Medical technology in rehabilitational counseling from the “Electronic Healthcare” perspective

Aim. To evaluate the readiness of acute coronary syndrome patients to distant physical rehabilitation (DPR) during the office rehabilitational counseling (ORC).

Material and methods. Open retrospective study included data of 148 patients (117 males, 31 female), who had participated in ORC with the aim to include to DPR. Main part of ORC was conducted in the format of physician work with a computerized algorithm. Completeness of data to form the programs of physical rehabilitation (PR) was assessed manually with reviewing of the discharge summaries. Clinical status was assessed, and if necessary, the 6 minute walking test was conducted. Motivational component was assessed by the results of questionnaire “Program of calculation of motivational readiness of patients to adhere clinician recommendations”. Cognition was assessed with MMSE.

Results. The part of “electronic” discharge summaries was 88,5%. Analysis of availability of epicrise data for algorithm modules showed that only 134 patients (97,3%) had complete data in clinical diagnosis. Also, an insufficiency was shown for number of stress tests with ECG registration: 22 (14,9%), but 96 (64,9%) with 6-minute test. In 30 patients (20,2%) the data on exercise tests was lacking. Data on PR regimen and related assessment of individual exercise tolerance was found in 34 (23% of ORC); and all who passed in-hospital stage. To the program of DPR about 1/3 (31,1%) of ORC participants were included. Under the framework of ORC, PR programs were created for all patients. By the results of investigation, a generalized clinical and instrumental characteristics of DPR patients were formulated, with added motivational and psychological specificities.

Conclusion. It is found that in every 5th myocardial infarction patient discharged from hospital, there is lack of data on individual PR parameters that significantly reduces the ability of primary care physician in prescription and implementation of PR events. Usage of eHealth instruments at outpatient stage of cardiorehabilitation make it to solve these issues of ORC, which has as its tasks the PR programs formulation and evaluation of patient readiness for ORC participation.

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