In late August our clients over at St. Pauls Hospital in the Heart Function Clinic will be heading Down Under. The clinic's research abstract entitled "The development and feasibility of a virtual heart failure clinic" was recently accepted at the 7th Annual Conference on Successes & Failures in Telehealth in Brisbane, Australia.
OpenRoad built the Heart Helper web application for the St. Pauls team to help chronic heart failure patients manage their disease. It's an example of a "telehealth" system, where patients can interact with clinical hospital staff through a remote web-based application.
Here's the abstract details:
The development and feasibility of a virtual heart failure clinic
Annemarie Kaan RN, MCN, CCN(C), Scott Lear PhD, Biljana Maric BSc.
Heart failure (HF) self-management seeks to empower patients by teaching and supporting them to understand and manage their illness. It includes monitoring daily weight, fluid and salt intake and reporting symptoms. However, one of the obstacles faced by people living at home with HF is the lack of day-to-day support in managing their illness.
For patients living with HF, a number of telemanagement systems have been reported in the literature. These systems allow patients to monitor their condition and to ask questions. Although the concept has been shown to provide an early warning system to staff and reduce readmissions to hospital, availability is restricted because of the need to install expensive, equipment in the patient’s home and provide resources to troubleshoot problems with the systems. Our group is exploring the feasibility of a free interactive web-based system.
The system asks the patient to log in, enter their weight and answer 5 simple yes/no questions about how they are feeling compared to yesterday. This information is then stored so that patients can obtain feedback and the nurse in the clinic is alerted to inappropriate weight gains or changes in condition. The nurse then phones the patient to provide support and education. There was some concern that older patients with HF may not use the Internet. We performed a survey that revealed up to 50% of outpatients attending the HF clinic had access to the Internet. This was surprising as the average age of patients with HF is over 70. Our findings were validated by Statistics Canada, in a report that confirmed more and more old people are logging onto the Internet.
We are currently completing phase two of the self-management project, which is a feasibility study of 20 patients using the “virtual Heart Failure Clinic” (vHFC). To date, six patients have completed the study with high levels of satisfaction with the system. Phase 3 will entail a larger scale randomized study examining different populations of patients.
This paper will outline the journey to the completion of phase 2 and present initial findings of the feasibility study.
The pilot project for the Heart Helper web application has been very successful to date and we're looking forward to our future collaborations with the Heart Function team as they take the pilot project and turn it into production clinical system.