Skip to main content

Model of Chronic Care Enabled with Information Technology

  • Chapter
Information Technology Solutions for Healthcare

Part of the book series: Health Informatics ((HI))

Abstract

The increase in prevalence of chronic disorders in modern societies has resulted in increasing organizational and financial pressure on healthcare systems. The challenge of adequate care delivered to patients with chronic conditions, who want to remain in their social context, promotes the search for effective models of care. Adequate use of information and communication technology may be an appropriate response to this challenge. Chronic patients require repetitive interactions with the healthcare system. High-quality care adhering to evidence-based medicine strategies must be delivered to a vast population of patients in a continuous manner. The experience from studies and pilot implementations of information technology tools in specific groups of patients suffering from chronic diseases indicates that considerable benefits may be gained related to improved cost-effectiveness and simultaneously maintained quality of care. It seems that e-health strategies may help to fulfill two contradictory requirements — provision of high-quality medical services and preservation of the cost-effective approach. Available evidence supports the use of e-health solutions for care delivery. The results of trials based on the use of integrated IT-enhanced model of care with focus on patient empowerment and better interdisciplinary team communication demonstrated improvement of such outcome measures like hospitalization rate, frequency of ambulatory visits and level of quality of life in populations of chronic patients. However, it must be emphasized that a new model of care based on the effective use of e-health solutions cannot be implemented without adherence to legal, ethical and psychosociological requirements existing in the healthcare environment.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

8 Bibliography

  1. Anhoj J., Moldrup C.: Feasibility of Collecting Diary Data From Asthma Patients Through Mobile Phones and SMS (Short Message Service): Response Rate Analysis and Focus Group Evaluation From a Pilot Study. J Med Internet Res 2004; 6(4): e42 [http://www.jmir.org/2004/4/e42/]

    Article  PubMed  Google Scholar 

  2. Artinian N.T., Washington O.G., Templin T.N.: Effects of home telemonitoring and community-based monitoring on blood pressure control in urban African Americans: a pilot study. Heart Lung 2001;30(3): 191–199

    Article  PubMed  CAS  Google Scholar 

  3. Baker D.B.: Patient-centered healthcare: The role of the Internet. Dis Manag Health Outcomes 2001; 9(8): 411–420

    Article  Google Scholar 

  4. Bellazzi R., Brugues E., Carson E., et al.: Multi-Access Services for the Management of Diabetes Mellitus: The M2DM Project. Diabetes 2002;51(Suppl. 2): A466

    Google Scholar 

  5. Bondmass M.D., Bolger N.E., Castro G.M., Orgain J., Avitall B.: Rapid control of hypertension in African Americans achieved utilizing home monitoring. Circulation 1998; 98: I–517

    Google Scholar 

  6. Boquete L., Bravo I., Barea R., Garcia M.A.: Telemetry and control system with GSM communications. Microprocessors Microsystems 2003; 27: 1–8

    Article  Google Scholar 

  7. Buchtela D., Anger Z., Peleska J., Vesely A., Zvarova J.: Presentation of Medical Guidelines on a Computer. In: Duplaga M., Zieliński K., Ingram D. (eds.): Transformation of Healthcare with Information Technologies. Amsterdam, IOS Press (2004) 166–171

    Google Scholar 

  8. Chan D.S., Callahan C.W., Sheets S.J., Moreno C.N., Person D.A.: Store and forward technology: Telemonitoring of children using their asthma medication in their home (abstract). Telemed J e-Health 20002; 8(2): 244

    Google Scholar 

  9. Contini E., Costantino G.P., Harti R., Quarello F., Sancipriano G., Selwood N.H.: Computerized monitoring of dialysis remote sites and follow-up of chronic patients using smart-phones. Medial Informatics Europe’96: Human Facets in Information Technologies. Amsterdam,: IOS Press (1996) 44–48

    Google Scholar 

  10. DeMaio J., Schwartz L., Cooley P., Tice A.: The Application of Telemedicine Technology to a Directly Observed Therapy Program for Tuberculosis: A Pilot Project. Clin Infect Dis 2001; 33: 2082–2084

    Article  PubMed  CAS  Google Scholar 

  11. Disease Management Association of America Webpag. Definition of Disease Management. [http://www.dmaa.org/definition.html]

    Google Scholar 

  12. Dodd N.: Enhanced alarm detection for telemonitoring using the neural network alarm monitor. Br J Healthcare Comp Inf Manag 1997; 14(6): 20–22

    Google Scholar 

  13. Duplaga M., Zielinski K., Szczeklik A.: Internet Telemonitoring Application for Improvement of the Quality of Severe Asthma Patient Care in Poland. 7th Int Conf on Medical Aspects of Telemedicine, Eur J Med Res 2002; 7(Suppl. 1): 21

    Google Scholar 

  14. Ewers M.: The Advent of High-Tech Home Care in Germany. Public Health Nursing 2002; 19(4): 309–317

    Article  PubMed  Google Scholar 

  15. Fail E.G., Glasgow R.E., Boles S., Mckay H.G.: Who participates in Internet-based self-management programs? A study among novice computer users in a primary care setting. Diabetes Educ 2000; 26(5): 806–811

    Google Scholar 

  16. Field M.J., Grigsby J.: Telemedicine and Remote Patient Monitoring. JAMA 2002; 4: 423–425

    Article  Google Scholar 

  17. Finkelstein J., Cabrera M.R., Hripcsak G.: Internet-based home asthma telemonitoring: Can patients handle the technology? Chest 2000; 117(1): 148–155

    Article  PubMed  CAS  Google Scholar 

  18. Finkelstein J., Hripcsak G., Cabrera M.R.: Patients’ acceptance of Internet-based home asthma telemonitoring. Proc AMIA Symp 1998; 336–340

    Google Scholar 

  19. Finkelstein J., O’Connor G., Galichina N.: Feasibility of Internet-based Home Automated Telemanagement in Patients with Chronic Obstructive Pulmonary Disease. Chest 2001; 120(4) Suppl.: 253S

    Google Scholar 

  20. Forkner-Dunn J.: Internet-based Patient Self-care: The Next Generation of Health Care Delivery. J Med Internet Res 2003; 5(2): e8 [http://www.jmir.org/2003/2/e8]

    Article  PubMed  Google Scholar 

  21. Friedman R.H., Kazis L.E., Jette A., Smith M.B., Stollerman J., Torgerson J., et al.: A telecommunications system for monitoring and counselling patients with hypertension. Impact on medical adherence and blood pressure control. Am J Hypertens 1996; 9: 285–292

    Article  PubMed  CAS  Google Scholar 

  22. Friedman R.H., Stollerman J.E., Mahoney D.M., Rozenblyum L.: The virtual visit: using telecommunications technology to take care of patients. J Am Med Inf Assoc 1997; 4: 413–425

    CAS  Google Scholar 

  23. Friedman R.H., Stollerman J.E., Rozenblyum L., Belfer D., Selim A., Mahoney D., Steinbach S.: A telecommunications system to manage patients with chronic disease. Medinfo 1998; 9 Pt 2: 1330–1334

    PubMed  Google Scholar 

  24. Friedman R.H.: Automated telephone conversations to assess health behaviour and deliver behavioural interventions. J Med Syst 1998; 22: 95–102

    Article  PubMed  CAS  Google Scholar 

  25. Gerber B.S., Eiser A.R.: The Patient-Physician Relationship in the Internet Age: Future Prospects and the Research Agenda. J Med Internet Res 2001;3(2):e15

    Article  PubMed  CAS  Google Scholar 

  26. Gillespie G.: Deploying an I.T. cure for chronic disease. Health Data Manag 2000; 8(7): 68–74

    PubMed  CAS  Google Scholar 

  27. Glick T.H., Moore G.T.: Time to learn: the outlook for renewal of patient-centred education in the digital age. Med Educ 2001; 35: 505–509

    Article  PubMed  CAS  Google Scholar 

  28. Gomaa W.H., Morrow T., Muntendam P., Smith G.: Technology-based disease management: A low-cost, high-value solution for the management of chronic disease. Dis Manag Health Outcomes 2001; 9(10): 577–588

    Article  Google Scholar 

  29. Gomaa W.H.: High-Tech, Low-Cost, Huge Results. Health Manag Tech 2002; April: 32–33,38

    Google Scholar 

  30. Gomez E.J., Del Pozo F., Hernando M.E.: Telemedicine for diabetes care: the DIABTel approach towards diabetes telecare. Med Inf 1996; 21(4): 283–295

    Article  CAS  Google Scholar 

  31. Gustafson D.H., Hawkins R.P., Boberg E.W., Bricker E., Pingree S., Chan C.L.: The Use and Impact of a Computer-based Support System for People Living with AIDS and HIV Infection. Proc Ann Symp Comp Appl Med Care 1994; 604–608

    Google Scholar 

  32. Gustafson D.H., McTavish F., Hawkins R., Pingree S., Arora N., Mendenhall J., Simmons G.E.: Computer support for elderly women with breast cancer. JAMA 1999; 28(14): 1268–1269

    Google Scholar 

  33. Hutten H.: Telesurveillance of Patients with Cardiac Risk. Eur Surg 2002; 34: 303–307

    Article  Google Scholar 

  34. Informatics for Diabetes Education and Telemedicine (IDEATel) Project Website [www.ideatel.com]

    Google Scholar 

  35. Institute of Medicine, Committee on Quality of Care in America. A new health care system for the 21st century. Washington, DC: National Academy Press; 2001 Friedewald V.E., Pion R.J.: Returning home. Health Manag Technol 2001; 22(9): 22–26

    Google Scholar 

  36. Jadad A.R.: Evidence-based decision making and asthma in the Internet age: the tools of the trade. Allergy 2002; 57(Suppl. 74): 15–22

    Article  PubMed  Google Scholar 

  37. Jerant A.F., Azari R., Nesbitt T.S.: Reducing the Cost of Frequent Hospital Admissions for Congestive Heart Failure. A Randomized Trial of a Home Telecare Intervention. Med Care 2001; 39(11): 1234–1245

    Article  PubMed  CAS  Google Scholar 

  38. Joch A.: Can the Web Save Disease Management? Healthcare Informatics March 2000 [http://www.healthcareinformatics.com/issues/2000/03_00/cover.htm]

    Google Scholar 

  39. Johnson A.L., Taylor D., Sackett D.L., Dunnett C.W., Shimizu A.G.: Self-recording of blood pressure in the management of hypertension. Can Med Assoc J 1978; 119: 1034–1039

    PubMed  CAS  Google Scholar 

  40. Johnson P., Andrews D.C., Wells S., de Lusignan S., Robinson J., Vandenburg M.: The use of a new continuous wireless cardiorespiratory telemonitoring system by elderly patients at home. J Telemed Telecare 2001; 7(Suppl 1): S1:76–77

    Google Scholar 

  41. Johnston B., Wheeler L., Deuser J., Sousa K.H.: Outcomes of the Kaiser Permanente Tele-Home Health Research Project. Arch Fam Med 2000; 9: 40–45

    Article  PubMed  CAS  Google Scholar 

  42. Kharitonow S.A., Kelly C., Meah S., Godfrey S., Pride N.B., Barnes P.J.: Home Overnight Monitoring of Breath Sounds in Normal and Asthmatic Subjects. ATS 98th Int Conf May 17–23, 2002, Atlanta, GA

    Google Scholar 

  43. Ladyzyński P., Wójcicki J.M., Krzymień-Blachowicz J., Józwicka E., Czajkowski K., Janczewska E., Karnafel W.: Teletransmission system supporting intensive insulin treatment of out-clinic type 1 diabetic pregnant women. Technical assessment during 3 years’ application. Int J Artif Organs 2001; 24(3): 157–163

    PubMed  Google Scholar 

  44. Leslie S.: Online consulting. The experience of a commercial service. J Telemed Telecare 2001; 7(Suppl. 2): S2:78–82

    Article  PubMed  Google Scholar 

  45. Maglaveras N., Koutkias V., Meletiadis S., Chouvarda I., Balas E.A.: The role of wireless technology in home care delivery. Medinfo 2001; 10 (Pt 1): 835–839

    PubMed  CAS  Google Scholar 

  46. Mahoney D., Tennstedt S., Friedman R., Heeren T.: An automated telephone system for monitoring the functional status of community-residing elders. Gerontologist 1999; 39: 229–234

    PubMed  CAS  Google Scholar 

  47. Mandl K., Kohane I., Brandt A.: Electronic Patient-Physician Communication: Problems and Promise. Ann Intern Med 1998; 129(6): 495–500

    PubMed  CAS  Google Scholar 

  48. Mason A., Drummond M., Towse A.: Is disease management relevant in Europe: some evidence from the United Kingdom. Health Policy 1999; 48: 69–77

    Article  PubMed  CAS  Google Scholar 

  49. Mc Kay H.G., King D., Eakin E.G., Seeley J.R., Glasgow R.E.: The diabetes network Internet-based physical activity intervention: a randomized pilot study. Diabetes Care 2001; 24(8): 1328–1334

    Article  CAS  Google Scholar 

  50. McGill M., Constantino M., Yue D.K.: Integrating telemedicine into a National Diabetes Footcare Network. Pract Diabetes Int 2000; 17(7): 235–238

    Article  Google Scholar 

  51. Mease A.: Telemedicine improved diabetic management. Milit Med 2000; 165(8): 579

    Google Scholar 

  52. Molfenter T., Johnson P., Gustafson D.H., DeVries K., Veeramani D.: Patient Internet Services: Creating the Value-added Paradigm. J Healthcare Inf Manag 2002; 16(4): 73–79

    Google Scholar 

  53. Morlion B., Knoop C., Paiva M., Estenne M.: Internet-based home monitoring of pulmonary function after lung transplantation. Am J Resp Crit Care Med 2002; 165(5): 694–697

    PubMed  Google Scholar 

  54. Nanevicz T., Piette J., Zipkin D., Serlin M., Ennis S., De Marco T., Modin G.: The feasibility of a telecommunications service in support of outpatient congestive heart failure care in a diverse patient population. Cong Heart Failure 2000; 6(3): 140–145

    Article  Google Scholar 

  55. Neville R., Greene A., McLeod J.: Mobile phone text messaging can help young people manage asthma. BMJ 2002; 325: 600

    Article  PubMed  Google Scholar 

  56. NUA Internet Surveys. CyberAtlas: Americans want online access to doctors. 2002 April 12 [http://www.nua.com/surveys/index.cgi?f=VS&art_id=905357844&rel=true]

    Google Scholar 

  57. O’Connor P., et al.: Continuous quality improvement can improve glycemic control for HMO patients with diabetes. Arch Fam Med 1996; 5: 502–506

    Article  PubMed  CAS  Google Scholar 

  58. Palmer K., Parrott J., Scott R., Garnett D.: Hospital to home telemonitoring post cardiac surgery. Telemed J e-Health 2001; 7(2): 127–128

    Google Scholar 

  59. Ploughmann S., Hejlesen O.K., Cavan D.A.: DiasNet — a diabetes advisory system for communication and education via the Internet. Int J Med Inf 2001; 64(2–3): 319–330

    Article  Google Scholar 

  60. Rabinowitz E.: Online MD programs must balance accessibility against legal risks. Managed Healthcare Executive 2001; 11(10): 35–37

    Google Scholar 

  61. Regan M.: Utilizing an Intranet in Disease Management. Dis Manag Health Outcomes 2002; 10(3): 147–154

    Article  Google Scholar 

  62. Rialle V., Noury N., Herve T.: An experimental health smart home and its distributed Internet-based information and communication system: First steps of a research project. Medinfo 2001; 10 (Pt 2): 1479–1483

    PubMed  CAS  Google Scholar 

  63. Rogers M.A.M., Small D., Buchan D.A., Butch C.A., Stewart C.M., Krenzer B.E., Husovsky H.L.: Home Monitoring Service Improves Mean Arterial Pressure in Patients with Essential Hypertension. A Randomized Controlled Trial. Ann Intern Med 2001; 134: 1024–1032

    PubMed  CAS  Google Scholar 

  64. Roglieri J.L, Futterman R., McDonough K.L., Malya G., Karwath K.R., Bowman D., Skelly J., Warburton S.W.: Disease management interventions to improve outcomes in congestive heart failure. Am J Manag Care 1997; 3(12): 1831–1839

    PubMed  CAS  Google Scholar 

  65. Roudsari A.V., Zhao S., Carson E.: Web-based decision support and telemonitoring system for the management of diabetes. Proc 22nd Ann Int Conf IEEE Engineering in Medicine and Biology 2000; 2: 1120

    Article  Google Scholar 

  66. Russo H.: Window of Opportunity for Home Care Nurses: Telehealth Technologies. Online J Issues Nursing 2001; 6(3) [http://www.nursingworld.org/ojin/topic16/tpc16_4.htm]

    Google Scholar 

  67. Selecky C.: Integrating technology and interventions in the management of diabetes. Dis Manag Health Outcomes 2001; 9(Suppl. 1): 39–52

    Article  Google Scholar 

  68. Shea S., Starren J., Weinstock R.S., Knudson P.E., Teresi J., Holmes D., Palmas W., Field L., Goland R., Tuck C., Hripcsak G., Capps L., Liss D.: Columbia University’s Informatics for Diabetes Education and Telemedicine (IDEATel) Project. Technical Implementation. J Am Med Inf Assoc 2002; 9: 25–36

    Google Scholar 

  69. Stammer L.: Future tech devices: Smart shirts. Healthcare Inf 2001; 18(9): 34

    CAS  Google Scholar 

  70. Tattersall R.: The expert patient: a new approach to chronic disease management for the twenty-first century. Clin Med 2002; 2(3): 227–229

    PubMed  Google Scholar 

  71. Tsai C., Starren J.: Patient Participation in Electronic Medical Record. J Am Med Assoc 2001; 285(13): 1765

    Article  CAS  Google Scholar 

  72. Wilkinson M., Mair F., Bonnar S.A., Angus R.M.: Initial Experience with Telemedicine in the Home Care of Patients with Acute Exacerbations of COPD. Proc ATS 98th Int Conf 2002; May 17–23, Atlanta, GA

    Google Scholar 

  73. Winnem O.M.: Integrating Electronic Guidelines into the Diagnostic Cycle. In: Duplaga M., Zieliński K., Ingram D. (eds.): Transformation of Healthcare with Information Technologies. Amsterdam, IOS Press (2004) 156–165

    Google Scholar 

  74. World Health Organization “Innovative Care for Chronic Conditions: Building Blocks for Action. Global Report.” 2002

    Google Scholar 

  75. Yatim L.: Israeli telenursing call center: Home cardiac telemonitoring: revisiting Israel’s Shahal. Telemedicine Today 1997; 5(6): 26–27,33

    Google Scholar 

  76. Yonghong Z., Bai J., Lingfeng W.: Development of a home ECG and blood pressure telemonitoring center. Proc 22nd Ann Int Conf IEEE Eng Med Biol Soc 2000; 3: 2282–2285

    Article  Google Scholar 

  77. Young M., Sparrow D., Gottlieb D., Selim A., Friedman R.: A Telephone-Linked Computer System for COPD Care. Chest 2001; 119: 1565–1575

    Article  PubMed  CAS  Google Scholar 

  78. Zrebiec J.F., Jacobson A.M.: What attracts patients with diabetes to an Internet support group? A 21-month longitudinal website study. Diabet Med 2001; 18(2): 154–158

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2006 Springer-Verlag London Limited

About this chapter

Cite this chapter

Duplaga, M., Winnem, O.M. (2006). Model of Chronic Care Enabled with Information Technology. In: Zieliński, K., Duplaga, M., Ingram, D. (eds) Information Technology Solutions for Healthcare. Health Informatics. Springer, London. https://doi.org/10.1007/1-84628-141-5_11

Download citation

  • DOI: https://doi.org/10.1007/1-84628-141-5_11

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-85233-978-4

  • Online ISBN: 978-1-84628-141-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics