Finkelstein J, Hripcsak G, Cabrera M R
Department of Medical Informatics, Columbia University, New York, USA.
Proc AMIA Symp. 1998:336-40.
We studied asthma patients from a low-income inner-city community without previous computer experience. The patients were given portable spirometers to perform spirometry tests and palmtop computers to enter symptoms in a diary, to exchange messages with physician and to review test results. The self-testing was performed at home on a daily basis. The results were transmitted to the hospital information system immediately after completion of each test. Physician could review results using an Internet Web browser from any location. A constantly active decision support server monitored all data traffic and dispatched alerts when certain clinical conditions were met. Seventeen patients, out of 19 invited, agreed to participate in the study and have been monitored for three weeks. They have been surveyed then using standardized questionnaire. Most of the patients (82.4%) characterized self-testing procedures as "not complicated at all." In 70.6% of cases self-testing did not interfere with usual activities, and 82.4% of patients felt the self-testing required a "very little" amount of their time. All patients stated that it is important for them to know that the results can be reviewed by professional staff in a timely manner. However, only 29.5% of patients reviewed their results at least once a week at home independently. The majority of the patients (94.1%) were strongly interested in using home asthma telemonitoring in the future. We concluded that Internet-based home asthma telemonitoring can be successfully implemented in the group of patients without previous computer background.
我们研究了来自低收入市中心社区且此前无计算机使用经验的哮喘患者。这些患者被给予便携式肺活量计以进行肺活量测定测试，并配备掌上电脑用于在日记中记录症状、与医生交流信息以及查看测试结果。自我测试在患者家中每天进行。每次测试完成后，结果立即传输至医院信息系统。医生可使用互联网浏览器从任何地点查看结果。一个持续运行的决策支持服务器监控所有数据流量，并在满足特定临床条件时发送警报。在受邀的19名患者中，有17名同意参与研究，并已接受了三周的监测。之后使用标准化问卷对他们进行了调查。大多数患者（82.4%）认为自我测试程序“一点也不复杂”。在70.6%的情况下，自我测试未干扰日常活动，82.4%的患者感觉自我测试只占用他们“很少”的时间。所有患者均表示，对他们来说，知道专业人员能及时查看结果很重要。然而，只有29.5%的患者在家中每周至少独立查看一次结果。大多数患者（94.1%）对未来使用家庭哮喘远程监测表现出强烈兴趣。我们得出结论，基于互联网的家庭哮喘远程监测能够在没有计算机背景的患者群体中成功实施。
