Even the elderly log on to Internet health care

Tapping into the Internet provides a new realm for managing patients’ health. But can you get the elderly — who make up much of the chronically ill population — to log on?

The answer is yes, according to those involved in early efforts to connect patients via computers.

In a pilot test of Community Health Advance-ment Through Technology (CHATT), an on-line disease management program, patients received very minimal computer training. Since the project provided free computers to participants, some patients had little previous exposure to the technology. Project coordinators wanted to see whether a lack of comfort with computers would be a barrier.

"Some people didn’t even know what a mouse was," says Tracy Carlino, RN, CDE. Carlino is director of community education for Virtua Health, a health system based in Marlton, NJ, that is sponsoring the project with Communi-Health, an on-line health information company in Malvern, PA, and Intel Corp. in Santa Clara, CA. "They thought it was something that ran through the backyard."

The response to the computer-based monitoring and education has been overwhelmingly positive, says Carlino. Chat rooms have been particularly popular, as diabetic patients form their own on-line support group.

Some stereotypes also have been quashed. One of the most enthusiastic users of the on-line program is a woman in her late 80s who lives in an extended care facility. "She relies on that communication she has with her diabetes peers, educators, and physicians," says Carlino.

The Health Hero Network, based in Mountain View, CA, uses an Internet connection but doesn’t place computers in patients’ homes. Instead, they use a Health Buddy, a small touch screen that offers a multiple-choice response. The technology doesn’t allow e-mail or chats, but it is more user-friendly, says Steve Brown, chief executive officer of Health Hero Network.

"I think what’s most interesting about it is that it’s so simple," says Calvin Chao, MD, MBA, IPA’s associate medical director of the Santa Clara County Independent Practice Association in San Mateo, CA, which uses the system. "If an 85-year-old woman can do this with no fear and no difficulty, it speaks to the effectiveness of the device."

Even so, there are some patients who will remain stubbornly resistant to the use of technology. A few patients at the Santa Clara County IPA declined to use the Health Buddy.

"It’s something that is unfamiliar. It isn’t so much that was difficult," he says. "They didn’t even take the device out of the box."