Implementing telemonitoring in the daily routine of a GP practice in a rural setting in northern Germany.

We conducted a two-month feasibility study of telemonitoring based on home visits by a specially trained nurse to 20 elderly patients who would otherwise have been receiving monitoring home visits from their general practitioner (GP). A specially-trained community medicine nurse was instructed to report important changes in the health status of a patient during her home visits immediately via telephone. In the case of 8 patients, various telecare devices were installed by the community medicine nurse according to the patients' needs. Patients were trained to use the devices independently in their homes. Three patients received a one lead ECG meter and made 100 successful transmissions in 101 patient-days. Three patients were supplied with an electric scale and successfully transferred 72 measurements in 73 patient-days. Two patients were equipped with a teletonometry system and used the blood pressure monitor and blood glucose meter successfully. The tonometer itself was used by only one of the patients as suggested by the GP (once per week; 5 successful transmissions in 39 days). The GP reported a positive effect on her work, with time saved because of less travelling for home visits. With the back-up of the measurements obtained by the telecare devices it was possible to delegate monitoring tasks to the community medicine nurse.