Digital home follow-up - challenges and opportunities

The opening speech was held by Henriette Thune. She is the Dean of Research at the faculty and emphasized the importance of the topic and thanked everyone for participating at the seminar.

Afterwards, project manager Anne Marie Lunde Husebø presented the research project responsible for the seminar. The eHealth @ Hospital-2-Home project is a study on digital follow-up of patients with heart failure and patients surgically treated for colorectal cancer transitioning from hospital to home. The project period is from 2020-2024 and the project is funded by The Research Council of Norway.

The project objective is to develop a nurse assisted eHealth service that can reduce burden of treatment and costly hospital readmissions, and increase health-related quality of life (HRQoL) and collaboration with health care professionals in patients with Non-Communicable Disease (NCD), post-hospital discharge.

“The seminar was originally scheduled to take place in March but was postponed due to Covid restrictions. I'm glad we can finally meet physically”, states Husebø.

– Digital platform with several ways of communication

The study’s digital platform is Dignio Connected Care:

“The patients’ interface is MyDignio., which features several functions. Although we knew what digital platform to use, we were not sure as to which one of these functions the patients in our project would find relevant as a follow-up service. That is why we needed to do a bit of mapping in WP1 and also through evaluations in WP2 as to what the users think will work. There are also several ways of communication”, states Husebø.

PhD student Hege Wathne has been responsible for data collection and all the results from the patients so far. The first publication of the project (Morken et al. 2022) consists of 18 studies published between 2015-2018. It displays findings from literature review on eHealth and heart failure.   

Husebø further emphasized that the project faced challenges in finding enough patients for work package 2. Omicron arrived at the same time as this was to start up in December. There are currently 14 patients in WP2: seven patients with heart failure at Stavanger University (SUH) Hospital, four patients with heart failure at St. Olavs Hospital and three patients surgically treated for colorectal cancer at SUH.

Digital home-based care: methods, findings, and dissemination. Evaluation of a National Welfare Technology Program

Siw Helene Myhrer is Senior Adviser at The Norwegian Directorate of Health.

The project is named "On the path from piloting to implementing Telehealth in Norway" - The national welfare technology program. The partners are The Norwegian Directorate of Health, the Norwegian Directorate for e-Health and the Norwegian Health Network. The program lasts until 2024.

She played a film that shows how patients' treatment is made easier by remote follow-up with digital aids, especially suitable for chronic diseases: «I used to call 911 a lot. Now I can handle this myself. I discover signs of deterioration and get supervision from a nurse when I need it.”, states a female patient in the film.

Overall, the evaluation indicates increased safety and improved Health with Telehealth. Three National advices on Telehealth:

• Municipal health and care services should facilitate and establish Telehealth.
• When you plan to establish Telehealth – cooperate within the health community.
• People with chronic conditions should be offered Telehealth as a tailored service.

Remote surveillance and Prostate Cancer

The project was presented by Alison Richardson, Professor of Cancer Nursing and End of Life Care. Executive Director: Southampton Academy of Research, Director: NIHR ARC Wessex, University of Southampton & University Hospital Southampton, UK.

The project aims to help men and their families get their lives back on track following diagnosis and treatment. It was established in 2015 and is funded by Movember in partnership with Prostate Cancer UK.

For men living with, and beyond, prostate cancer the impact of the disease on their everyday life is significant. As treatment for men with prostate cancer is completed, many men report a wide range of problems including fear of recurrence, fatigue, erectile dysfunction and urinary incontinence.

MyMedicalRecord is a cloud-based service, hosted in Microsoft Azure (UK data centre). It is a secure record that the patient owns and enables ongoing interaction between patient and clinical teams. The service is available 24/7 from any location or device with an internet connection. The software has a simple two-way integration to add patients and required hospital data and is built on a modern open platform enabling multiple apps and wearables to connect to the same data store.

Shared Decision Making

Glyn Elwyn, Professor.  Coproduction Laboratory, The Dartmouth Institute for Health Policy & Clinical Practice, Dartmouth College, USA.

“We are in a moving world. It is moving very quickly”, states Elwyn. He discussed the communication between treater and patient with the attended people at UiS based on illustrations in the presentation.

According to him there are four key features of complexity in healthcare:

• Populations of agents + artefacts
• Interacting
• Dynamically
• With emergent rules and governance mechanisms, and bottom-up networks

“Technology links people in ways we didn’t know before”, states Elwyn, who further discussed the definition of shared decision making, which is central in health care. It is an approach where clinicians and patients make decisions together, using the best available evidence about the likely benefits and harms of each option, and where people are supported to arrive at informed preferences. Elwyn stated that the last part is the most important.

Technology will according to him help in the process of developing the communication in the health care sector in a modern way. Explained this by the functionality of several mobile applications.

Text and photo: Eigil Kloster Osmundsen