Factors affecting provision of successful monitoring in home Telehealth.
ABSTRACT To investigate acceptance and usage issues in relation to Telehealth products as used by frail older clients of the Transition Care Program and their carers.
The study design was a quasi-randomised controlled clinical trial. A stratified random sample of participants was allocated to one of five groups using a random number table. Study participants who were already in possession of a pendant alarm provided by the study service provider at study commencement, or were assessed as needing a pendant alarm, were allocated to the first number out of 1 (control group), 4 or 5 (home Telehealth monitoring with a pendant alarm up to 12 or 24 weeks) on the random number table list. If they were in possession of a pendant alarm that was not from the study service provider they were automatically allocated to the control group. If they were assessed as not needing a pendant alarm they were allocated to the first number on the list out of 2 or 3 (home Telehealth monitoring up to 12 or 24 weeks). In all instances, when a participant was allocated to the first applicable number on the list, that number was crossed off the list.
A total of 43 participants who commenced the study used Telehealth equipment. There was a 13% Telehealth reading failure rate. There was no significant difference between clients with and clients without carers for the reading failure rate. This non-significant difference was consistent across all of the identified reasons for why readings failed including staff not following up, participant non-compliance (with and without carer), equipment failure, participants not returning a call from the staff investigating non-reading and user error.
If the health of the client requires high reading rate reliability, the fact that the client has a carer to assist them cannot be assumed to increase the safe usage of the Telehealth equipment for reading rate reliability. As such staff should ensure that they are diligent in monitoring in-home Telehealth regardless of the presence or absence of a carer.
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ABSTRACT: This paper investigates the acceptance of in-home telehealth by frail older adults and carers of the Transition Care Program (TCP), and evaluates telehealth acceptance as a predictor for usage compliance. A STRATIFIED RANDOM SAMPLE OF PARTICIPANTS WAS ALLOCATED TO ONE OF FIVE GROUPS: either a control group or to receive telehealth monitoring of their vital signs for a period of 12 or 24 weeks; with or without a medical alarm pendant. Before being trained in and using telehealth, the majority of participants and carers demonstrated acceptance of the technology by reporting that they perceived it would be "useful" and "easy to use." This acceptance was also reported post-TCP (up to 12 weeks of usage). The "perceived ease of use" of the telehealth equipment increased significantly from pre-telehealth training and usage to post-TCP (up to 12 weeks of usage) (P = 0.001). There was no change, (pre-training and usage to post-TCP) in the "perceived usefulness" of the telehealth equipment. The telehealth acceptance constructs of "ease of use" and "usefulness," at pre-telehealth training and usage, approached statistical significance as a predictor of future compliance (P = 0.06). "Perceived ease of use," at pre-training and usage, had a positive relationship with future compliance (P = 0.02). There is currently limited knowledge about the influences and determinants of home telehealth compliance in frail older people and their carers, potentially a significant user group for the technology into the future. This study's finding that frail older people and their carers perceive that home telehealth is useful and easy to use demonstrates their acceptance of home telehealth as a therapeutic tool. Further, perceived ease of use of home telehealth is a significant predictor of compliance with frail older people and their carers' use of home telehealth. Additional research is required in order to identify other influences and determinants of home telehealth compliance with this group. Knowledge about the influences and determinants of home telehealth compliance may assist the development of targeted interventions aimed at encouraging high compliance with users who are recording lower reading rates.Risk Management and Healthcare Policy 01/2012; 5:25-33.