Momentum telemedicine service descriptions
COPD Patients Briefcase (NO)
Objectives, expected outcomes, main beneficiaries
The COPD patients briefcase is a health service comprising both primary and specialist healthcare. It is intended as an integral part of future healthcare, delivering quality-assured, specialist consultation to patients in their home environment. It enables patients to have more quality days in their own home, shorter stays in hospital, and fewer readmissions. Patient empowerment is enhanced by providing expert multidisciplinary consultation, patient monitoring and education at home.
The main beneficiaries are patients and healthcare professionals.
Targeted population, number of patients
Broadly, the target population of the service can be categorised as elderly citizens with chronic obstructive pulmonary disease (COPD), and people with chronic conditions (e.g., who receive long-term monitoring or coaching).
From 20 to 50 people receive the service each month. An estimated 350,000 Norwegians have COPD, and this often involves frequent readmission to hospital. Home-dwelling patients with a FEV1 under 50% are the targeted population of the service.
Type of telemedicine service
The service category is home-hospitalisation. The relationship between key actors in the service is patient/secondary care.
Set-up that was being replaced
Traditional hospital treatment are made shorter and replaced by treatment via the COPD Patients Briefcase, introducing telemedicine-assisted discharge of COPD patients to their home environment.
Outcomes and results expected after introduction
Danish surveys show a 46 per cent improvement in readmissions to hospital in the telemedicine group versus the control group, with 68 per cent improvement regarding total days stay in hospital in the telemedicine group. In a patient survey, 97 per cent of those receiving telemedicine consultations would recommend it to others, and 86 per cent report that it gives them the “necessary help” with their lung disease. In the Norwegian project, similar results are expected.
The Dalane District Medical Centre (DDMC) user survey (of 2,000 consultations) shows that nearly all participants managed the technology without assistance. In the survey, 80 per cent reported that the technology made them feel more secure on discharge from hospital, and 65 per cent reported that use of the COPD briefcase had an important effect on their coping strategies.
Via the Briefcase (a two-way audio-visual “laptop” with spirometry and pulsoximetry capability), home-dwelling patients with an FEV1 of under 50 per cent are connected to the hospital for 14 days. They receive a pre-arranged, 30-minute video consultation with a specialist nurse each day of the week. At weekends they are offered telephone consultations. In addition, all patients can contact the hospital via an alarm telephone around the clock. This alarm telephone is connected to a manual call point in the briefcase.
The patient’s FEV1, forced vital capacity (FVC), blood-oxygen saturation and subjective checklists are recorded. Medical, physiotherapy and occupational therapy consultations are undertaken as required. Data is encrypted, anonymised and recorded.
The service is operational and part of the mainstream health service.