"Docobo’s flagship telehealth service to enable monitoring, management and self care of patients at home with various long term conditions..."

Service Overview
doc@HOME is an integrated telehealth solution for the remote management of patients with a range of Long Term Conditions (also known as Chronic Diseases). It is the means for the collection and analysis of essential patient related data, permitting effective management through efficient interaction between clinicians and patients at home.

The doc@HOME service is designed to provide a systematic approach to the management of chronic disease in the home and other locations remote from the clinicians office. Patient/Clinician interaction is typically via the Docobo HealthHub, a fit for purpose, robust, handheld data collection unit which connects through a standard telephone line at the patients home to secure server. Healthcare Professional interaction with the doc@HOME service is via secure Web access using standard browsers, enabling patient management at a range of locations.

Changes in patient trends can be identified and notified to the authorised user. An authorised clinician can access the patient record on demand and send messages directly to the patient, for example, a request to visit the surgery or to change the frequency and/ or volume of medication.

Functionality

Patient Interface
Patient compliance in using the system is crucial for the cost effectiveness of the service, and therefore the interface with the patient is crucial. The doc@HOME service allows patient interface via the web, mobile phones or Docobo’s own fit for purpose HealthHUB. Evaluations across the EU have shown that patient compliance is greater with a specific fit for purpose device for managing their health. The Docobo HealthHUB is the result of extensive user needs analysis, and offers patients a simple, portable method of inputting information and interacting with their health provider.

The integrated display and associated functional keys enable measurement, entry and reading of information from a variety of sources. Each HealthHUB is programmed to meet individual patient needs across a range of chronic diseases. In accordance with clinical recommendations the HealthHUB can be set to monitor a range of long term conditions and co-morbidities wellbeing and/ or any combination of these. It can be easily adapted to monitor patients that require additional monitoring over time as well as those with other specific disease. All data is managed and controlled in accordance to the European Data Protection Directive. Built in sensors are used to record twenty second rhythm strips of the ECG and Bio- Impedance. Dependent variables are calculated and stored alongside physiological information derived from other optional devices. Vital sign monitors of choice can be connected to provide automated data transfer. In addition a wide range of quantitative and qualitative information enabling continuous assessment of a patients quality of life, medication and treatment compliance is collected through the HealthHUB. The patient can access regular information in the form of a four week trend display.

Clinical operation
doc@ HOME is a solution that enables clinicians to manage the care of patients with long term conditions in their own homes. The service can be easily tuned to the specific and changing needs of patients and their clinical support requirements. Information, collected each day, is available on the server and can be reviewed at any time, courses of treatment adjusted as necessary and messages and advice sent to patients using only a standard web browser. Each patient has a personal health envelope which is automatically tracked. Individual patient alert criteria can be defined and assessment questions customised by the clinician. A default ‘general question set’, based on the outcomes of clinical studies, is available as standard. Motivation feed back is provided to the patient and alert calls sent to nurse led support when key parameters go outside the envelope. All information is available, subject to authorised access, across existing and evolving care agencies. Secondary and primary care clinicians are able to review and confer without the complications of existing referral processes directly contributing to achievement of performance targets and objectives.

Cost Effectiveness
doc@ HOME, is cost effective, offering a range of solutions that satisfy operational need. The service is compliant with current standards and infrastructure set- up cost is insignificant, obsolescence and depreciation is eliminated and repair logistics considerations are not necessary Pilot evaluation studies can be conducted on any scale.
Compliance to Standards
doc@ HOME uses open database standards and as such compatibility with emergent Electronic Patient Record systems at local, national and European level is assured. It offers the highest standard of interoperability and is fully compliant European and International standards. European Medical Device Directive compliant EN13485 accredited Interfaces to Electronic Patient Record Systems

Patient Benefits
For the delivery of public healthcare, remote health management provides the cost effective way to manage burdens on public services caused by an increasing proportion of chronically ill and elderly people requiring healthcare. Point- of- care motivator for improvement in lifestyle and wellbeing leads to increased values and enhanced Quality of Life Enhances patient choice, prompts ‘expert’ patient self- care and empowerment and increases satisfaction through delivery of high quality and timely care. Reduced demand on clinics and home visits with ultimate reduction in acute hospital presentations. Increased acceptance and adoption of preventative care regimes within ‘wellbeing’ programmes, for example smoking cessation and weight reduction. Improved understanding of health related issues resulting in motivated and condition- aware patients contributing to their own care. Easier and more flexible access to healthcare services and support.