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Technology Partnerships Bring Nursing Care to Inner-City Baltimore

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Posted: 11/23/2009

Congestive heart failure (CHF) patients in Baltimore City will be using a new FDA-approved electronic health monitoring device to help manage their heart disease at home as part of a new Johns Hopkins University School of Nursing (JHUSON) study.

With funding from the National Institutes of Health, lead investigator and associate professor Patricia Abbott, PhD, RN, will measure whether having an Intel Health Guide -- which allows patients to monitor their conditions, participate in learning modules, and connect with clinicians online -- in CHF patients' homes can improve their health.  "We need to find ways to reach the medically underserved, and I think technology is one way that we can begin to build those bridges," says Abbott.

With telehomecare devices provided by Intel Corporation, this is the first study to use the technology in community-dwelling African American CHF patients.   It is also the first such study to form a unique partnership with Clearwire Corporation, which will support the Internet connectivity requirements of the Health Guide by providing access to its 4G WiMAX wireless connection, now live in Baltimore.

According to Abbott, wireless technology may be an important tool as telehomecare for chronic disease management becomes more common place. "Not having to pull cables or wires into a patient's home or require telephone lines is a critical step in the battle to reduce barriers to access to healthcare services, particularly in underserved populations," she says.

As part of a larger NIH-funded study led by JHUSON professor Miyong Kim, PhD, RN, Abbott's pilot study will involve 60 inner-city, home-dwelling, African-American patients. Half of the patients will receive the Health Guides, while the others will receive usual care. Researchers want to find ways to accelerate the use of technology to keep patients in their homes, rather than in the hospital, Abbott said. "Our goal is to gain a deeper understanding of how to work more efficiently with patients who have chronic disease utilizing newer technological approaches. The research shows us that an informed and engaged patient may have fewer complications and has higher levels of satisfaction with the healthcare system."

Using the simple, touch-screen device, patients will be able to take their own blood pressure, weight, and other measurements. Patients can connect with researchers through video and voice over IP and access a library of educational videos about chronic diseases. An important component of this study is in the construction and testing of intelligent branching logic, which creates an interactive session for the patient while taking measurements and answering health questions. The device will also be programmed to remind patients about medications, the basics of sodium and fluid management, and medical appointments. The outcomes of the study will demonstrate the impact of such interactivity on heart failure knowledge and disease self-management.

Abbott said this technology will help better engage patients and close the digital divide. "We know that our current ways of working with chronic disease patients is not working as well as it should," she said.