OBJECTIVE: This program aimed to implement the feasibility and acceptability of virtual symptom and compliance management systems with patients in rural communities receiving Home Based Primary Care, Assessment in the changes of patient outcomes from baseline and implementation of the virtual monitoring will be evaluated for effectiveness, cost reduction and hospitalizations.
METHODS: Repeated patient measures, chart abstractions, interviews and completion of reported outcomes measures at baseline and annually are assessed and provider survey and interviews.
RESULTS: Dramatic improvements were seen in the continuity of care, compliance with medications, and significant reduction in hospital admissions. Clinical improvements in patient blood pressure, glucose, Drug levels, anxiety, and self-care self-efficacy were also observed. Clinicians perceived the use of "real-time" monitoring data and risk algorithms positively contributing to improved clinical care and improved time efficiency and satisfaction. Reducing the complexity of the system was seen as important to promote the utility of technology by both patients, families and providers.
CONCLUSIONS: The connection between the Advanced Practice Nurse, clinical staff and the patient is critical to the success of the virtual monitoring program in Home Based Primary Care. Integrating monthly visits to the home into the clinical program reinforces the importance of using the virtual monitoring equipment to the patient. The results annually suggest that monitoring patient symptoms using technology, computer or mobile based is feasible in rural communities and acceptable in practice.
IMPLICATIONS FOR PRACTICE: Future research would be most beneficial if the use of this technology expanded the number of applications and expanded the scope of the system to encompass a wider range of supportive care needs. Opportunities for a limitless number of technology enhanced applications.
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