Complex Tele-Monitoring: Facilitating Patient Self-Care of the Chronically-Ill

J. Cafazzo, K. Leonard, T. Easty, P. Rossos, C. Chan, and A. Logan (Canada)


Telemonitoring, chronic illness, diabetes, hypertension, hemodialysis, selfcare


The development of two tele-monitoring systems that facilitate patient self-care is detailed in this study. The continuous real-time monitoring of nocturnal hemodialysis (NHD) patients in the home can potentially reduce the perceived barriers to the adoption of this therapy. Vital signs and hemodialysis machine data are transmitted to a data repository, where rules are applied and alerts are generated for clinical staff to address as necessary. NHD patients perceive greater confidence and less anxiety through the difficult transitional period from hospital to home. Contrasting this application, a home blood-pressure monitoring system for diabetics with uncontrolled hypertension was also developed. A Bluetooth-enabled home blood pressure monitor communicates with their PDA or mobile phone to relay data back to the hospital’s data repository. Alerts to the patient can be generated locally, warning them of measurements that are trending outside the desired range. This level of feedback improves greatly on the less frequent follow-up by the family doctor and assists them in more timely management. Both these examples, using a common technical infrastructure and through the use of a user-centred design process, demonstrate the potential benefits of patient self-care facilitated through the use of tele-monitoring.

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