Home-based integrated care in patients with COPD with the use of e-health services
G. Kontopirgias, T. Vontetsianos, P. Giovas, A. Rigopoulou, G. Mpirmpa, P. Giaboutdakis, T. Katsaras (Athens, Greece)
Aim: The aim of the study was the evaluation of clinical usefulness of an advanced e-health system in home-based rehabilitation, follow up and home hospitalization of patients with advanced stages of COPD.
Methods: Eighteen subjects (mean FEV1 0.73 L) with at least four admissions for COPD in the previous 2 years were treated at home for 1 year, after an initial out-patient rehabilitation phase. The system consisted of a specially designed electronic health record (HER) and a compilation of advanced telemedicine devises (spirometer, oximetry, ECG) for the transmission of patients‘ examinations from their homes to the hospital. Through the system the patients were able to undergo home tele-visits, with a real time video connection by the members of the rehabilitation team in the hospital on a regular or on emergency basis.
Results: During the first year, hospital days fell from 17.5 to 4 per patient as compared to the previous year. This was due to both, reduction of the number of admissions (from 2.1 to 0.4), as well as in the length of stay. Patients had a significant improvement in their quality of life (using CRQ), exercise tolerance (6 min walk test) and emotional status score.
Conclusion: It seems that the adoption of such systems in today's clinical practice can offer hospital-quality services at home resulting in improvement in patients' quality of life and significant cost savings.