Medical Centre Daniël den Hoed uses laptops for tele-home-monitoring of cancer patients

Rotterdam 08 December 2000The Medical Centre Dijkzigt/Daniël den Hoed in Rotterdam is the first hospital in The Netherlands to provide cancer patients who have been discharged from the clinic, with a laptop for health monitoring at home. Daniël den Hoed Clinical Centre forms part of the University Hospital of Rotterdam. The Medical Informatics Division at the Erasmus University in Rotterdam is co-ordinating the project, whereas the industry partner Lifeline Networks has taken up the role of application service provider.

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Cancer patients, who no longer have to stay at the hospital, are handed a laptop computer to fill out medical documents at regular intervals. The forms, based on a decision tree, are sent electronically to a computer at LifeLine Networks. The questions can differ from case to case and depend on formerly provided answers. Both physical complaints and patients' psycho-social behaviour are being registered.

In a first phase, patients suffering from tumours in the neck or the brain are being monitored. Physicians have learnt through experience that most of the complications occur within six weeks after surgical intervention, according to Dr. Jaap van den Brink. In this critical period, the patients are provided with the laptop. Whenever a problem emerges, it is possible to directly trace it, as Dr. van den Brink explained. Also the fact that doctors now have the chance to enter into communication with a well-targeted patient group, of whom the power to speak has been affected, constitutes an additional advantage of this approach.

General practitioners and medical experts can remotely access the system at Lifeline Networks to consult their own patients' medical records exclusively. The opportunity to view their own personal data is also open to the patients, who at the same time are allowed to ask specific questions to the physicians, discuss disease-concerned issues with other cancer patients, and search for practical information.

The electronic form application includes additional benefits. A well-defined protocol clearly indicates which answers to the questionnaire require special attention or give cause to alarm. In such cases, an e-mail message is being sent automatically to a medical support team, consisting of two health care takers who are specialised in oncology as well as in home care. They decide which type of action has to be undertaken. In case of emergency, they will contact the general practitioner or medical expert.

In the pilot phase, twelve laptops have been reserved to monitor a number of fifty patients during the first year. The research project has been awarded a DFL one million grant by the City of Rotterdam OBR innovation fund and the Roparun organisation. All system functions are based upon Web-technology and communications are transmitted over a private intranet. The application runs on a Web server, coupled to an Oracle-database. The users have access to the different features via a Web browser. Within two years, according to the Automatisering Gids, a scientific evaluation study will be set up to assess the project results.


Leslie Versweyveld

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