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Web-based telemonitoring and delivery of caregiver support for patients with Parkinson disease after deep brain stimulation: protocol.

Marceglia S, Rossi E, Rosa M, Cogiamanian F, Rossi L, Bertolasi L, Vogrig A, Pinciroli F, Barbieri S, Priori A - JMIR Res Protoc (2015)

Bottom Line: The results of this analysis will be represented in a formal graphical model of the process of DBS patient care at home.The results of this project will provide a novel approach to long-term evaluation of patients with chronic, severe conditions in the homecare environment, based on caregiver empowerment and tailored applications developed according to consensus care pathways established by clinicians.The creation of a direct communication channel between health care professionals and caregivers can benefit large communities of patients and would represent a scalable experience in integrating data and information coming from a clinical setting to those in home monitoring.

View Article: PubMed Central - HTML - PubMed

Affiliation: Clinical Center for Neurostimulation, Neurotechnology, and Movement Disorders, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy. sara.marceglia@policlinico.mi.it.

ABSTRACT

Background: The increasing number of patients, the high costs of management, and the chronic progress of the disease that prevents patients from performing even simple daily activities make Parkinson disease (PD) a complex pathology with a high impact on society. In particular, patients implanted with deep brain stimulation (DBS) electrodes face a highly fragile stabilization period, requiring specific support at home. However, DBS patients are followed usually by untrained personnel (caregivers or family), without specific care pathways and supporting systems.

Objective: This projects aims to (1) create a reference consensus guideline and a shared requirements set for the homecare and monitoring of DBS patients, (2) define a set of biomarkers that provides alarms to caregivers for continuous home monitoring, and (3) implement an information system architecture allowing communication between health care professionals and caregivers and improving the quality of care for DBS patients.

Methods: The definitions of the consensus care pathway and of caregiver needs will be obtained by analyzing the current practices for patient follow-up through focus groups and structured interviews involving health care professionals, patients, and caregivers. The results of this analysis will be represented in a formal graphical model of the process of DBS patient care at home. To define the neurophysiological biomarkers to be used to raise alarms during the monitoring process, neurosignals will be acquired from DBS electrodes through a new experimental system that records while DBS is turned ON and transmits signals by radiofrequency. Motor, cognitive, and behavioral protocols will be used to study possible feedback/alarms to be provided by the system. Finally, a set of mobile apps to support the caregiver at home in managing and monitoring the patient will be developed and tested in the community of caregivers that participated in the focus groups. The set of developed apps will be connected to the already existing WebBioBank Web-based platform allowing health care professionals to manage patient electronic health records and neurophysiological signals. New modules in the WebBioBank platform will be implemented to allow integration and data exchange with mobile health apps.

Results: The results of this project will provide a novel approach to long-term evaluation of patients with chronic, severe conditions in the homecare environment, based on caregiver empowerment and tailored applications developed according to consensus care pathways established by clinicians.

Conclusions: The creation of a direct communication channel between health care professionals and caregivers can benefit large communities of patients and would represent a scalable experience in integrating data and information coming from a clinical setting to those in home monitoring.

No MeSH data available.


Related in: MedlinePlus

Expected architecture of the prototype system. The WebBioBank Web-based platform supports the information exchange between the Care Pathway module that defines the configuration of the homecare monitoring/treatments and the Caregiver Support module, a mobile app dedicated to the caregiver.
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figure2: Expected architecture of the prototype system. The WebBioBank Web-based platform supports the information exchange between the Care Pathway module that defines the configuration of the homecare monitoring/treatments and the Caregiver Support module, a mobile app dedicated to the caregiver.

Mentions: The architecture will consist of two modules, Care Pathway and Caregiver Support, which are both connected to the WebBioBank Web-based platform (Figure 2). The Care Pathway module will be a part of the WebBioBank EHR system and will be devoted to supporting the continuous monitoring of the disease progression and updating of home treatments, customized for each patient. The Caregiver Support module will be designed to provide the tools and information the patient and caregiver need for the proper implementation of the Care Pathway, according to the needs and requirements defined in the first phase of the project. A set of mobile apps will be made available to patients and caregivers to support symptom interpretation, emergency management, and routine daily activities and allow information exchange with the reference neurologist. A mobile device, such as a tablet, will be provided to patients who do not have a personal one.


Web-based telemonitoring and delivery of caregiver support for patients with Parkinson disease after deep brain stimulation: protocol.

Marceglia S, Rossi E, Rosa M, Cogiamanian F, Rossi L, Bertolasi L, Vogrig A, Pinciroli F, Barbieri S, Priori A - JMIR Res Protoc (2015)

Expected architecture of the prototype system. The WebBioBank Web-based platform supports the information exchange between the Care Pathway module that defines the configuration of the homecare monitoring/treatments and the Caregiver Support module, a mobile app dedicated to the caregiver.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4376163&req=5

figure2: Expected architecture of the prototype system. The WebBioBank Web-based platform supports the information exchange between the Care Pathway module that defines the configuration of the homecare monitoring/treatments and the Caregiver Support module, a mobile app dedicated to the caregiver.
Mentions: The architecture will consist of two modules, Care Pathway and Caregiver Support, which are both connected to the WebBioBank Web-based platform (Figure 2). The Care Pathway module will be a part of the WebBioBank EHR system and will be devoted to supporting the continuous monitoring of the disease progression and updating of home treatments, customized for each patient. The Caregiver Support module will be designed to provide the tools and information the patient and caregiver need for the proper implementation of the Care Pathway, according to the needs and requirements defined in the first phase of the project. A set of mobile apps will be made available to patients and caregivers to support symptom interpretation, emergency management, and routine daily activities and allow information exchange with the reference neurologist. A mobile device, such as a tablet, will be provided to patients who do not have a personal one.

Bottom Line: The results of this analysis will be represented in a formal graphical model of the process of DBS patient care at home.The results of this project will provide a novel approach to long-term evaluation of patients with chronic, severe conditions in the homecare environment, based on caregiver empowerment and tailored applications developed according to consensus care pathways established by clinicians.The creation of a direct communication channel between health care professionals and caregivers can benefit large communities of patients and would represent a scalable experience in integrating data and information coming from a clinical setting to those in home monitoring.

View Article: PubMed Central - HTML - PubMed

Affiliation: Clinical Center for Neurostimulation, Neurotechnology, and Movement Disorders, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy. sara.marceglia@policlinico.mi.it.

ABSTRACT

Background: The increasing number of patients, the high costs of management, and the chronic progress of the disease that prevents patients from performing even simple daily activities make Parkinson disease (PD) a complex pathology with a high impact on society. In particular, patients implanted with deep brain stimulation (DBS) electrodes face a highly fragile stabilization period, requiring specific support at home. However, DBS patients are followed usually by untrained personnel (caregivers or family), without specific care pathways and supporting systems.

Objective: This projects aims to (1) create a reference consensus guideline and a shared requirements set for the homecare and monitoring of DBS patients, (2) define a set of biomarkers that provides alarms to caregivers for continuous home monitoring, and (3) implement an information system architecture allowing communication between health care professionals and caregivers and improving the quality of care for DBS patients.

Methods: The definitions of the consensus care pathway and of caregiver needs will be obtained by analyzing the current practices for patient follow-up through focus groups and structured interviews involving health care professionals, patients, and caregivers. The results of this analysis will be represented in a formal graphical model of the process of DBS patient care at home. To define the neurophysiological biomarkers to be used to raise alarms during the monitoring process, neurosignals will be acquired from DBS electrodes through a new experimental system that records while DBS is turned ON and transmits signals by radiofrequency. Motor, cognitive, and behavioral protocols will be used to study possible feedback/alarms to be provided by the system. Finally, a set of mobile apps to support the caregiver at home in managing and monitoring the patient will be developed and tested in the community of caregivers that participated in the focus groups. The set of developed apps will be connected to the already existing WebBioBank Web-based platform allowing health care professionals to manage patient electronic health records and neurophysiological signals. New modules in the WebBioBank platform will be implemented to allow integration and data exchange with mobile health apps.

Results: The results of this project will provide a novel approach to long-term evaluation of patients with chronic, severe conditions in the homecare environment, based on caregiver empowerment and tailored applications developed according to consensus care pathways established by clinicians.

Conclusions: The creation of a direct communication channel between health care professionals and caregivers can benefit large communities of patients and would represent a scalable experience in integrating data and information coming from a clinical setting to those in home monitoring.

No MeSH data available.


Related in: MedlinePlus