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eHealth

The department Dermatology and Allergology and the department Rheumatology and Clinical Immunology have developed some eHealth solutions. The aim of the eHealth solutions is making good care available, self management driven, effective and tailored for as many people as possible.

Aim

The aims, goals and applications of our various eHealth innovations differ, but there are important similarities in their development.

All our innovations are:

  • developed in close cooperation with the patients, software engineers and our multidisciplinary team
  • tailored to their specific target groups (children, adolescents, adults, parents, elderly)
  • based on medical guidelines and clinical evidence
  • tested by patients to improve user acceptance, usability and intention to use
  • studied (qualitative and quantitative) and in a RCT
  • adapted using the findings of the studies and made available to a larger group

By using this framework in the development of all of our eHealth solutions, we hope to achieve our aim: making good care available, self management driven, effective and tailored for as many people as possible.

Self management

Self management is an important aspect in the treatment of patients with a chronic disease. Effective self management can improve patients' quality of life and help the patient to feel more in control. However, effective self management requires the patient to master a set of skills and certain knowledge about their disease, as well as self-efficacy.
 

Self management trainingprograms

We developed three self management trainingprograms:

Challenge your arthritis

About

ReumaUitgedaagd! is a self-management program for young adults (16-25 years old) and adults (26 years and older) with a rheumatic disease. The program is led by patients who are suffering from a rheumatic disease themselves and who are specially trained by Work21 and UMCUtrecht. Participants may follow the program in a weekend (young adults), in a six weeks program (adults) or online (young adults and adults). The aim of ReumaUitgedaagd! is to enhance patient’s self-management in coping with rheumatism in daily life. The online self management training is developed with a funding of the Dutch Arthritis Association Amsterdam.

Background

  • The self management program Reuma Uitgedaagd! for young people with a rheumatic disease is based on “the self-efficacy theory of Bandura and is based on the needs and preferences of the young adult. Together with young adults from the transition outpatient clinic of the University Medical Center Utrecht and the young patient organization Youth-R-well.com, is developed. 
  • The self management program Reuma Uitgedaagd! for adults with a rheumatic disease is based on “the self-determination theory of Ryan and Deci and is based on the needs and preferences of the adult.

More information

Program for young adults

The online program is a six-week digital group program led by two trainers, in which a maximum of six young patients take part.

The online program consists of six modules:

  • Are you a self-manager?
  • Communication
  • Feeling blue
  • Relations and intimacy
  • Sport and exercise
  • Having control over your live and arthritis

One module is worked through each week. Each module begins with a group chat session lasting an hour and a half, during which the group leader discusses the theme with the participants. The group members can share their experiences and do exercises together (for example, a quiz, watching a video, or reacting to propositions).

During the week the participants do exercises by themselves that are going to be discussed with the group during the next chat session. Participants can stay in touch with one another through a discussion board in order to ask questions, receive support and share experiences. The online program is held four times a year.

Program for adults

The online program consists of nine thematic modules (willing, knowing, skills, feeling, living together, influence, exercise, work and moving on), a chat application, a discussion board and a message box. Each module involves informative text and exercises. The participant performs the intervention individually and has 2 months to complete it. The training includes three chat sessions between the participant and the trainer. On the discussion board, participants can exchange experiences and questions.
 

Living with eczema

About

The online self management training is developed with a funding of the Dutch Arthritis Association Amsterdam.

The training is an addition to the medical treatment of a dermatologist or general practitioner. Patients are referred to the training by their dermatologist, general practitioner or dermatology nurse. The online training is currently offered by caregivers of different hospitals in the Netherlands.

The training was developed in cooperation with the Dutch patients' organization, VMCE. A feasibility study among patients, nurses, dermatologists and general practitioners showed that the training is useful and easy to use. The development of the training was funded by Stichting Voorzorg Utrecht, the Netherlands and the UMC Utrecht.

More information about the training living with eczema

Program

Both online trainings consist of information and instruction, videos and patient’s stories, exercises with feedback and e-consultation.

Topics are:

  • What is atopic dermatitis?
  • Medical treatment and use of topical steroids
  • Coping with AD in daily life
  • Coping with itch
  • Communication
     

Research and publications

  • Os-Medendorp, H. van, A.J.J. Vergouwe-Meijer, A.D.Michelsen, A.Knulst. (2011). Online training for chronically ill (in Dutch: Online training voor chronisch zieke). Medisch Contact, 66,13, p819-821.
  • Aly Vergouwe-Meijer & Harmieke van Os-Medendorp. 2011. Self management support by internet (in Dutch: Zelfmanagement ondersteunen via internet) DermaNovum, september 2011, p18-20. 
  • van Os-Medendorp H, van Veelen C, Hover M, Eland-de Kok P, Bruijnzeel-Koomen C, Sonnevelt GJ, Mensing G, Pasmans S. The digital eczema centre utrecht. J Telemed Telecare. 2010;16(1):12-4.
  • Harmieke van Os-Medendorp, Ilse van Leent-de Wit, Marjolein de Bruin-Weller, André Knulst Usage and users of online self-management programs for adult patients with atopic dermatitis and food allergy; an explorative study. 2015. JMIR Res Protoc (forthcoming). resprot.4134 

Living with food allergy

about

Living with food allergy is an online self management training for adults with a food allergy and for parents of children with a food allergy. The training is written in Dutch. 

The training aims to help patients to cope with a food allergy in daily life and consists of information and instruction, videos and patients' stories, exercises with feedback and e-consultation with a dietician.

The training is an addition to the medical treatment of a medical specialist or general practitioner and patients can be referred to the training by them or by a dietician.

More information about the training living with food allergy
 

Program

The trainings are tailored to the specific target group of adults patients or parents of children.

Topics in both trainings are:

  • What is a food allergy
  • Diet
  • Diagnostics
  • Cross reactivity
  • Allergic reaction and treatment
  • Living with a food allergy

APP

In 2016-2017, an allergy app will be developed  to support of patients or  caregivers in an emergency. Thereby, a step-wise approach to cope with allergic reactions will be used. The app will be patient-tailored, including personal information and emergency medication. Also general information about the most important causes e.g. food allergy or insect allergy will be given. The app will be developed in cooperation with Allergy patient’s organizations, the Dutch dermatologists’ association and the University Medical Centre Utrecht, the Netherlands and is funded by ‘Vrienden UMC Utrecht’ & Stichting Louise Vehmeijer’.

 

Research and publications

  • Os-Medendorp, H. van, A.J.J. Vergouwe-Meijer, A.D.Michelsen, A.Knulst. (2011). Online training for chronically ill (in Dutch: Online training voor chronisch zieke). Medisch Contact, 66,13, p819-821.
  • Aly Vergouwe-Meijer & Harmieke van Os-Medendorp. 2011. Self management support by internet (in Dutch: Zelfmanagement ondersteunen via internet) DermaNovum, september 2011, p18-20. 
  •  Harmieke van Os-Medendorp, Ilse van Leent-de Wit, Marjolein de Bruin-Weller, André Knulst Usage and users of online self-management programs for adult patients with atopic dermatitis and food allergy; an explorative study. 2015. JMIR Res Protoc May 23;4(2).

Informative websites

About

We develope informative websites in close cooperation with the patients. The information on the website is tailored to a specific target group.

Jong-en-reuma.nl

Jong-en-reuma.nl is an informative website for young adults with a rheumatic disease. The website consists information and videos where other youngsters tell about their disease and how they cope with their disease. The website fulfills demands of young adults for information and enhances knowledge and self-efficacy, which in turn improves self-management.

Website eczema

Information about eczema, symptoms and treatment is given on the website UMC Utrecht. Different kind of ointments are explained and questions are answered  about how to use ointments and how much is needed. The website also contains information about itching and scratching, with links to  patients’ leaflets.

Research and publications

  • Ammerlaan JW, Scholtus LW, Drossaert C, Os-Medendorp H, Prakken B, Kruize AA, Bijlsma JWJ. Feasibility of a website and a hospital based online portal for young adults with juvenile idiopathic arthritis: views and experiences of patients. JMIR Res Protoc 2015 (forthcoming) doi:10.2196/resprot.3952

Patient portals

Online access to the hospital

A patient portal offers the patient online access to the hospital. The portal gives the patient insight in his personal medical record and allows him to communicate online with the medical specialist or nurse. A portal also offers  specific devices to monitor the disease.

It is important to tailor a portal to the needs of patients with a specific disease. We created portals for patients with atopic dermatitis and for (young) patients with juvenile and rheumatoid arthritis and investigated feasibility and effectiveness.

Publication

Patient portal UMC Utrecht

The patient portal is only accessible to patients from the University Medical Center Utrecht. Using the portal, patients have access to the following tools:

  • eConsult, in which patients have the opportunity to ask questions to the clinical nurse specialist
  • their medical record, including written reports of the multidisciplinary team
  • their laboratory results
  • their own medication and
  • their appointments in the out-patient clinic

> Dutch information about patient portal UMC Utrecht
 

E-learning

Courses for nurses

Atopic dermatis

We developed an e-learning course for nurses, who care for patients with atopic dermatitis or itch. The course was developed during an implementation project of the nursing programme 'Coping with itch', funded by ZonMW.

The course is written by Harmieke van Os-Medendorp and Petra Eland-de Kok and is offered by e-nursing. More information about the course is available on http://www.e-nursing.nl/leren/cursus/25 .

 

The course

Food Allergy

Since 2014, an e-learning for nurses is available about Food Allergy. The course contains the following topics: what is food allergy,: diagnostics, medical treatment of allergic reactions, dietary management and coping with food allergy in daily life.
The course is written by Astrid Versluis, Jette de Groot and Harmieke van Os-Medendorp. More information: http://www.e-nursing.nl/leren/cursus/202.

Both courses contain written information, videos and exercises. After each chapter follows an online exam and the course is completed by a final test online.

Contact

Judy Ammerlaan

Petra Eland-de Kok


 

Harmieke van Os-Medendorp