Dr. Kathryn Dansky is the Principal Investigator on the project entitled Empowering Elders Through Technology that is housed at The Pennsylvania State University in University Park, PA.

What is unique and/or innovative about your study?
This is a technology that individuals use in their homes to communicate with health providers electronically. The technology can help them function at a higher level and avoid undesirable hospitalizations by reinforcing changes in their everyday behaviors. Although telehealth is not new, its application in home settings is relatively recent. By using modalities that allow data to be transmitted over ordinary telephone lines, the technology will connect greater numbers of individuals with health providers.

The subject population – elderly persons with heart failure – is unique. We hope to develop a profile of user preferences for an elderly population. Also, previous studies in this topic area have involved small sample sizes and traditionally have not randomized patients into a research group and control group. We believe that our large sample size and study design will address validity issues in eHealth research.

How is your project progressing so far?
We had a late start due to IRB and HIPAA regulations. We were required to get IRB clearance for all of the home health agencies (HHAs) that are participating in the study. This was a lengthy process.
On the positive side, several of the HHAs are very excited to be part of this national initiative and have gone to great lengths to promote the study.

What prompted you to explore this research?
I have been studying the effect of telehealth on organizational and individual outcomes for several years. This project extends the research scientifically and uses an empowerment framework to explain changes in behavior. In addition, this project complements efforts by the Pennsylvania Homecare Association (PHA) to promote the use of technology in homecare and has provided an opportunity to expand upon an existing partnership with the association.

How would a typical end-user utilize the final product/results of your research?
The possibilities for using telehealth have no boundaries. It is designed for a home setting – but where is home? The unit can travel anywhere and be plugged into a telephone jack. It could be used out in the community, in places such as schools, prisons and Senior Centers. Some models are designed as kiosks, where the user has an ID card, similar to an ATM card. This type of unit could be placed in a public setting such as a mall or a retirement village. The key functionality – transmission of vital signs and other clinical indices – remains unchanged, as long as one of the system users is a health care provider.

This research also has a practical application in that it will provide independent data to help promote this technology among consumers. Home Health Agencies will be able to use this project to promote the implementation of new telehealth programs and the expansion of existing telehealth programs in their communities. The partnership with the Pennsylvania Homecare Association and the participation in this project by PHA’s member agencies will provide some unique dissemination opportunities for our research results.

What are the greatest challenges in eHealth and more specifically, your project?
Our greatest challenges have centered around two issues: enrollment and randomization. Many of the individuals who are eligible for the study have been unwilling to enroll because they are too sick. Ironically, we find that the unit has great benefits for very sick clients because it allows frequent monitoring. But the effort to learn how to use the technology, however minimal it may be, is too overwhelming for some frail elders.

A second issue is randomization. We have been unable to convince some of the home health directors and nurses that randomization is essential. They would like to make decisions about assignment of units based on patient need and physician preference.

In what ways would you like to see eHealth evolve?
I think the “digital divide” is still an issue for eHealth. Many individuals are unable to use technology because they lack the hardware, software, computer skills, etc. As we learn more about eHealth, we need to be sensitive to equity. Not only is this a moral issue, but also it’s critical from a research perspective, to include subjects who are representative of our entire population.

How do you stay informed of advances and innovations in eHealth?
That’s a great question. I think we all struggle with this, particularly those of us who are not IT specialists. eHealth is layered on to my other interests – management, organizational studies, clinical outcomes. The major associations (ATA, AMIA) don’t really bridge this gap for me. I don’t know of any professional organization that really addresses consumer issues in eHealth, which is where my priorities are. I look for trends in the popular media (newspapers and magazines) and try to keep abreast of research issues by reading a variety of professional journals.

Thanks to Kathryn and Tammy Sanner, Grants Manager, Pennsylvania Homecare Association, who contributed to this article.

Check back in November when we will hear from Dr. Kevin Wildenhaus of HealthMedia, Inc.