Mobile Technologies Assisting Patients & Family Caregivers in Healthy Living

描述（由申请人提供）：本研究测试移动技术如何参与和增强家庭健康生活能力，并减轻家庭医疗负担（PAR-11-020）。专业人员通过XOOM-EVO运动视频和照片快照对患者进行实时家庭观察，可以早期发现通常致命的血流败血症感染和终身每日家庭外营养（HPN）静脉注射（IV）的家庭管理的其他严重并发症。每年有数百万美元花费在与复杂的家庭护理相关的健康状况不佳，以及我们国家最昂贵但可预防的静脉败血症诊断上，这是NIH研究的前25名优先事项。该项目将确定移动技术访问我们基于证据的干预措施（基于互联网的分步家庭护理算法，说明复杂HPN家庭护理IV程序的视频场景以及支持家庭健康生活活动的自动提示和激励游戏）的成本效益。此外，我们的XOOM-EVO系统（使用摩托罗拉XOOM内置摄像头电脑平板电脑和EVO移动智能手机的低成本集成系统）使用我们的多点单元或“桥梁”技术，在家庭和多个专业人员以及同伴支持团体之间同时进行互动。具体目的是测试通过XOOM移动平板电脑和EVO移动电话向80名HPN患者及其护理人员提供的FamHomeCare的效果：(a)健康状况和生活质量；(b)进行健康的生活活动；(c)静脉感染；(d)照顾者负担；(e)疲劳;并使用创新的计量经济效率统计数据包络分析（DEA）将确定XOOM-EVO系统的成本，相对于患者的亲自医疗服务。嵌套线性混合模型分析用于测试随时间的影响。此外，“虚拟护士护理”的新概念通过电脑、平板电脑、远程医疗、互联网和智能手机来评估受试者（患者和护理人员）从远处被“照顾”的感觉。该项目将对以下方面产生持续影响：(a)生物技术，通过计算流动系统与所使用的面对面保健服务的成本效率之比，转化可靠的“最佳做法”技术；(b)临床医生和管理人员，通过提供新的远程护理干预。本研究将通过科学验证的移动接入互联网家庭护理算法的集成系统，获得复杂慢性病移动管理的新知识；通过与多名专业人员和小组同伴会议的桥接传输，在家中与患者及其家庭护理人员进行照片和视频预约。

DESCRIPTION (provided by applicant): This study tests how mobile technologies engage and empower families in healthy living and reduce their home healthcare burden (PAR-11-020). Professionals' real-time home observation of patients via XOOM-EVO motion video and photograph snapshots will provide early detection of the often fatal blood stream sepsis infections and other serious complications of home management of life-long daily home parenteral nutrition (HPN) intravenous (IV) infusions. Millions of dollars are spent annually on poor health associated with complex home-caregiving and on our nation's most costly but preventable diagnosis of IV sepsis, a top 25 NIH research priority. This project will determine the cost-efficiency of mobile technology access to our evidence-based interventions (internet based step-by-step home-caregiving algorithms, video scenes illustrating complex HPN home-care IV procedures and automated prompts and motivating games support families' healthy living activities). Also our XOOM-EVO system (a low cost integrated system using the Motorola XOOM built-in camera computer tablet and the EVO mobile smart phone) uses our multi-point unit or "bridge" technology for simultaneous interactions among the family at home and multiple professionals and for peer support groups. Specific aims are to test the effects of the FamHomeCare delivered via XOOM mobile tablet PC & EVO mobile phone with 80 HPN patients and on their caregivers: (a) health status and quality of life; (b) use of healthy living activities; (c) IV infections; (d) caregiver burden; (e) fatigue; and also use of the innovative econometric efficiency statistics of Data Envelopment Analysis (DEA) will determine the XOOM-EVO system costs, relative to patients' in-person health services. Nested linear mixed model analyses are used to test effects over time. Also, the novel concept of "Virtual Nurse Caring" evaluates subjects' (patients and caregivers) sense of being "cared for" from a distance via computer tablet telehealth, internet and smart phones. This project will have a sustained impact on: (a) biotechnology, by translating reliable "best practices" technology by calculating the cost efficiency of mobile system in ratio to in-person health services used; and (b) clinicians and administrators, by providing new distance care interventions. This study will gain new knowledge about mobile management of complex chronic conditions using an integrated system with scientifically validated mobile access to internet home-care algorithms; photographs and video appointments to and from patients and their family caregivers at home via bridged transmissions with multiple professionals and group peer sessions.