scholarly journals The Use of Telehealth Technology to Support Health Coaching: A Scoping Review (Preprint)

2020 ◽  
Author(s):  
Carl Markert ◽  
Farzan Sasangohar
Keyword(s):  
Health Care ◽  
Scoping Review ◽  
Remote Monitoring ◽  
Chronic Conditions ◽  
Hospital Admissions ◽  
Health Coaching ◽  
Activity Level ◽  
Current Status ◽  
Use Of Technology ◽  
Health Related

BACKGROUND Health coaching is an intervention process for driving behavior change through goal-setting, education, encouragement and feedback on health-related behaviors. Telehealth systems that include health coaching and remote monitoring are making inroads in managing chronic conditions in elderly populations. OBJECTIVE To conduct a scoping review investigating the current status of health coaching interventions incorporating telehealth technology and the associated effectiveness of this intervention to deliver health care to seniors. METHODS A scoping literature review was conducted to identify the research conducted on health coaching combined with remote monitoring for delivering health care to seniors. The Ovid MEDLINE and CINAHL databases were queried using a combination of relevant search terms (including middle aged, aged, older adult, elderly, health coaching, and wellness coaching). The search retrieved 196 papers published from January 2010 to September 2019 in English. Following a systematic scoping review process, the titles and abstracts of the papers retrieved were screened for applicability to health coaching for seniors to define a subset for further review. The full text of the 42 papers in this subset were then reviewed, and 13 papers related to health coaching combined with remote monitoring for seniors were included in this scoping study. RESULTS Of the 13 studies reviewed, seven found coaching supported by telehealth technology to be effective in managing chronic conditions in seniors. Effectiveness outcomes assessed in the studies included hospital admissions/readmissions, mortality, hemoglobin A1c (HbA1c) level, body weight, blood pressure, physical activity level, fatigue, quality of life, and user acceptance of the coaching program and technology. CONCLUSIONS Telehealth systems that include health coaching have been implemented in senior populations as a viable intervention method for managing chronic conditions with mixed results. Health coaching combined with telehealth may be an effective solution for providing health care to older adults while enabling them to remain in their homes as they age. However, health coaching is predominantly performed by human coaches with limited use of technology to augment or replace the human coach. The opportunity exists to expand health coaching to include automated coaching.

scholarly journals Organisational models in primary health care to manage chronic conditions: A scoping review

2021 ◽  
Author(s):  
Jessica Longhini ◽  
Federica Canzan ◽  
Elisabetta Mezzalira ◽  
Luisa Saiani ◽  
Elisa Ambrosi
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Scoping Review ◽  
Chronic Conditions ◽  
Primary Health

scholarly journals Wearable Bioimpedance Monitoring: Viewpoint for Application in Chronic Conditions (Preprint)

2020 ◽  
Author(s):  
Willemijn Groenendaal ◽  
Seulki Lee ◽  
Chris van Hoof
Keyword(s):  
Health Care ◽  
Chronic Conditions ◽  
Wearable Technology ◽  
Current Status ◽  
Time Varying ◽  
Early Detection Of Disease ◽  
Fluid Status ◽  
Wide Range ◽  
Patients With Heart Failure ◽  
Care Costs

UNSTRUCTURED Currently, nearly 6 in 10 US adults are suffering from at least one chronic condition. Wearable technology could help in controlling the health care costs by remote monitoring and early detection of disease worsening. However, in recent years, there have been disappointments in wearable technology with respect to reliability, lack of feedback, or lack of user comfort. One of the promising sensor techniques for wearable monitoring of chronic disease is bioimpedance, which is a noninvasive, versatile sensing method that can be applied in different ways to extract a wide range of health care parameters. Due to the changes in impedance caused by either breathing or blood flow, time-varying signals such as respiration and cardiac output can be obtained with bioimpedance. A second application area is related to body composition and fluid status (eg, pulmonary congestion monitoring in patients with heart failure). Finally, bioimpedance can be used for continuous and real-time imaging (eg, during mechanical ventilation). In this viewpoint, we evaluate the use of wearable bioimpedance monitoring for application in chronic conditions, focusing on the current status, recent improvements, and challenges that still need to be tackled.

scholarly journals Wearable Bioimpedance Monitoring: Viewpoint for Application in Chronic Conditions

10.2196/22911 ◽  
2021 ◽  
Vol 6 (2) ◽  
pp. e22911
Author(s):  
Willemijn Groenendaal ◽  
Seulki Lee ◽  
Chris van Hoof
Keyword(s):  
Health Care ◽  
Chronic Conditions ◽  
Wearable Technology ◽  
Current Status ◽  
Time Varying ◽  
Early Detection Of Disease ◽  
Fluid Status ◽  
Wide Range ◽  
Patients With Heart Failure ◽  
Care Costs

Currently, nearly 6 in 10 US adults are suffering from at least one chronic condition. Wearable technology could help in controlling the health care costs by remote monitoring and early detection of disease worsening. However, in recent years, there have been disappointments in wearable technology with respect to reliability, lack of feedback, or lack of user comfort. One of the promising sensor techniques for wearable monitoring of chronic disease is bioimpedance, which is a noninvasive, versatile sensing method that can be applied in different ways to extract a wide range of health care parameters. Due to the changes in impedance caused by either breathing or blood flow, time-varying signals such as respiration and cardiac output can be obtained with bioimpedance. A second application area is related to body composition and fluid status (eg, pulmonary congestion monitoring in patients with heart failure). Finally, bioimpedance can be used for continuous and real-time imaging (eg, during mechanical ventilation). In this viewpoint, we evaluate the use of wearable bioimpedance monitoring for application in chronic conditions, focusing on the current status, recent improvements, and challenges that still need to be tackled.

Ambulatory care sensitive chronic conditions: what can we learn from patients about the role of primary health care in preventing admissions?

2018 ◽  
Vol 24 (4) ◽  
pp. 304 ◽  
Author(s):  
Jo M. Longman ◽  
Elizabeth Rix ◽  
Jennifer J. Johnston ◽  
Megan E. Passey
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Ambulatory Care ◽  
Chronic Conditions ◽  
Hospital Admissions ◽  
Telephone Interviews ◽  
Primary Health ◽  
Comprehensive Primary Health Care ◽  
Modifiable Factors ◽  
Ambulatory Care Sensitive

Developing and targeting interventions to reduce hospital admissions for ambulatory care sensitive (ACS) chronic conditions for older people is a key focus for improvement of the health system. To do this, an understanding of any modifiable factors that may contribute to such admissions is needed. To date, the literature on ACS admissions has rarely included the patient perspective. This qualitative study involved one-to-one telephone interviews with 24 patients aged ≥45 years who had had an unplanned admission for an ACS chronic condition to one of two participating regional hospitals between February and August 2015. Data were transcribed and analysed thematically. Most participants did not perceive their admission to be preventable, yet they described a series of interlinking factors, which may have contributed to their admission and which may offer potential points of leverage. Key interlinked themes interpreted were: ‘support deficits’, ‘non-adherence to treatment’ (including medication), ‘mental health’ and ‘lack of awareness or understanding of condition’. Improving system-, clinician- and patient-level factors within a framework of appropriately resourced and supported comprehensive primary health care that is accessible, affordable, holistic, practical and evidence-based may contribute to improving patients’ quality of life and to delaying or preventing hospital admission.

Remote leadership in health care: a scoping review

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Mari Kiljunen ◽  
Elina Laukka ◽  
Tarja K. Koskela ◽  
Outi Ilona Kanste
Keyword(s):  
Health Care ◽  
Scoping Review ◽  
Work Environments ◽  
Research Gaps ◽  
Content Type ◽  
The Past ◽  
Use Of Technology ◽  
Research Themes ◽  
Distance Leadership ◽  
Research Stream

Purpose The degree of remote working has increased in the health-care sector, but remote leadership in health-care contexts has not been systematically studied. Thus, the purpose of this review was to map existing literature and research themes of remote leadership in health care and identify potential research gaps to guide future studies. Design/methodology/approach A scoping review with narrative synthesis was conducted, covering all published literature addressing remote, virtual, online or distance leadership practices. The ABI/INFORM Collection, CINALH, PsycArticles, Scopus and Web of Science, MedNar, Open Grey and PQDT Open databases were searched electronically, and Finnish Journal of eHealth and eWelfare was searched manually. Findings In total 15 articles were included in the review. Most literature concerning remote leadership in health care has been published during the past three decades. The main themes discerned in this research stream are related to interactions, work environments, leadership in practice, use of technology and needs for more study of remote leadership and guidance for remote leaders. Research limitations/implications Research on remote leadership in health care is limited, patchy and associated concepts vary substantially. More comprehensive research on the phenomenon is needed, with more systematic attention to, and coverage of, relevant populations, concepts, contexts and the identified themes. Originality/value To the best of the authors’ knowledge, this appears to be the first review to map research on remote leadership in health care and identify research gaps, which is important as its prevalence has rapidly increased.

Private health insurance and quality of life: perspectives of older Australians with multiple chronic conditions

2012 ◽  
Vol 18 (3) ◽  
pp. 212 ◽  
Author(s):  
Yun-Hee Jeon ◽  
Annie Black ◽  
Janelle Govett ◽  
Laurann Yen ◽  
Ian McRae
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Health Insurance ◽  
Older People ◽  
Chronic Conditions ◽  
Private Health Insurance ◽  
Multiple Chronic Conditions ◽  
Financial Pressure ◽  
Health Related

A qualitative study was conducted to explore in-depth issues relating to the health costs of chronic illness as identified in a previous study. A key theme that emerged from interviews carried out was the benefits and challenges of private health insurance (PHI) membership, and choices older Australians with multimorbidity make in accessing health services, with and without PHI. This is the focus of this paper. Semistructured interviews were conducted with 40 older people with multiple chronic conditions. Data were analysed using content analysis. Key motivators for maintaining PHI included: fear of an inability to access timely health care; the opportunity to exercise choice in service provider; a belief of being ‘better off’ both medically and financially, which was often ill-founded; and the core values of self reliance and independence. Most described financial pressure caused by rising PHI premiums as well as other out-of-pocket health related expenses. Many older people who can ill afford PHI still struggle to maintain it, potentially at the cost of their quality of life, based on beliefs about costs of health care that they have never properly assessed. The findings highlight the degree to which people whose resources are constrained are prepared to go to maintain access to private hospital care. Attention should be given to assisting older people to make informed and valid choices of health insurance derived from the facts, rather than being based on fear and assumptions.

Ten years of hospitalisation for oral health-related conditions in Western Australia: an unjust dichotomy

2016 ◽  
Vol 22 (2) ◽  
pp. 153 ◽  
Author(s):  
Estie Kruger ◽  
Marc Tennant
Keyword(s):  
Health Care ◽  
Oral Health ◽  
Western Australia ◽  
Hospital Admissions ◽  
Aboriginal People ◽  
Age Groups ◽  
Morbidity Data ◽  
Health Related ◽  
Almost All ◽  
Oral Conditions

The objective of this study was: (1) to examine the demographics of in-patient oral health care by Aboriginal status; (2) to identify the mix of oral conditions by Aboriginal status; and (3) to describe trends over a 10-year period, comparing Aboriginal and non-Aboriginal groups. Hospitalisation data were obtained from the Western Australian Morbidity Data System (HMDS). The principal diagnosis, as classified by the International Classification of Disease (ICD-10AM), was obtained for every episode for adult patients who were discharged from all hospitals in Western Australia (WA) for the financial years 1999–2000 to 2008–09. Results indicated that more than 130 000 persons were admitted to hospitals in WA over 10 years, for oral health-related conditions, at a direct cost of more than $400 million. Most of those admitted were younger than 30 years, and 2.8% of all those admitted were Aboriginal people. Aboriginal people were admitted at significantly higher rates, for a very different mix of conditions, they were mostly from younger age groups, were mostly from very remote and the most disadvantaged areas and were almost all uninsured, compared with non-Aboriginal people. Hospital admissions for oral health-related conditions, as well as the mix of conditions that drive these hospitalisations, are strongly divided across social, racial and geographic variables, and remain a burden to the health-care system.

scholarly journals A randomised comparison of the effect of haemodynamic monitoring with CardioMEMS in addition to standard care on quality of life and hospitalisations in patients with chronic heart failure

2019 ◽  
Vol 28 (1) ◽  
pp. 16-26 ◽  
Author(s):  
J. J. Brugts ◽  
J. F. Veenis ◽  
S. P. Radhoe ◽  
G. C. M. Linssen ◽  
M. van Gent ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Health Care ◽  
Clinical Trial ◽  
Cost Effectiveness ◽  
Remote Monitoring ◽  
Hospital Admissions ◽  
Haemodynamic Monitoring ◽  
Western European

Abstract Background Assessing haemodynamic congestion based on filling pressures instead of clinical congestion can be a way to further improve quality of life (QoL) and clinical outcome by intervening before symptoms or weight gain occur in heart failure (HF) patients. The clinical efficacy of remote monitoring of pulmonary artery (PA) pressures (CardioMEMS; Abbott Inc., Atlanta, GA, USA) has been demonstrated in the USA. Currently, the PA sensor is not reimbursed in the European Union as its benefit when applied in addition to standard HF care is unknown in Western European countries, including the Netherlands. Aims To demonstrate the efficacy and cost-effectiveness of haemodynamic PA monitoring in addition to contemporary standard HF care in a high-quality Western European health care system. Methods The current study is a prospective, multi-centre, randomised clinical trial in 340 patients with chronic HF (New York Heart Association functional class III) randomised to HF care including remote monitoring with the CardioMEMS PA sensor or standard HF care alone. Eligible patients have at least one hospitalisation for HF in 12 months before enrolment and will be randomised in a 1:1 ratio. Minimum follow-up will be 1 year. The primary endpoint is the change in QoL as measured by the Kansas City Cardiomyopathy Questionnaire (KCCQ). Secondary endpoints are the number of HF hospital admissions and changes in health status assessed by EQ-5D-5L questionnaire including health care utilisation and formal cost-effectiveness analysis. Conclusion The MONITOR HF trial will evaluate the efficacy and cost-effectiveness of haemodynamic monitoring by CardioMEMS in addition to standard HF care in patients with chronic HF. Clinical Trial Registration number NTR7672.

scholarly journals Inequalities in Health Care Experience of Patients with Chronic Conditions: Results from a Population-Based Study

Healthcare ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 1005
Author(s):  
Roberto Nuño-Solínis ◽  
Maider Urtaran-Laresgoiti ◽  
Esther Lázaro ◽  
Sara Ponce ◽  
Juan F. Orueta ◽  
...  
Keyword(s):  
Health Care ◽  
Chronic Conditions ◽  
Population Based ◽  
Relational Model ◽  
Chronic Patients ◽  
Care Experience ◽  
Health Care Experience ◽  
Health Related ◽  
Patients Experience

Patients’ experience is an acknowledged key factor for the improvement of healthcare delivery quality. This study aims to explore the differences in healthcare experience among patients with chronic conditions according to individual sociodemographic and health-related variables. A population-based and cross-sectional study was conducted. The sample consisted of 3981 respondents of the Basque Health Survey (out of 8036 total respondents to the individual questionnaire), living in the Basque Country, aged 15 or older, self-reporting at least one chronic condition. Patient experience was assessed with the Instrument for Evaluation of the Experience of Chronic Patients questionnaire, which encompasses three major factors: interactions between patients and professionals oriented to improve outcomes (productive interactions); new ways of patient interaction with the health care system (the new relational model); and the ability of individuals to manage their care and improve their wellbeing based on professional-mediated interventions (self-management). We conducted descriptive and regression analyses. We estimated linear regression models with robust variances that allow testing for differences in experience according to sociodemographic characteristics, the number of comorbidities and the condition (for all chronic or for chronic patients’ subgroups). Although no unique inequality patterns by these characteristics can be inferred, females reported worse global results than males and older age was related to poorer experience with the new relational model in health care. Individuals with lower education levels tend to report lower experiences. There is not a clear pattern observed for the type of occupation. Multimorbidity and several specific chronic conditions were associated (positive or negatively) with patients’ experience. Health care experience was better in patients with greater quality of life. Understanding the relations among the patients’ experience and their sociodemographic and health-related characteristics is an essential issue for health care systems to improve quality of assistance.

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