Momentum telemedicine service descriptions
Objectives, expected outcomes, main beneficiaries
The full name of the service is ITHACA -Innovant en el Tractament de la Hipertensió Augmentant el Compliment i l’Adherència.
ITHACA is an innovative integrated service that optimises the care of patients with chronic diseases. The telemedicine tool facilitates the monitoring of chronic patients through motivation and co-responsibility. The service offers a system of self-measurement of blood pressure at the patient’s home. This is done through a GPRS gateway that sends the blood pressure readings directly to the platform. The service integrates three levels of care: primary care, tertiary care (hospital), and social care.
Since the model is based on a population stratification model (according to chronic disease) risks are labelled in three types: low, moderate and high. Patients with hypertension – who represent about 35% of the population – will require far fewer visits to tertiary care and fewer admissions to the social care units (for the treatment of sub-acute patients).
This leads to a significant decrease in costs and improves quality of daily life.
The main beneficiary is the patient.
Targeted population, number of patients
The service is categorised as a monitoring service. The relationship between key actors in the service is between the patient and primary care.
Set-up that was being replaced
The service substitutes the conventional procedure where patients go regularly to a general practitioner to control their hypertension; sometimes it also replaces the follow-up protocol after hospital discharge of patients. In fact, this is a change in the organisational model of procedures, but the clinical treatment remains the same.
Outcomes and results expected after introduction
The respondent reports both the main actual outcomes and the expected outcome(s).
The main outcome of ITHACA is that patients assume a greater role in their treatment and take it more seriously.
Since the telemedicine service has been in place, therapeutic outcomes have improved significantly. Patients have improved control of their blood pressure, and have used fewer clinical resources, which has decreased cost.
Using telemonitoring has decreased the costs per patient by 65€/year. There are 120,000 inhabitants with a potential for hypertension in the area where the service is in place. Bearing in mind that hypertension is present in 35% of the adult population, this means a significant cost reduction. The pharmaceutical costs are the same.
The expected outcome of the service is to reduce seriously the hypertension events.
With this service, there is a well-defined interaction protocol for the telemonitoring with a dashboard of the measurements, alerts, documental material sharing and document exchange.
The platform to be accessed by the professionals is a web service integrated on their workstations.
The technology used is for the platform development. Architecture: Java – J2EE – Spring and Web development technology: RichFaces Java Server Faces (JSF) Operating platform; Web Server: Apache; Application Server: Tomcat
Concerning the device integration the Measuring Devices: Sending Data: GPRS Gateway Communications and the Data Integration is SOAP using XML Web Services.
The service is operational, and is part of mainstream healthcare service.