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Columbia University's Informatics for Diabetes Education and Telemedicine (IDEATel) Project

Technical Implementation

Affiliations of the authors: Columbia University, New York, New York (JS, CH, SSengupta, SShea); American Telecare, Inc., Eden Prairie, Minnesota (CRA); SUNY Upstate Medical University, Syracuse, New York (PEK, RSW).

Correspondence and reprints: Steven Shea, MD, Division of General Medicine, 622 W. 168th Street, New York, NY 10032; e-mail: <ss35{at}columbia.edu>.

The Columbia University Informatics for Diabetes Education and Telemedicine IDEATel) project is a four-year demonstration project funded by the Centers for Medicare and Medicaid Services with the overall goal of evaluating the feasibility, acceptability, effectiveness, and cost-effectiveness of telemedicine. The focal point of the intervention is the home telemedicine unit (HTU), which provides four functions: synchronous videoconferencing over standard telephone lines, electronic transmission for fingerstick glucose and blood pressure readings, secure Web-based messaging and clinical data review, and access to Web-based educational materials. The HTU must be usable by elderly patients with no prior computer experience. Providing these functions through the HTU requires tight integration of six components: the HTU itself, case management software, a clinical information system, Web-based educational material, data security, and networking and telecommunications. These six components were integrated through a variety of interfaces, providing a system that works well for patients and providers. With more than 400 HTUs installed, IDEATel has demonstrated the feasibility of large-scale home telemedicine.

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