Telemedicine and elderly care: Towards an Internet blood pressure monitoring system Tineke Fitch, Jim Briggs and Roger Beresford University of Portsmouth, UK

Contents §Why elderly care? §Why hypertension? §Why the Internet? §Previous work §Survey of elderly in Portsmouth

The healthcare battleground §Increasing numbers of elderly people §Forming larger proportion of population §Over 65s form 2/3rds of NHS patients and 40% of emergencies §Increasing role of ICT in delivering healthcare

Hypertension §More than 50% of over 60s are hypertensive §Trend monitoring is an important tool l usually needs attendance at clinic or home visit (may be stressful/inconvenient) l fluctuations likely to mask trend when measured at 4-6 week intervals l white coat hypertension

Technological advances §Telephone §Television §Internet §WAP §All: l Available in homes l Getting cheaper

Project aims §Investigate implications of using Internet to support elderly care Focus on monitoring at home trends in blood pressure of older patients l Are elderly people prepared to use the technology? l Can the healthcare professionals work this way? l How best to use Internet technologies

Previous work l Elderly people are not less inclined to use new technology [Erkert] - pragmatic l 30% of US year olds own a computer and 23% of over 75s [Post] l May lag behind younger use [Brinkmann] l Once experienced, positive attitude [Czaja] l Attitudes are modifiable [Jay & Willis] l Little UK research

Survey §Carried out at 3 Portsmouth day hospitals §Questionnaire issued at hospital staff discretion §Ethical sensitivities: l Many patients deemed “unsuitable” l Follow-ups and reminders disallowed §289 issued, 46 responses, 2 excluded

Results §Age range 61-91; 55% over 80 l 41% male, 57% female §11% with regular computer access l Primarily for word processing, home finance and education l 5% (2) used and WWW l Professional background much more likely

Attitudes to computers §54% “not interested” in owning a computer; 25% perceived little benefit §Bars to becoming involved: l 45% lack of understanding of technology l 25% cost l 15% physical impairment (e.g. vision, arthritis) l 11% considered decision §6% interested in finding out more

Attitudes to healthcare 1 §Would you be prepared to perform home tests (e.g. blood pressure)? l Yes: 55% l Maybe: 23% l No: 20% §45% already consult their GP by phone §65% said they would not consult via computer

Attitudes to healthcare 2 §40% would seek advice from HCPs using “modern technology” §However... l distinct preference for telephone over or video conferencing §30% prepared to take part in testing and evaluating new technology l higher among older respondents

Observations §No noticeable difference in attitude between under-80s and over-80s §Conservative attitude towards technology §Willingness to have a go §More affluent/better educated more likely to have a computer §Physical impairment is an issue

Healthcare Computing Group