Good Practices Overview | Basque Country | Czech Republic | Norrbotten | Puglia | Scotland
Telehomecare, Telemonitoring, Teleconsultation and telecare project aimed at patients with Heart Failure, Chronic obstructive pulmonary diseases and Diabetes
Summary of the good practice:
TeleHomeCare Project is proposed as a technological support already structured the activities of home care with the main objective to affect favourably on the reduction of re-hospitalization rate and improving the quality of care at the patient’s home, also validating new telemedicine models applied for diagnostic and therapeutic pathways for the management of chronicity.
Patients, opportunely selected, are followed by their family doctors with by telemonitoring using the innovative technological instruments H@H Hospital at Home, able to detect the main clinical and instrumental parameters in addition to the therapeutic administration, based on oxygen and bronco-aspiration.
The telemedicine project is to implement a new type of monitoring of the patients who suffering of chronic diseases, based on continuous collaboration and patient monitoring, by different professionals and different users. TeleHomeCare includes the following main objectives:
- Reduce the number of patients with heart disease, Chronic Diseases and Diabetes in the process of instability;
- Reduce hospitalization and re-hospitalization;
- Activate protected de-hospitalization;
- Optimize the therapy and diagnosis according to international guidelines;
- To promote the integrated management of Hospital and Territory;
Evaluate the satisfaction of the doctor, caregiver and patient;
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Challenge addressed by the good practice
TeleHomeCare project wants to implement a new type of monitoring of the patients suffering from chronic diseases, based on continuous collaboration and patient monitoring, by different professionals and different users. The five challenges that the Project intends to pursue are:
- Reduce the number of patients with heart disease, Chronic Diseases and Diabetes in the process of instability; •Reduce hospitalization and re-hospitalization;
- Activate protected resignation;
- Optimize the therapy and diagnosis according to international guidelines;
To promote the integrated management of Hospital and Territory.
Key innovative elements of the good practice
The examination of the data of the activity with the monitoring of about 100 patients, allows appreciating the effectiveness of the remote monitoring system as well as detect a favourable judgment on the part of the patients with reference to a better quality of care. patients are directly supervised by their General Practitioners, in a much faster and performance. We notice a very facilitated dialogue between General Practitioner and Specialist. Finally, the general practitioner feels more supported by the Specialist when he needs a quick consultation. 60% of patients are over 65. 30% of them suffering of heart disease, 40% of COPD, the remaining diabetes. In all patients who presented outside threshold values of blood oxygen saturation, oxygen administration by concentrator has allowed to re-establish the normal clinical condition. In approximately 30% of patients is the drug therapy was improved thanks to telemonitoring..
Full Scirocco information on the good practice
SciroccoGP-Puglia-6-TeleHomeCare-Project.pdf [PDF]
Publications and reports on the good practice
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Contact point: Doctor Francesco Galasso; francesco.galasso15@tin.it