Developing a Home Telecare Service for Elderly Patients with COPD: Steps and Challenges

Home telecare (HTC), including remote monitoring and interactive video, is increasingly seen as a promising avenue for the timely provision of nursing interventions from a distance to patients at home. While empirical evidence are published regarding satisfaction, costs, suitable patient-populations and clinical outcomes, only three articles outlined the challenges that must be anticipated and taken into consideration to take into account before planning a new HTC service. This type of initial information is crucial for understanding the steps involved, and the challenges that need to be overcome in developing such a service. This article describes the process our team went through in designing a feasibility study which involved the implementation of a HTC service for elderly patients with Chronic Obstructive Pulmonary Disease (COPD), and adds to the limited amount of procedural data currently available regarding HTC. In this paper we briefly review the literature on HTC for COPD patients, describe our research methods which include how our team members were involved and their roles, and present the steps and challenges we faced in running this service. The primary challenges included: 1) team building, 2) Tele-nurse training 3) patient recruitment and installation of the HTC technology, and 4) dealing with technology-related issues. The discussion focuses on three main areas discovered to need improvement prior to conducting future studies: 1) building nurse and patient-training, 2) defining clear roles and responsibilities for the clinical team, and 3) utilizing more user-friendly technology.