As part of the ITTS demonstrator projects Ireland has begun a new approach to enabling participants to actively engage in exercise within a safe environment.
Exercise is only one aspect to a new approach, participants are also educated on the benefits of exercise, how to use health monitoring equipment and encouraged to monitor their own personal health statistics prior to, or directly after, a visit with their General Practitioner (GP).
The goal of the health portal is to capitalise on the 'waiting room anxiety' experienced in primary care centres. By having the portal within a primary care setting, participants have a new confidence to simply have a go, knowing that clinical support is nearby if they feel they need attention.
The health portal is set up in an easy to follow pathway. Participants continue from one station to the next, as can be seen below:
Blood pressure measurement
Station 3 Respiratory
BMI = Body Mass Index =
Walking on the treadmill
Step, Chair and Weight lifting
Benefits of Exercise
Dr Mike Evans
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During the first visit to the portal, participants are guided through each of the self-health check and exercise stations. When they feel competent enough, they are encouraged to continue on at a pace at which they are comfortable.
One of the challenges of the health portal is to get participants to make the first step; the next challenge is to encourage the use of the room on an ongoing basis with visits to the portal on days they are not on a GP visit.
In Sweden, a drop-in service for self-measuring of blood pressure and INR values is now available at healthcare centres in Malå (since November 2012), Sorsele (since January 2013) and Storuman (since May 2013). A room at each site has been adapted for this purpose.
The technology delivers direct results; it is not necessary to send samples to a hospital laboratory and wait between 24-48 hours for results.
To date, over 500 patients have used this new service which has resulted in fewer home visits by the district nurse who carries a portable check-up bag.
In Finland, the Oulu Arc Subregion have developed a service based on supported self care with a specific focus on patients living at home in the two municipalities of Utajärvi and Vaala.
Elderly people are willing to live at home as long as possible but social isolation can cause loneliness and also lead to various problems with physical, mental and social wellbeing. Although healthcare staff do visit patients at their homes, time is of a premium and patients often find interaction is too short lived. In fact, home visits are increasingly hard to schedule as healthcare staff deal with a pressured workload. As more clinics (for example rehabilitation) are centralised, ITTS are working to develop ways to keep those patients in remote locations 'connected', prolonging their ability to stay living at home.
One solution is the use of videoconference (VC) technology which has the potential to enable participation in both clinical appointments and social activities, including engaging with distant friends and relatives. It is this social interaction which is key to the success of the project.
Through ITTS, a number of VC units have now been installed at local healthcare centres, with portable units situated in patients homes throughout the region.
VC is just one tool to support patients with multimorbidity who are living at home. Oulunkaari Self Care portal is another tool which can be used as a database for patients' self measurement results (eg. INR) and other health care information.
Since October 2012, 50 patients have used the VC service (for a range of conditions) and over 1,700 patients have used the self care portal.