Home telecare: system architecture to support chronic disease management

A system architecture to support information transfer between hospital, general practitioner and the home is described in the context of a Home Telecare System (HTS). The HTS facilitates the acquisition, review, analysis and archiving of a longitudinal clinical record to support chronic disease management. The system allows the clinician to schedule for his,her patient the regular recording of clinical measurements (weight, temperature, lung function, blood pressure, single lead electro-cardiogram and ambulation). The patient has in their home a PC with a serially-connected clinical workstation. In addition, the HTS allows the scheduling of questionnaires, medication reminders and the monitoring of an emergency alarm button. The clinician´s interface uses standard Web browser technology to connect to a Web and database server. Use cases indicate that this configuration is not suitable for the patient interface in the home. In this case, a separate stand-alone application with a local subset of the database that periodically communicates with a central server is more appropriate to support a highly usable interface that can be easily customised and maintained.