TEAhM-Technologies for Enhancing Access to Health Management: a pilot study of community-based telehealth.

Objective: To explore implementation of nurse-mediated telehealth in community-based senior centers.

Materials And Methods: Two senior centers had telehealth kiosks installed, and two other centers served as control sites. Participants with diagnosed hypertension were instructed to use the equipment at least once per week to measure blood pressure (BP). Nurses monitored BP data for 10 months and made referrals based on primary care physicians' protocols.

Results: Participants' mean age was 74.1 years, 75% were women, and mean baseline systolic BPs were 131 and 138 mm Hg in the intervention and control groups, respectively. At baseline, 64% and 85% of participants reported ever having owned a home computer and cell phone, respectively, and 84% reported having used an automated BP device outside of a doctor's office. At 10 months, mean systolic BP was 126 and 132 mm Hg in the intervention and control groups, respectively. Intervention participants used the telehealth station once per week during 69% of all follow-up weeks, and 71% of high readings received nurse follow-up within 24 h. Kiosk use increased steadily during the follow-up period, peaking at 80%, but declined over time to 47% at 10 months. Nearly all intervention group participants reported being "very comfortable" with the technology at study end, 81% reported it was "very easy" to use, and 89% would recommend it to friends. Senior center staff reported that the technology was consistent with their organizational mission and that clients and boards of directors were enthusiastic about it.

Conclusions: This pilot study demonstrates that telehealth was embraced by clients and staff of community-based senior centers. A larger study is needed to determine the clinical impact and cost-effectiveness of using senior centers as a venue for telehealth-based management of hypertension and other common chronic conditions.