Home and Community Care Digest
Methods: CCCS staff attended exhibitions, conferences, reviewed the literature, and performed internet scans to determine which technologies would work best with different populations. Technologies were chosen for use in the home or other residential settings, and were evaluated for efficacy, or ease of use.
Patient acceptance and satisfaction of technology for specific chronic conditions like diabetes, heart disease, and mental health conditions were also evaluated by survey, through face-to-face and phone interviews at 12 and 24 months post-enrolment. Results taken after 24 months were reported from a random sample of enrolees who had participated in the CCCS program for at least 12 months.
Findings: The CCCS staff selected traditional telemonitors with peripheral biometric attachments, videophones, in-home messaging devices (e.g., Health Buddy), instamatic cameras, and personal computers with Internet connectivity. Almost all of the elderly patients in the pilot projects preferred non-computer technology for meeting their health needs. Many factors including literacy levels, sensory deficits, functional ability, willingness to use technology, and compliance with other healthcare treatments affected the veteran's overall acceptance of technology. A thorough caregiver and family support assessment in the home was an important factor in considering which technology to use for the patient. Less than 5% of veterans interviewed for enrolment in the CCCS pilot projects declined participation because of issues directly related to using technology in their home. CCCS staff experienced tremendous success in coordinating care and services when the chosen technologies were easily accepted and best used by patients and caregivers. If the technology did not work the first time or was too complicated for the patient to use and therefore had to be changed, acceptance was not as high and continued reassurance by staff was required to maintain use and compliance. The lack of human touch, often a concern in the use of technology, was never an issue. As the patients' conditions changed, so did the technologies. "One size does not fit all" was a common theme.
Conclusions: The assessment technology developed by the Veterans Health Administration seems to be successful because its underlying foundation was in meeting patient need(s) and improving health, rather than promoting technology. Using a technology that meets the patient population's needs is critical for success. Older patients preferred to use simpler, non-computer devices for meeting their health needs. Patients used technology without much difficulty, and acceptance was greater than expected.
Reference: Kobb R, Hilsen P, Ryan P. "Assessing technology needs for the elderly. Finding the perfect match for the home". Home Healthcare Nurse, (2003); 21 (10), 666-673.
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