• Web-based communities for home care patients (that link patients and their families to health care providers, peers, and the community)

  • Personal health records (that enable patients to create and store their personal health information)

  • Passive monitoring and management (for which IT implementation does not require training or operation by the end-user)

    • Robotic applications (standalone artificial intelligence applications that support home care needs)

    • “Smart homes” (in which IT based on the use of sensors becomes part of the residential infrastructure)

This chapter describes these different types of IT applications and discusses technical, practical, and ethical implications.

TELEHEALTH APPLICATIONS FOR HOME-BASED DISEASE MANAGEMENT

Telehealth applications offer a platform to support disease management for home care patients diagnosed with chronic conditions and their families. This section is organized by the disease or condition addressed by the application.

For asthma management, an example of Internet utilization is the home asthma telemonitoring system (Finkelstein, O’Connor, and Friedmann, 2001), which provides patients with continuous individualized help in the daily routine of asthma self-care and coping and alerts health care providers if specific conditions or patterns emerge. The system is operated by the patient or an informal caregiver (including family members or friends) and involves web-based questionnaires and the operation of a spirometer to assess lung capacity. The data sets (including the spirometry readings) are transmitted to health care providers.

Another example involves diabetes. As diabetes has in many cases an asymptomatic nature, the time frame between sustained hyperglycemia and observable complications can be extended, thus making a long-term program of secondary prevention an essential part of appropriate diabetes care and a suitable domain for technology-based diabetes management applications. McKay, exploring the development and feasibility of a web tool for diabetes self-management that emphasized personalized goal setting, feedback, and social support (McKay et al., 1998) found that patients were satisfied with the system and appreciated the social support and the availability of information.

Similarly, the Center for Health Services Research’s Henry Ford Health System in Detroit developed the web-based Diabetes Care Management



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