Introducing a telemonitoring platform for diabetic patients in primary care: will it increase the socio-digital divide?

AIMS: This study investigates whether diabetes patients visiting a primary care setting are interested in using a telemonitoring platform and if so, whether characteristics of interested users could be distinguished. METHODS: Three questionnaires were administered by 92 diabetes persons recruited between May and September 2011. Descriptive statistics and logistic regression analysis were performed. Special attention was drawn to include patients with low educational levels. RESULTS: Patients with middle or high educational levels show quite some interest in the use of a telemonitoring platform, especially for the transmission of glycaemic data or for asking questions. Patients with low educational levels only show a minor interest in using such a platform. CONCLUSIONS: It is possibly worthwhile to implement a telemonitoring platform in a primary care setting; however this study did not show immediate profit for implementation in a CHC that organises diabetes clinics on regular basis. In primary care settings where it will be implemented, even if there is a social-digital divide today, the use of a telemonitoring platform could possibly reduce inequity in health care as time could become available for those most in need for face-to-face contact with their physician.

Introducing telemonitoring for diabetic patients: development of a telemonitoring 'Health Effect and Readiness' Questionnaire.

PURPOSE: Till now no validated instrument exists to measure the readiness and attitude of diabetic patients towards the use of telemonitoring. The purpose of the described study was to develop a Telemonitoring Attitude and Readiness Questionnaire and to check its validity and reliability. METHODS: After performing in-depth interviews in two separate sessions, the Telemonitoring Attitude and Readiness Questionnaire was completed by a convenience sample of 138 patients with type 1 and type 2 diabetes to determine internal consistency. Test-retest reliability was further evaluated with a subsample of 21 patients. RESULTS: Analysis supports the validity and reliability of the 13-item Telemonitoring Health Effect and Readiness Questionnaire (THERQ) with three subscales: Communication with peers or during holidays with a professional (Cronbach's alpha=0.84), telemonitoring health effect (Cronbach's alpha=0.87), and communication with a professional from home (Cronbach's alpha=0.88). Test-retest reliability is satisfactory (intraclass correlation coefficients between 0.58 and 0.92). CONCLUSIONS: The results of this study provide preliminary evidence that the Telemonitoring Health Effect and Readiness Questionnaire is a valid and reliable instrument to measure the readiness and subjective feelings of health effect towards the use of telemonitoring. The THERQ could be used before the implementation of telemonitoring to check if diabetic patients are interested in the use of it but it could also be used in (randomized) controlled trials as the questions are put in such a way that also patients not (yet) using telemonitoring can answer the questions.

Privacy enhancing techniques in E-health: an overview.

This overview highlights the relevance of Privacy Enhancing Techniques (PETs) in the context of e-Health. A number of validated privacy protecting techniques is briefly presented. The implementation of such PETs could provoke, for a number of applications, a shift in paradigm, namely from "Privacy through Security" to "Security through Privacy".