Tele-homecare

The introduction of technologies for housekeeping, work, education, leisure, care and cure, etc. is one of the main aspects of the information society. As a consequence, the importance of the home as a location for many activities has increased. More specifically, home based technologies include: security technologies (such as security telephones, telealarms and video telephones, burglar alarms, fire alarms and warning devices, safety devices for home equipment); health care monitoring systems, treatment devices and analyzers; daily activity support devices and personal aids (such as aids for therapy rehabilitation and mobility, aids for personal care and protection, aids for housekeeping, aids for communication, recreation and training); environmental control devices (such as furniture and adaptations to home, aids for handling products and goods, aids and equipment for environmental improvements and control). Home health care is one of home based technologies, and it is the fastest growing area of health care provision, as a consequence of a trend towards community as opposed to institutional care which is present in many countries. This is mainly due to the decline of the social infrastructure for informal care (e.g. increased participation of women in the labor force, decline of the nuclear family, increase in alternative lifestyles etc.) along with the cost containment climate in the health and social services. Supportive technologies are being developed with a number of applications for the assistance of older and disabled persons in carrying out activities of daily living, which can help them control their environment, manage their households and which allow them to summon help in emergencies. Moreover, these applications provide older and disabled persons with a better access to social and medical services from their homes, having also care delivered from distant locations in the home; example of this are: emergency homecare, tele-assistance, improving medical compliance and patient education, routine monitoring at home. Telemedicine can be applied to home care to transmit information from home to a specialist, a general practitioner or someone who takes care, in a broad sense, of the people living in a house. From a technical point of view, a home telecare system consists of home equipment (sensors, monitoring and treatment devices and transmitter unit) and of the receiving units at service points, such as hospitals, health centers, home care offices, homes of relatives or of other “carers” (fig. 1). From a functional point of view, a telemedicine service can be set up in many ways, according to different needs and applications. A cardiotelephone service, for example, requires an expert for 24 hours a day; an electronic mailing system (based on telephone and modem) can be used for monitoring of chronically ill, e.g. diabetic of hypertension patients; in this case, the system can send the data when appropriate and the physician can read it when convenient. The introduction of a tele-homecare system always requires changes in organization. It is not enough to transmit the data, somebody must receive it, interpret it and give advise for care. System maintenance and education and training of the personnel and clients must also be provided. Some reasons for applying a tele-homecare system are: Economic aspects, which must be considered from both the health service system and the patient's point of view. Improving the quality of measurements. The quality of the measurement may decrease if the patient is moved from home. This is the case for blood pressure and other cardiovascular parameters, specially in elderly people. Obtaining a new kind of follow-up. Home care technology may increase possible applications of ambulatory monitoring of ECG, heart rate, blood pressure, sleep parameters and body temperature [1]. Improving the quality of life. Whenever measurement can be taken or treatment can be given at home without decreasing the quality of care, there is no reason for transferring the patient to a hospital. Also, retaining the home environment is often crucial for the success of treatment of particularly vulnerable patients, such as elderly, children and handicapped people.