Development of an integrated telehealth system to facilitate self management of long term conditions

Objective. This paper describes the user-centred specification, development and evaluation of a prototype telehealth system, capable of enhancing self management for people with congestive heart failure (CHF). The overall aim is to produce a system to enable people with a range of long term conditions to self manage. CHF is one of three exemplar conditions under investigation in the SMART2 (Self Management supported by Assistive, Rehabilitative and Telecare Technologies) project.

Main content. User requirements were established by conducting focus groups and semi structured interviews with health care professionals, users and their informal carers. From these, a list of features for a Personalised Self Management System was determined and prioritised based on long term conditions policy and guidance in England and Wales, existing clinical guidance and expertise held within the project Consortium. A technology appraisal mapped these features with relevant existing technologies and a system structure was produced. This was validated by semi structured interviews with users and carers and data informed the development of a working prototype. An iterative cycle of feedback and evaluation is ongoing.

Results. Health care professionals discussed the role of information and communication technologies (ICTs) in their working practice and how ICTs could support their patients to self manage. Users and carers discussed their views of everyday technologies and how they lived with and managed their condition. The resulting system structure comprised the following elements: Setting personal goals. Personalised self management sessions to improve condition specific knowledge and physical fitness (a cross cutting theme in all three conditions). Assessment of progress and appropriate feedback. Links to the healthcare team and external sources of support. Users welcomed the idea of such a system and emphasis was placed on the importance of personalisation and flexibility. The physical prototype comprises a touch screen home hub and mobile device and further evaluation and iteration is ongoing.

Conclusion. This system is both feasible and acceptable to health care professionals, users and carers. It is responsive to the current direction of UK policy and offers a unique opportunity for telehealth to fulfil a much wider remit than it currently provides