Evaluation of a remote training approach for teaching seniors to use a telehealth system

Objective: There has been a growth of home healthcare technology in rural areas. However, a significant limitation 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 evaluation of an architecture for remote training of patients in a telemedicine environment. This work examines the viability of a remote training architecture called REmote Patient Education in a Telemedicine Environment (REPETE). 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. Methods: A number of qualitative and quantitative evaluation tools were developed and used to study the effectiveness of the remote training sessions evaluating: (a) task complexity, (b) changes in patient performance and (c) the communication between trainer and patient. Specifically, the effectiveness of the training was evaluated using a measure of web skills competency, a user satisfaction survey, a cognitive task analysis and an interaction analysis. Results: Patients not only reported that the training was beneficial, but also showed significant improvements in their ability to effectively perform tasks. Our qualitative evaluations scrutinizing the interaction between the trainer and patient showed that while there was a learning curve for both the patient and trainer when negotiating the shared workspace, the mutually visible pointer used in REPETE enhanced the computer-mediated instruction. Conclusions: REPETE is an effective remote training tool for older adults in the telemedicine environment. Patients demonstrated significant improvements in their ability to perform tasks on their home telemedicine unit.