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CRM Service Line Baseline FY03 Plan (PowerPoint)

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					           Midterm Workshop
              Odense (DK),
         15th of September 2010

        ElDeRly-friEndly Alarm
       handling and MonitorING

Italian Site Trieste: A.S.S. n. 1 and Tesan-Televita Srl
                    Italian Pilot Site in Trieste
                   Region Friuli Venezia Giulia
                           The Partners:



                                         ICT PSP

               Accessibility, Ageing and Social Integration Programme




                   elDeRly-friEndly Alarm handling and MonitorING
“monitoraggio domiciliare e dell’inclusione sociale dei soggetti fragili ed in particolare
                                     degli anziani”
Geographic location




                        we are here

 Trieste: 214.000 Inhabitants
 26% elderly - (21.000> 80)
                                      3
Trieste trial site - Consort flow chart
                         Assessed for eligibility
                                N = 97

            Excluded:
            N = 2 dead
            N = 13 refused
            N = 22 not meeting
                 inclusion criteria



                               Randomized
                                  N = 60



           TM intervention                    Control Group
                N = 30                            N = 30
        Updated on 31/08/2010             Updated on 31/08/2010
           drop out N = 6                     drop out N = 6
          TM GROUP N = 24                  Control GOUP N = 24


                                                                  4
     Trieste trial site - Demographic Profile

                                                           STUDY GROUP

                                                      MEAN AGE              76


                                                      N. FEMALES            18

                                                       N. MALES             12


                                                      AGE RANGE           66-89




                    Control Group
9
8
                                                  F
7            2
                                                  M
6                                                         CONTROL GROUP
                           3
5
                                                      MEAN AGE              76
4    2                               6
3            6
                                                      N. FEMALES            15
2                          4                  2
     3
1                                                      N. MALES             15
                                     1        1
0
    65-69   70-74        75-79      80-84   85- (+)   AGE RANGE           65-94
                         years
 Trieste
trial site

 Living
Situation




             6
   Trieste trial site - Pathological Profile




                Diabetes     Chronic                   Histoy of          History of
                                           COPD
                Mellitus   Heart Failure          Myocardial Infarction    Stroke

 STUDY GROUP      17            16          5              6                  5

CONTROL GROUP     16            18          5              7                  3



                                                                                       7
Trieste trial site - Progress achieved
                           08/09/2010




 20   DREAMING users
 2    Connection programmed
 2    Users with ADSL problems
 6    Cases dropped out
             Installations started: 28/09/2009
               Trieste trial site - Drop Out
 6 DROP OUT IN TRIAL GROUP:
     1 moved to another city (*)
     1 for personal reasons (*)
     1 refused the devices
     1 afraid of radiation from wireless equipment (*)
     1 permanently transferred to an elderly home (*)
     1 dead

 6 DROP OUT IN CONTROL GROUP:
    3 for personal reasons
    3 dead
      Trieste trial site - Equipments
                                                              activated     Total
    Devices                                                  31/08/2010   Purchased

•   Central Unit                                                20           30
•   Environmental Monitor    (smoke, water, temp., motion)      20           30
•   Mambo 2 - senior mobile                                  replaced        30
•   Ello! Set-Top Box Videoconferencing                         20           30
•   Blood Pressure Monitor                                      20           30
•   Asthma Monitor                                               2           7
•   Weight Monitor - Scale                                       5           5
•   Weight, body-fat, body water – Scale                         3           5
•   ECG 1-Lead ECG                                               2           5
•   ECG 12-Lead ECG                                              1           3
•   Pulse/Oxymeter Monitors                                      7           10
•   Glucometer (replaced)                                       11           15
    Trieste Trial Site               -   Contact Centre
   managing clinical folders                   monitoring use of devices

   promoting social inclusion                  videoconferencing

   managing type 1 and 2 alarms/h24            activating network
   maintaining stable contacts with users      earning the trust of users
The   web Portal
    Trieste trial site – Type of alarms
           From 28/09/2009 to 08/09/2010 (11 months):



                                        MANAGED
    Alarm Type 1                         BY CC

•   Hypotension (90/60 mmHg)              188
•   Hypertension (140/90 mmHg)          1.105
•   Bradycardia (55 bpm)                  561
•   Tachycardia (110bpm)                   96
•   Hypoglycemia (60 mg%)                   5
•   Hyperglycemia (140 mg%)               350
•   Respiratory failure (O2 sat. 95%)      87
    TOTAL                               2.392
    Trieste trial site – Type of alarms
          From 28/09/2009 to 08/09/2010 (11 months):
                                         MANAGED BY CC               + WARNED
    Alarm Type 2
                                          37 (cooking)          1 (daugther)
•   Smoke detector                       (+1 sensor problem)

•   Absence of motion                     12                    1 (118/no problem)
•   Severe hypotension   (70/50 mmHg)     21                    2 (case manager)
•   Severe hypertension (210/120 mmHg)    17                    1 (daugther)
•   Severe bradycardia (40 bpm)            8                    2 (case m.-daugther)
•   Severe tachycardia (150 bpm)           3                    2 (case manager)

•   Severe hypoglycemia    (50 mg%)
                                           3                    3 (user assistant)
                                         (+17 user mistakes)
                                         (+20 device mistake)

•   Severe hyperglycemia    (300 mg%)     15 (+3 user mist.)    1 (118/Hosp.)
•   “Mambo 2” alarms                       3 (+2 user mist.)    1 (118/Hosp.)

    TOTAL                                119                    11
      Trieste trial site - Helpdesk
                      Objectives

   to provide a single contact point for technical queries
   to provide answers for demands or problems of users
    and operators
   to facilitate the restoration of normal operational service


                       Functions
    to receive calls
    to identify problems
    to record and to track complaints
    to call the elderly users and keep them informed

                                                                  19
Trieste trial site - Status 08/09/2010
 All the case managers get their personal account and use the HIS
   portal (training session ad hoc)

 30+30 baseline questionnaires completed (SF-36        for QOL and
   HADS for depression)

 Every participant (trial + control group) received the “personal diary”
   and was instructed to fill in them

 Collection of “secondary outcomes” for the first period of the trial
   (for both group) completed

 Monthly meetings in order to coordinate the professionals, increase
   the motivation to follow-up the trial protocol and the patients

 Nurses are the key-operators of the projec
     Trieste trial site



Thank you for your attention !



          Barbara Dodi
        Tesan-Televita Srl

    Paolo da Col, Sara Koterle
      A.S.S. N. 1 Triestina

				
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