Program Evaluation of Telehomecare: TeLeCare Study

NCT02311114 | Unknown

• 1 other identifier: 30158
• Study Type: observational
• Target: N/A
• Locations: 1 country
• Sites: 1

Brief Summary

This study will evaluate the Telehomecare (THC) Program offered to patients with heart failure or chronic obstructive pulmonary disease across the Central West, Toronto Central and North East Local Health Integration Networks in Ontario. It will explore the opinions and experiences of patients, providers, technicians and administrators involved with THC Program in order to provide stakeholders with information about the processes and organizational factors impacting the program's adoption, the experiences of its participants, impact on patient outcomes, costs to the health-care system and who is benefiting the most from participating. These factors will be determined using semi-structured interviews, surveys, and observation of practices of everyone involved with THC. The study will also evaluate patient data to determine changes in patients' utilization of healthcare services.

Conditions

Heart Failure; Chronic Obstructive Pulmonary Disease

Keywords

Program Evaluation; Telehomecare; Chronic Obstructive Pulmonary Disease; Heart Failure; LHINs; Local Health Integrative Network; OTN; Ontario Telemedicine Network

Outcome Measures

Primary Outcomes (1)

• Organizational Factors (Semi-structured interviews and general observation)

  Those factors will be identified via qualitative research methods, hence no measurable units are applicable for them. Semi-structured interviews and general observation of all types of participants will be done at different times/stages of program.

  The data collection period will be approximately 3 months

Secondary Outcomes (6)

• Overall patterns of use (length of stay, drop out rates, nurse workload, etc.)

  Retrospectively using Ontario Telemedicine Network database, for all participants who were enrolled in the Telehomecare program. The data collection period will be approximately 3 months

• Telemedicine perception (Telemedicine perception questionnaire (TMPQ))

  Prospectively at baseline, and at month 1, 2, 3 follow-up

• Health services utilization (hospitalization, LOS, ED visits, etc.)

  Retrospectively, six months before, during and after the Telehomecare program. Will be collected for the patients who completed the Telehomecare by the 28 Feb 2014.

• Quality of life

  Prospectively at baseline, and at month 1, 2, 3 follow-up

• Client satisfaction (satisfaction questionnaire (CSQ-8)

  Prospectively at baseline, and at month 1, 2, 3 follow-up

Study Arms (4)

Telehomecare patients

Observational fieldwork, in depth interviews and surveys up to 4 times will be conducted.

Other: In Depth interview; Other: Observational fieldwork; Other: Survey

Health care providers

In-Depth interviews, observational fieldwork and one time survey will be conducted.

Other: In Depth interview; Other: Observational fieldwork; Other: Survey

Telehomecare administrators

In depth interviews will be conducted

Other: In Depth interview; Other: Observational fieldwork

Telehomecare technicians

In-depth interviews, observational fieldwork will be conducted.

Other: In Depth interview; Other: Observational fieldwork

Interventions

In Depth interview OTHER

In Depth interview will be conducted for 30-60 min using semi-structured questionnaire to assess participants experience with telehomecare program.

Health care providers; Telehomecare administrators; Telehomecare patients; Telehomecare technicians

Observational fieldwork OTHER

Observational fieldwork will conducted to observe everyday routine activities related to telehomecare. May last up to 1h per observation.

Health care providers; Telehomecare administrators; Telehomecare patients; Telehomecare technicians

Survey OTHER

Surveys with participants will be conducted using validated survey tools.

Health care providers; Telehomecare patients

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Health care providers, technicians, administrators/decision makers and patients enrolled in the Telehomecare Program.

You may qualify if:

• Patient
• The patient has a documented diagnosis of HF or COPD (with or without co-morbid conditions)
• The patient is a 'heavy user' of the health care system, characterized by any of the following:
• A minimum of one hospitalization for a respiratory or cardiac complaint in the past six months
• A minimum of two emergency department/urgent care center visits for a respiratory or cardiac complaint in the past six months
• Is receiving nursing services via CCAC
• Frequent visits to primary care provider in the past year
• The patient or informal caregiver (if applicable) is an adult (over 18 yrs) able and willing to provide informed consent.
• The patient or informal caregiver (if applicable) is fluent in English
• The patient or informal caregiver is able and willing to operate the THC equipment
• The patient lives in a residential (private home or retirement home) setting with an active landline
• The patient or informal caregiver have agreed to be contacted for evaluation of this program when consenting to participate in the Telehomecare program.
• Health Care Provider
• Any health care provider who referred a patient to the telehomecare program
• Primary care providers of patients who are enrolled in the study

You may not qualify if:

• Patient
• Less than 18 years of age
• Individuals without an established diagnosis of COPD or chronic HF
• Unable or unwilling to provide verbal informed consent
• Demonstrated non-adherence to the THC program
• The THC Clinician works with each patient on a case-by-case review to assess willingness to partner in their own care, and if the number of missed consultation appointments and reasons for demonstrate overall non-adherence with the program.
• Inability or unwillingness to use THC equipment
• Do not have a regular caregiver to assist in the use of the equipment
• Health Care Provider, Technician, Administrators and/or Decision Makers
• \- Unable or unwilling to provide verbal informed consent

Sponsors & Collaborators

• University of Toronto: lead
• Ontario Ministry of Health and Long Term Care: collaborator

Study Sites (1)

University of Toronto

Toronto, Canada

Location

MeSH Terms

Conditions

Heart Failure; Pulmonary Disease, Chronic Obstructive

Interventions

Surveys and Questionnaires

Condition Hierarchy (Ancestors)

Heart Diseases; Cardiovascular Diseases; Lung Diseases, Obstructive; Lung Diseases; Respiratory Tract Diseases; Chronic Disease; Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Data Collection; Epidemiologic Methods; Investigative Techniques; Health Care Evaluation Mechanisms; Quality of Health Care; Health Care Quality, Access, and Evaluation; Public Health; Environment and Public Health

Study Officials

• Murray Krahn, MD,MSc

  THETA Collaborative

  PRINCIPAL INVESTIGATOR

• Valeria Rac, MD, PhD

  THETA Collaborative

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: OTHER
• Time Perspective: OTHER
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: MD MSc

Study Record Dates

• First Submitted: June 27, 2014
• First Posted: December 8, 2014
• Study Start: June 1, 2014
• Primary Completion: December 1, 2014
• Study Completion: September 1, 2018
• Last Updated: March 22, 2018

Record last verified: 2018-03

Locations

CA (1)