Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis MN 55455, USA.
J Telemed Telecare. 2011;17(6):288-92. doi: 10.1258/jtt.2011.100712. Epub 2011 Aug 15.
We conducted a randomized controlled trial to evaluate the perception, satisfaction and utilization of a home telehealth service for frail elderly people living independently in their home communities. Control group subjects continued with their usual care and intervention group subjects were able to supplement their usual care with the use of a web portal. The web portal allowed videoconferencing and electronic messaging between home care nurses and clients, ordering health-related and home care services, access to health-related information and general access to the Internet. A total of 99 eligible people (59 female, 40 male) from one urban and one rural study site agreed to participate in the study. Eighty-four subjects were active participants for nine months. There were no significant differences in perception of technology between the two groups at baseline. At 60-day follow-up, the intervention group was significantly more positive towards technology compared to their own baseline (P < 0.001) and compared to the 60-day scores for the controls (P < 0.001). The intervention group indicated that overall the telehealth service met their expectations (mean score 9 out of 10) and they would recommend it to others (mean score 9.5 out of 10). All subjects were able to use the portal without difficulty after brief instructions from the nurses. A total of 1054 videoconferences were conducted with the intervention subjects. Fifty-six of these (5%) had to be discontinued after successful connection because of technical problems. Intervention subjects made fewer emergency department visits than control subjects, more visits to the eye doctor, fewer visits in all categories of home care utilization, and lower use of transportation services. Frail elderly people are able to adopt home telehealth technologies which may enable them to maintain independent living arrangements.
我们进行了一项随机对照试验，以评估独立居住在社区家中的体弱老年人对家庭远程医疗服务的感知、满意度和利用情况。对照组的受试者继续接受常规护理，而干预组的受试者则可以使用网络门户来补充常规护理。该网络门户允许家庭护理护士和客户之间进行视频会议和电子消息传递、订购与健康相关和家庭护理服务、访问健康相关信息以及一般访问互联网。来自一个城市和一个农村研究地点的 99 名符合条件的人（59 名女性，40 名男性）同意参加这项研究。84 名受试者在九个月内是活跃参与者。在基线时，两组对技术的感知没有显著差异。在 60 天随访时，与自身基线相比（P < 0.001），与对照组的 60 天评分相比（P < 0.001），干预组对技术的态度明显更为积极。干预组表示，总体而言，远程医疗服务符合他们的期望（平均得分为 10 分中的 9 分），他们会向其他人推荐（平均得分为 10 分中的 9.5 分）。所有受试者在接受护士的简短指导后都能够毫不费力地使用门户。干预组共进行了 1054 次视频会议。其中 56 次（5%）在成功连接后因技术问题不得不中断。与对照组相比，干预组就诊的急诊次数更少，看眼科医生的次数更多，所有类别的家庭护理利用次数更少，交通服务的使用也更少。体弱的老年人能够采用家庭远程医疗技术，这可能使他们能够维持独立的生活安排。
