A remote training approach for teaching seniors to use a telehealth system

There has been a growth of home health care technology in rural areas. However, a problem with its use has been the need for costly and repetitive training in order for patients to efficiently use their home telemedicine unit (HTU). This research describes the development and evaluation of an architecture for remote training of patients in a telemedicine environment. Repetitive traditional training sessions can be costly due to the amount of travel time that is necessary to reach patients' homes. A potential solution would be to remotely educate patients to use their HTUs. By supporting more frequent sessions, a remote training method may be helpful in improving patients' ability to interpret their self-monitored physiological data.; This work examines the viability of a remote training architecture called REmote Patient Education in a Telemedicine Environment (REPETE). This architecture allows for audio communication simultaneous with remote control and observation of the patient's HTU. REPETE was implemented and evaluated in the context of the IDEATel project, a large-scale telemedicine project, focusing on Medicare beneficiaries with diabetes in New York State. The architecture is evaluated for efficacy of training digital divide seniors, a population that is likely to be one of the most challenging for a remote training task.; Patients were trained on a series of relevant tasks using REPETE. The effectiveness of the training was determined using a combination of qualitative and quantitative methods. Benchmarks were developed to evaluate web skills competency prior to and following training. Patients not only reported that the training was beneficial, but also showed statistically significant improvements in their ability to effectively perform tasks. We also performed qualitative evaluations scrutinizing the interaction between the trainer and patient. This analysis shows that the mutually visible pointer used in REPETE enhances the computer-mediated instruction. In addition, there is a learning curve for both the trainer and the patient when negotiating the shared workspace.; To our knowledge, this work represents the first formal evaluation of the effectiveness of remote training in any population. The training approach taken in this study could have widespread application to domains outside of telemedicine, including that of the corporate training and support market.