Delivering group-based services to the home via the Internet: Maximising clinical and social benefits

Delivering clinical services to people in their homes by means of technology may improve access for patients, but may compromise personal and social interactions with health professionals. Rehabilitation programs improve wellbeing and quality of life in a number of conditions, such as Chronic Obstructive Pulmonary Disease (COPD), Ischemic Heart Disease and Stroke. Programs are conventionally delivered to groups, who undertake shared physical exercise, education and socialization. However, travel demands or poor health mean that many patients cannot participate. In a previous paper, we reported a new design for a group pulmonary rehabilitation program delivered to the home via the Internet and videoconferencing, and reported findings from the first feasibility trial performed with four patients. A second feasibility trial has been performed with three patients. Across both trials, the technology worked well, patients found the system easy to use, felt part of a group and felt safe. Satisfaction was high and clinical outcomes were similar to those in a conventional clinic-based program. Limited social interaction between participants occurred. In future, this could be enhanced by modifying the program schedule to dedicate time for socialization, and by allowing use of the system for interaction outwith the scheduled sessions. The technology could potentially be applied to other forms of rehabilitation such as Ischemic Heart Disease and Stroke.