The examples and perspective in this article may not represent a worldwide view of the subject.(October 2020) |
This article needs additional citations for verification .(February 2010) |
Telecare is technology-based healthcare such as the monitoring of patient vital organs so that they may remain safe and independent in their own homes. Devices may include health and fitness apps, such as exercise tracking tools and digital medication reminder apps, or technologies that issue early warning and detection. [1] The use of sensors may be part of a package which can provide support for people with illnesses such as dementia, or people at risk of falling. [2]
Most telecare mitigates harm by reacting to untoward events and raising a help response quickly. Some telecare, such as safety confirmation and lifestyle monitoring have a preventive function in that a deterioration in the telecare user's wellbeing can be spotted at an early stage.
Telecare is specifically different from telemedicine and telehealth. Telecare refers to the idea of enabling people to remain independent in their own homes by providing person-centred technologies to support the individual or their carers.
Mobile telecare is an emerging service where state of the art mobile devices with roaming SIMs are utilised to allow a client to go outside their home but still have a 24/7 telecare service available to support them. Typical devices that do this are such things as the Pebbell mobile GPS tracker.
The meaning and usage of the term 'telecare' has not yet settled into consistent use. In the UK it is grounded in the social care framework and focuses on the meaning described above. In other countries 'telecare' may be applied to the practice of healthcare at a distance.
In its simplest form, it can refer to a fixed or mobile telephone with a connection to a monitoring centre through which the user can raise an alarm. Technologically more advanced systems use sensors, whereby a range of potential risks can be monitored. These may include falls, as well as environmental changes in the home such as floods, fire and gas leaks. Carers of people with dementia may be alerted if the person leaves the house or other defined area. When a sensor is activated it sends a radio signal to a central unit in the user's home, which then automatically calls a 24-hour monitoring centre where trained operators can take appropriate action, whether it be contacting a local key holder, doctor or the emergency services.
Telecare also comprises standalone telecare which does not send signals to a response centre but supports carers through providing local (in-house) alerts in a person's home to let the carer know when a person requires attention.
It is important to note that 'telecare' is not just a warning system if someone strays from home but is also preventative measure whereby people are brought back and kept in the community through regular communication. There are now a large range of telecare services available with some of the most well known being the pendant alarm, mobile carephone system, pill dispenser, telephone prompt service the movement monitoring, fall detector and more. Multi-lingual telecare services have now been introduced opening the service up to a wider audience. All play a role in maintaining people's independence and allowing people to stay in their own homes.
Technological advances result in the possibility of promoting independence and for providing care from the social initiative sector, which now contemplates eCare, and navigation/positioning systems, such as GPS for people with dementia or other cognitive impairments.
In 2005 the UK's Department of Health published Building Telecare in England to coincide with the announcement of a grant to help encourage its take up by local councils with social care responsibilities. [3]
The UK’s Department of Health’s Whole System Demonstrator (WSD) [4] launched in May 2008. It is the largest randomised control trial of telehealth and telecare in the world, involving 6191 patients and 238 GP practices across three sites, Newham, Kent and Cornwall. The trials were evaluated by: City University London, University of Oxford, University of Manchester, Nuffield Trust, Imperial College London and London School of Economics.
The WSD headline findings after the telehealth trial, involving 3154 patients, included these outcomes: [5]
The telecare findings were supposed to be published at some point in the future. [6] In fact they have never surfaced. Some patients are still hopeful that telecare will lead to substantial improvements in the quality of services. [7] The research showed that the telecare approach was not cost effective, with an incremental cost per QALY when added to usual care of £92,000. [8]
The Government's Care Services minister, Paul Burstow, stated in 2012 that telehealth and telecare would be extended over the next five years (2012-2017) to reach three million people. [9] This ambition was formally abandoned in November 2013. In September 2014 NHS England announced a replacement, but much lower profile, new “technology enabled care services” programme. [10]
Blood glucose monitoring is the use of a glucose meter for testing the concentration of glucose in the blood (glycemia). Particularly important in diabetes management, a blood glucose test is typically performed by piercing the skin to draw blood, then applying the blood to a chemically active disposable 'test-strip'. The other main option is continuous glucose monitoring (CGM). Different manufacturers use different technology, but most systems measure an electrical characteristic and use this to determine the glucose level in the blood. Skin-prick methods measure capillary blood glucose, whereas CGM correlates interstitial fluid glucose level to blood glucose level. Measurements may occur after fasting or at random nonfasting intervals, each of which informs diagnosis or monitoring in different ways.
Telehealth is the distribution of health-related services and information via electronic information and telecommunication technologies. It allows long-distance patient and clinician contact, care, advice, reminders, education, intervention, monitoring, and remote admissions. Telemedicine is sometimes used as a synonym, or is used in a more limited sense to describe remote clinical services, such as diagnosis and monitoring. When rural settings, lack of transport, a lack of mobility, conditions due to outbreaks, epidemics or pandemics, decreased funding, or a lack of staff restrict access to care, telehealth may bridge the gap as well as provide distance-learning; meetings, supervision, and presentations between practitioners; online information and health data management and healthcare system integration. Telehealth could include two clinicians discussing a case over video conference; a robotic surgery occurring through remote access; physical therapy done via digital monitoring instruments, live feed and application combinations; tests being forwarded between facilities for interpretation by a higher specialist; home monitoring through continuous sending of patient health data; client to practitioner online conference; or even videophone interpretation during a consult.
eHealth describes healthcare services which are supported by digital processes, communication or technology such as electronic prescribing, Telehealth, or Electronic Health Records (EHRs). The use of electronic processes in healthcare dated back to at least the 1990s. Usage of the term varies as it covers not just "Internet medicine" as it was conceived during that time, but also "virtually everything related to computers and medicine". A study in 2005 found 51 unique definitions. Some argue that it is interchangeable with health informatics with a broad definition covering electronic/digital processes in health while others use it in the narrower sense of healthcare practice using the Internet. It can also include health applications and links on mobile phones, referred to as mHealth or m-Health. Key components of eHealth include electronic health records (EHRs), telemedicine, health information exchange, mobile health applications, wearable devices, and online health information. These technologies enable healthcare providers, patients, and other stakeholders to access, manage, and exchange health information more effectively, leading to improved communication, decision-making, and overall healthcare outcomes.
Telenursing refers to the use of information technology in the provision of nursing services whenever physical distance exists between patient and nurse, or between any number of nurses. As a field, it is part of telemedicine, and has many points of contacts with other medical and non-medical applications, such as telediagnosis, teleconsultation, and telemonitoring. The field, however, is still being developed as the information on telenursing isn't comprehensive enough.
Telerehabilitation (or e-rehabilitation is the delivery of rehabilitation services over telecommunication networks and the internet. Telerehabilitation allows patients to interact with providers remotely and can be used both to assess patients and to deliver therapy. Fields of medicine that utilize telerehabilitation include: physical therapy, occupational therapy, speech-language pathology, audiology, and psychology. Therapy sessions can be individual or community-based. Types of therapy available include motor training exercises, speech therapy, virtual reality, robotic therapy, goal setting, and group exercise.
Telepsychiatry or telemental health refers to the use of telecommunications technology to deliver psychiatric care remotely for people with mental health conditions. It is a branch of telemedicine.
Home automation for the elderly and disabled focuses on making it possible for older adults and people with disabilities to remain at home, safe and comfortable. Home automation is becoming a viable option for older adults and people with disabilities who would prefer to stay in the comfort of their homes rather than move to a healthcare facility. This field uses much of the same technology and equipment as home automation for security, entertainment, and energy conservation but tailors it towards old people and people with disabilities.
mHealth is an abbreviation for mobile health, a term used for the practice of medicine and public health supported by mobile devices. The term is most commonly used in reference to using mobile communication devices, such as mobile phones, tablet computers and personal digital assistants (PDAs), and wearable devices such as smart watches, for health services, information, and data collection. The mHealth field has emerged as a sub-segment of eHealth, the use of information and communication technology (ICT), such as computers, mobile phones, communications satellite, patient monitors, etc., for health services and information. mHealth applications include the use of mobile devices in collecting community and clinical health data, delivery/sharing of healthcare information for practitioners, researchers and patients, real-time monitoring of patient vital signs, the direct provision of care as well as training and collaboration of health workers.
Teledermatology is a subspecialty in the medical field of dermatology and probably one of the most common applications of telemedicine and e-health. In teledermatology, telecommunication technologies are used to exchange medical information over a distance using audio, visual, and data communication. Applications comprise health care management such as diagnoses, consultation, and treatment as well as (continuous) education.
Connected health is a socio-technical model for healthcare management and delivery by using technology to provide healthcare services remotely. Connected health, also known as technology enabled care (TEC) aims to maximize healthcare resources and provide increased, flexible opportunities for consumers to engage with clinicians and better self-manage their care. It uses readily available consumer technologies to deliver patient care outside of the hospital or doctor's office. Connected health encompasses programs in telehealth, remote care and disease and lifestyle management, often leverages existing technologies such as connected devices using cellular networks and is associated with efforts to improve chronic care. However, there is an increasing blur between software capabilities and healthcare needs whereby technologists are now providing the solutions to support consumer wellness and provide the connectivity between patient data, information and decisions. This calls for new techniques to guide Connected Health solutions such as "design thinking" to support software developers in clearly identifying healthcare requirements, and extend and enrich traditional software requirements gathering techniques.
Wireless health is the integration of wireless technology into traditional medicine, such as diagnosis, monitoring and treatment of illness, as well as other tools that can help individuals improve their personal health and wellbeing. Wireless health differs from mHealth in that wireless health solutions will not always be mobile and mobile health solutions will not always be wirelessly enabled. Mobile broadband connectivity is useful in reaching new patients in remote areas while improving productivity and convenience through data transmission.
Remote patient monitoring (RPM) is a technology to enable monitoring of patients outside of conventional clinical settings, such as in the home or in a remote area, which may increase access to care and decrease healthcare delivery costs. RPM involves the constant remote care of patients by their physicians, often to track physical symptoms, chronic conditions, or post-hospitalization rehab.
Digital health is a discipline that includes digital care programs, technologies with health, healthcare, living, and society to enhance the efficiency of healthcare delivery and to make medicine more personalized and precise. It uses information and communication technologies to facilitate understanding of health problems and challenges faced by people receiving medical treatment and social prescribing in more personalised and precise ways. The definitions of digital health and its remits overlap in many ways with those of health and medical informatics.
Telehomecare (THC) is a subfield within telehealth. It involves the delivery of healthcare services to patients at home through the use of telecommunications technologies, which enable the interaction of voice, video, and health-related data. The management of care is done from an external site by a healthcare professional.
Telepharmacy is the delivery of pharmaceutical care via telecommunications to patients in locations where they may not have direct contact with a pharmacist. It is an instance of the wider phenomenon of telemedicine, as implemented in the field of pharmacy. Telepharmacy services include drug therapy monitoring, patient counseling, prior authorization and refill authorization for prescription drugs, and monitoring of formulary compliance with the aid of teleconferencing or videoconferencing. Remote dispensing of medications by automated packaging and labeling systems can also be thought of as an instance of telepharmacy. Telepharmacy services can be delivered at retail pharmacy sites or through hospitals, nursing homes, or other medical care facilities.
Model for assessment of telemedicine (MAST) is a framework for assessment of the value of telemedicine.
Mental health informatics is a branch of health or clinical informatics focused on the use of information technology (IT) and information to improve mental health. Like health informatics, mental health informatics is a multidisciplinary field that promotes care delivery, research and education as well as the technology and methodologies required to implement it.
e-consult is a mechanism developed by the Department of Veterans Affairs that enables primary care providers to obtain specialists' inputs into a patient's care treatment without requiring the patient to go to a face-to-face visit.
Internet-based treatments for trauma survivors is a growing class of online treatments that allow for an individual who has experienced trauma to seek and receive treatment without needing to attend psychotherapy in person. The progressive movement to online resources and the need for more accessible mental health services has given rise to the creation of online-based interventions aimed to help those who have experienced traumatic events. Cognitive behavioral therapy (CBT) has shown to be particularly effective in the treatment of trauma-related disorders and adapting CBT to an online format has been shown to be as effective as in-person CBT in the treatment of trauma. Due to its positive outcomes, CBT-based internet treatment options for trauma survivors has been an expanding field in both research and clinical settings.
Telehealth refers to the delivery of healthcare services through electronic communication methods, facilitating interactions between healthcare practitioners and patients using devices such as telephones, smartphones, tablets, and computers. It enables patients to engage with healthcare professionals through various means, including telephone calls, secure email, video conferencing, and secure messaging. Additionally, telehealth systems can be utilized by physicians for remote monitoring of patients in their homes.