Mobile Technologies Assisting Patients & Family Caregivers in Healthy Living

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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.