Mobile Technologies Assisting Patients & Family Caregivers in Healthy Living

描述(由申请人提供)：这项研究测试了移动技术如何让家庭参与并支持他们的健康生活，并减轻他们的家庭医疗负担(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家庭实时观察，将及早发现家庭管理中经常致命的血流、败血症、感染和其他严重并发症，这些并发症是终生每日家庭静脉外营养(HPN)静脉(IV)输注的。每年有数百万美元被花费在与复杂的家庭护理相关的糟糕的健康状况上，以及我们国家最昂贵但可预防的静脉感染诊断上，这是NIH排名前25位的研究重点。该项目将确定移动技术获取我们基于证据的干预措施(基于互联网的循序渐进的家庭护理算法、演示复杂的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、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”技术，在家庭和多个专业人员以及同伴支持小组之间同时进行互动。具体目的是测试通过XOOM移动平板电脑和EVO手机提供的FamHomeCare对80名HPN患者及其照顾者的影响：(A)健康状况和生活质量；(B)健康生活活动的使用；(C)IV感染；(D)照顾者负担；(E)疲劳；以及利用数据包络分析(DEA)的创新计量经济学效率统计数据，将确定XOOM-EVO系统相对于患者的面对面医疗服务的成本。嵌套的线性混合模型分析被用来检验随时间推移的效果。此外，“虚拟护士护理”的新概念通过电脑平板远程医疗、互联网和智能手机，评估受试者(患者和照顾者)远距离被“照顾”的感觉。该项目将对以下方面产生持久的影响：(A)生物技术，通过计算移动系统的成本效益与所使用的面对面保健服务的比率，转化可靠的“最佳做法”技术；(B)通过提供新的远程护理干预措施，使临床医生和管理人员受益。这项研究将获得有关复杂慢性疾病的移动管理的新知识，使用一个集成系统，该系统具有经过科学验证的移动互联网访问家庭护理算法；通过与多名专业人员的桥接传输和小组同行会议，在家中与患者及其家人照顾者之间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.