Telemedicine service supporting patients with long-term conditions (Heart Failure and/or Diabetes type 2) at their self-management of the disease at home.
Prolonged medical care for the ageing society, the costs for managing chronic diseases, and the citizens’ increased demands are major factors that contribute to the complexity problem of delivering quality healthcare. TM services for chronic patient care are becoming very important for patients in the self-management of their chronic conditions in their home environment.TM service for patients with long-term care conditions staying at home is offered by the Centre for Telehealth (CEZAR) at the General Hospital Slovenj Gradec, Carinthia. The Centre and the services were developed form the European R&D project UNITED4HEALTH. CEZAR offers TM support to patients with heart failure(HF) and/or diabetes mellitus type 2(DM2) in their home environment. Patients perform daily measurements of their blood pressure, heart rate, body weight, and oxygenation or blood sugar following the recommendation of their specialist regarding the time and frequency of measurements. Data from measuring device are immediately automatically sent to the gateway (mobile phone) and then further to the TM server at the GH-SG. When deteriorated condition is confirmed, the patient is contacted by phone and the specialist decides on the action to be taken by the patient. Later the CEZAR centre coordinator advises the patient on the doctor’s decision.
Stakeholders/beneficiaries are patients with chronic conditions, healthcare staff, relatives/carers, health insurance institute, healthcare policy system.
For the service set-up 450.000 EUR was invested, partially from EU project UNITED4HEALTH.
Personnel running TM: 1 project manager, 2 Medical specialists, 1 nurse, 1 informatician, 0,2 technician
The service is free for the patients and is not yet reimbursed by the health insurance.
Evidence of success
TM service has proven to be effective in providing support to DM2 and HF patients. Hospitalisation rate and duration were reduced by 70% in HF patients. A survey (363 patients) confirmed that the TM service is adequate, the technology acceptable, and the organisation of the service effective. This was prooved during the COVID-19 restrictions when standard support was cancelled but not TM. AWARDS: the Best innovation of Carinthia (2016) & Silver award for innovation (Chamber of Commerce, 2017).
The major challenge was to provide a service that is well accepted by the end-users. The critical issue for broader deployment is a lack of a reimbursement system and absence of financial support for the service dissemination on the national level.
Potential for learning or transfer
CEZAR is a good example of a project which was successfully continued after the end of the funding period (UNITED4HEALTH project). So far, over 440.000 measurements were sent by the patients, what resulted in over 1.200 therapy changes.
The CEZAR’s success and its potential to be implemented as a home telemedicine solution in other (Slovenian and EU) regions can be supported by empirical data:
- In the cohort of 134 HF patients, the participation in CEZAR resulted in 77% decrease in number of hospitalization day, and 70% decrease in the number of (re)admissions to the hospital. Both bring a significant reduction in the care costs.
- Survey on TM acceptance and perception among 363 users revealed high overall satisfaction with service and equipment, and likelihood of recommendation of TM services to other patients with same type of disease. It has been shown that peer recommendation can significantly contribute to the acceptance of new service among non-users.
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