A pioneering telemedicine project for chronic obstructive pulmonary disease (COPD) has recently been launched in a hospital in central France to assess the impact of readmissions due to COPD exacerbations.
"Telemedicine programmes already exist in pulmonology, but mainly for patients with sleep apnea," said project leader Dr André Marcuccilli. To his knowledge, the 'Hospitadom' project, which is being carried out at the Moulins-Yzeure Hospital, is the first COPD feasibility study of its kind in France; it uses a Danish pilot as a model.
According to the hospital media kit, the pilot project aims to 'establish a telemonitoring system to support and improve the care of chronic respiratory patients.'
The study plans to recruit 100 COPD patients who were hospitalised following exacerbations, and then to randomly distribute them between home telemedicine monitoring and conventional care for 15 days.
The media kit explains that this telemonitoring activity involves the transmission of oxyhemoglobin saturation, spirometry, weight and temperature parameters of patients via a secure web interface that can be analysed by the two telemedicine nurses at the hospital in cooperation with the referring pulmonologist. Abnormal values alert the telemedicine platform during working hours and the private telehealth service platform outside of them. A protocol was developed to determine which decision to trigger following a set of alerts (new measurements, calling the patient's general practitioner, calling the Emergency medical assistance service, etc).
The telemonitoring patients also benefit from eight monitoring sessions by telephone or videophone with nurses who assist them in the process of therapeutic patient education. The intention is to help in the early detection of exacerbations and to ensure homecare support under sound conditions. All patients are to be reexamined six weeks, six months and a year after hospitalisation.
Dr Marcuccilli specified that patients can call upon the telemedicine platform nurses if needed; however, if they are readmitted because of exacerbations, they will not be monitored remotely.
The purpose is to measure over the course of a year the number of readmissions due to exacerbations, length of stay, number of unscheduled visits, number of calls to the platforms, use of homecare nurses and quality of life.
Subscribing to a therapeutic approach to education, 'Hospitadom' seeks to 'simulate a platform in terms of human and technical support for patient care around a hospital and a regional hospital community,' states the media kit. Furthermore, it 'aims to be sustainable and reproducible.' The kit further adds that the pilot forms part of the telehealth component of the 'Hospital of the future' project at Moulins-Yzeure Hospital whose objective is to 'deploy telehealth and telemedicine (management of chronic diseases at home, support and networking of remote health professionals, and emergency medical imaging).'
Dr Marcuccilli noted that experiences in other countries were positive.
'Hospitadom', which is entirely financed by the hospital, is being conducted in partnership with the Catel eHealth Actors' Association (Association de télésanté Catel - in French), a private IT services company specialising in consultancy and project management and a medical equipment supplier.
Plans are already underway to assess the pilot project's implementation on heart failure. A medico-economic evaluation has also been planned and the results of the study are expected at the end of 2012.