The Blue Angel for Asthma Kids
The Blue Angel for Asthma Kids application is an internet-based highly interactive asthma control program. The program helps children monitor their peak expiratory pattern and flow, and control the effects of asthmatic attacks. The program also checks the children’s adherence to inhaled corticosteroid medication. It offers a self management formula, after the children enter their peak flow levels and symptoms daily (Jan et al., 2007). The Blue Angel for Asthma Kids application was implemented to address public health-related issues of increasing adverse effects among Taiwanese children. The implementation took the form of a controlled randomized trial, aimed at evaluating the effectiveness of the model. The aim of the implementation was to manage asthmatic children, using the interactive education and monitoring model.
During the implementation, 164 pediatric patients affected by persistent asthma were registered and randomized into two classifications, for a 12-week duration. The intervention faction held 88 subjects, who were educated on checking their symptoms and peak expiratory flows (PEF) over the internet on daily basis. These subjects also received a self-management outline from the program. The control group held 76 subjects, who were taken through traditional care (McNabb et al., 2006). This comprised of education on asthma control tests and the use of a written asthma control diary. The level of disease control was evaluated using weekly averaged PEF variables, asthma control testing and symptom variations. Adherence levels were checked through diagnostic and therapeutic monitoring. The results from the program were checked on the basis of the retention of asthma awareness and the overall quality of life (Jan et al., 2007, pp. 257-268).
The results showed that the application led to several potential benefits. These included reduction in nighttime and daytime symptoms; improved morning and night PEFs; increased levels of adherence, increased know-how on self-management, and improved quality of life. As a result, the application improved self-management knowledge and improved patient outcomes, therefore appearing as an effective and well-accepted system for the care of asthmatic children as well as their caregivers. The program proved highly beneficial, thus was adopted by care providers and health officials. The model also influenced the general population into its adoption (Jan et al., 2007, pp. 257-268).
Teledentistry
Teledentistry is a real-time telehealth application. For years, the application has advanced to involve the use of new connectivity models to administer care. In practice, the application involves digitization and electronic transmission of dental photographs, diagrams, drawings and X-rays to a specialist. The process of digitizing and transmitting these information bases is carried out by a local dentist. Together with the digitized data, the dentist fills-out a standard consultation form over the website of the specialist. In response, the specialist consultant develops and transmits a confidential consultation report to the local physician or dentist asking for assistance. For this service, a time-based fee is paid to the specialist. Some doctors also seek dentistry patients over the internet, thus becoming cyber-dentists. Teledentistry is more of a practice builder, and helps dentists serve their patients better, as well as increase their knowledge of dentistry (Fricton & Chen, 2009, pp. 537-548).
Telenursing is an application that uses technology to offer nursing care and administer nursing practice. The nursing personnel involved in telenursing execute the roles of assessing, planning, evaluating and controlling the outcomes realized from nursing care. The technologies used to execute these roles include computers, the internet, digital assessment appliances, telephones and telemonitoring equipments. Throughout this process, there is characteristic digitization and transmission of the medical data of patients, imparting education over interactive audio and visual communication tools, and data communication (Finkelstein et al., 2006).
Home-based nocturnal dialysis is a remote patient monitoring system, which is used to administer hemodyalisis at the home of a patient suffering from stage 5 chronic kidney condition. It is an established model of renal replacement therapy, and it can be traced back to the 1970s. The patient on this telemedication is tracked by a nephrologist, who offers the dialysis prescription. The patient relies on the information and support offered by a dialysis unit. The dialysis unit offers information case management and back-up treatment. The model improves the well-being of patients, as it helps them control and know more about their treatment and dialysis needs (Suri et al., 2006).
The challenges to the telehealth models discussed above are discussed next. The first challenge is the regulatory barriers imposed in the way of presenting expected privileges to the physicians administering the services. For instance, there is an issue with licensing out-of-state practitioners, and concerns over the liability resulting from malpractice. The second challenge is financial barriers, mainly due to the inability to bill for the services under these categories, despite the need to pay for additional technology and machinery. The third challenge is cultural barriers, especially those resulting from the lack of preparedness to change clinical paradigms and the practice of telehealth (Yasnoff et al., 2000). These barriers are affecting the application of telehealth, as regulatory barriers are affecting the coverage and administration of the applications. For example, out-of-state regulations limit the coverage of care and the experts incorporated into the service delivery. Financial barriers make it expensive for the patients to access the services, which may not be offered by cheaper providers. Lastly, cultural barriers limit the rate of adoption, especially among solidly cultural-bound societies (Zawada et al., 2009).
References
Finkelstein, S., Speedie, S., & Potthoff, S. (2006). Home telehealth improves clinical outcomes at lower cost for home healthcare. Telemed J E Health, 12 (2), 128– 136.
Friction, J., & Chen, H. (2009). Using teledentistry to improve access to dental care for the underserved. Dent Clin North Am, 53 (3), 537-548.
Jan, R. L., Wang, J.Y., Huang, M.C., Tseng, S. M., SU, H.J., & Liu, L. F. (2007). An internet-based interactive telemonitoring system for improving childhood asthma outcomes in Taiwan. Telemed J E Health, 13 (3), 257-268.
McNabb, S., Koo, D., Pinner, R., & Seligman, J. (2006). Informatics and public health at CDC. MMWR, 55 (4), 25–28.
Suri, R. et al. (2006). Daily hemodialysis: a systematic review. Clin J Am Soc Nephrol, 1 (1), 33–42.
Yasnoff, W., O’Carroll, P., Koo, D., Linkins, R., & Kilbourne, E. (2000). Public health informatics: Improving and transforming public health in the information age. Journal of Public Health Management and Practice, 6 (6), 67–75.
Zawada, E., Herr, P., Larson, D., Fromm, R., Kapaska, D., & Erickson, D. (2009). Impact of an Intensive care unit telemedicine program on a rural health care system. Postgrad Med., 12 (1), 160–170.