Home-based Health Services: Attitude towards the system

Note: This page is part of the Home-based Health Services article in the September 23, 2003 issue of our report.

Medical Staff

In order to determine the reactions of all participants, both structured interviews and questionnaires were used.

From the medical staff point of view, the Home Hospitalization Service will save time and travel to the patients homes, making their tasks easier and more effective. They also think that the control and attention of the patient will be improved.

Usefulness

The following chart shows how doctors and nurses rate the usefulness of each of the available services. It is interesting to see the differences in perceptions of usefulness between doctors and nurses, which seems related to the work they have to accomplish. For example, radiology –used almost exclusively by doctors— is judged badly by nurses.

Figure 1: Usefulness of services (Scale ranges from 1 to 7)
(Note: The “vademecum" service provides information about all available medicines)

As they see it, there are three classes of services: remote monitoring, alarms and information services. The information services were found very useful because the patient information is centralized; quickly accessed; clearly structured; and is accessible for all staff.

Remote monitoring and videoconferencing were considered a great improvement. Previously, the only available way to communicate with the patients was a cellular phone. The medical staff thought the service both improves the monitoring of patients, and reduces the number of visits to them. Some visits are still necessary, however, since physical presence cannot be completely replaced by videoconferencing, particularly for some emotional aspects. The general conclusion is these services improve the quality of home-based assistance.

User Friendliness

The following chart shows the user-friendliness ranking for the different services. Doctors, who are more familiar with PCs than the nurses, found the services much more user friendly.

Figure 2: User-friendliness (Scale ranges from 1 to 7)

Patients and Caregivers

The following chart reflects the end-user usefulness ranking for the different services.

Figure 3: Usefulness from end-users

Patients and caregivers think that this system improves the assistance. There were some complaints about the multiplicity of equipment and difficulties in the installation. Videoconferencing obtained the highest marks, and the impression of users was very similar to the opinion of the medical staff.

Another important service well judged by the users was the remote monitoring. To stress some differences with the medical staff, the warning service was considered to be very useful by the patient to use as a remainder (e.g , for when they should take a pill).