respiratory Critical Care Med, 187, pp.347-365.

[35] Yin, R. 2014, Case Study Research: Design and Methods. 5th ed. California: Sage Publications Ltd., Thousand Oaks. 

Citeringar i Crossref