1. PUBLIC PERCEPTIONS OF TELEHOMECARE SYSTEM FOR THE ELDERLY Roziah Abdul Latiff, Khairiani Othman, Mohd Khanapi Abd Ghani and Nor Afirdaus Zainal Abidin Presenter : Khairiani Othman 17 February 2016 Jakarta, Indonesia

2. SCOPE OF PRESENTATION INTRODUCTIONPROBLEM STATEMENTRESEARCH OBJECTIVESLITERATURE REVIEWMETHODOLOGYFINDINGSCONCLUSION

3. INTRODUCTION In Malaysia, the Ministry of Health (MOH) is gradually converting its healthcare facilities from paper-based information to an electronic system. (Malaysia Health System Review, 2013).

4. INTRODUCTION Telehomecare system is a kind of telemedicine or telehealth technology which utilizes the information and communication technology in providing healthcare services at a distance (Abd. Ghani et al, 2008).

5. INTRODUCTION The patient is based at home and remotely supervised or monitored by nurses and doctors from the hospital and carried out using CCTV, bio- sensors, and the internet as a medium for communication and transmission of biological data

6. INTRODUCTION Telehomecare is expected: i.to improve the existing medical system towards efficiency of patient care, particularly chronic diseases such as diabetes, heart disease and high blood pressure. ii.reduce ward congestion, government costs, and patients cost. iii.provide adequate comfortability and improve family relationships.

7. PROBLEM STATEMENTS 1 The monitoring process for acute patients in the hospital sometimes takes days and weeks. ward congestion and bed occupancy rate (BOR) of more than 85%. (MOH statistics in 2012) 2 Comfort and conduciveness are very important aspects in treatment process. most patients are more comfortable receiving treatment in their homes compared to staying in a hospital ward. (Abd. Ghani et al., 2008) comfortable in the home, close to their family members, and easily accessible by the relatives. 3 cost of living is increasing (Malaysian Digest.com, 2015) other costs WERE HIGH such as taxi charges, petrol, toll, meals, and accommodation for family members caring for the patients in hospitals. to provide cost-effective care in long term.

8. PROBLEM STATEMENTS 4 Nurse shortage. ratio of nurses to population in Malaysia is 1.35:1000 (Country Health Plan, Ministry of Health, 2011). 5 dramatic increase in the number of elderly people. population aged 65 years and above has increased to 5.1% as compared to 3.9% in 2000 and expected to continue at a high rate (Akil et al., 2014). 6 Telehomecare is being adopted across many jurisdictions in the US still new in Malaysia (Ghani, 2013). Source : (Akil et al., 2014)

9. RESEARCH OBJECTIVES The objectives of this research is to explore Malaysian public perceptions of Telehomecare System for managing elderly with chronic diseases at home.

10. LITERATURE REVIEW The acceptance of a new technology depends on the consumer's perception of benefits and cost. Monroe and Krishman (1985) - consumer perceived value as the difference between the utility inferred from the perceptions of quality and utility.

11. LITERATURE REVIEW Holak and Lehmann,(1990) indicate that perceived product attributes includes compatibility and complexity. - compatibility :the degree to which an innovation is consistent with adopters behaviour pattern, life style and value. - complexity relates to the degree to which an innovation is perceived to be relatively difficult to understand and use.

12. LITERATURE REVIEW Chronic diseases lessen the quality of life of those suffering from the diseases and also of their caretakers’ especially family members and friends. It reduces economic productivity of the caretakers by contributing to increased absenteeism and poor at work performance (Ghani, 2013). In Malaysia, top 10 causes for hospitalization & top five leading causes of death is stroke (Loo & Gan, 2012).

13. LITERATURE REVIEW Home tele monitoring of chronic diseases appears to be a promising patient management approach that produces accurate and reliable data, empowers patients, influences their attitudes and behaviors, and potentially improves their medical conditions (Maric et al., 2009).

14. LITERATURE REVIEW Tele monitoring systems have become an important progressive approach in health care, which involves creative user-friendly technologies that empower patients and support monitoring of their health status from home. (Darkins, 2008).

15. METHODOLOGY General population for this study consisted of Polytechnic staff in Malaysia. Convenience sampling was used. 200 copies of the questionnaires were distributed and 134 successfully completed and returned

16. METHODOLOGY Part I : Demographic information, Part II : General information on patient’s medical condition Part III : Basic facilities of ICT used and respondent perception of telehomecare system for managing elderly with chronic diseases at home

17. METHODOLOGY Part III instrument was adapted from Technology Acceptance Model (TAM) (Davis, 1989) The reliability of the instrument for Part III : CRONBACH’S ALPHA was 0.783. Likert scale with a five-response scale used.

18. METHODOLOGY Source: Davis et. al. (1989), Venkatesh et. al. (2003)

19. FINDINGS : DEMOGRAPHIC PROFILE

23. FINDINGS : General Information on Patients Condition

27. FINDINGS : Public Perception of Telehomecare System

30. Perceived Usefulness Measurement Mean Score Telehomecare system would help me to monitor the elderly with chronic diseases at home from office. 3.56 Telehomecare system would improve my job performance. 3.59 Telehomecare system would improve my knowledge and skills managing the elderly with chronic diseases 3.45 Telehomecare system improves a patient’s quality of life. 3.84 Telehomecare system improves a caretaker’s quality of life. 3.90 Telehomecare system improves a patient’s health management. 3.78

31. FINDINGS : Public Perception of Telehomecare System Perceived Ease of Use Measurement : Mean Score Telehomecare system provides training for new users. (complexity) 3.74 Telehomecare system provides user friendly interface. (compatibility) 4.53

32. FINDINGS : Public Perception of Telehomecare System Respondent most concerned about telehomecare system Mean Score a. confidentiality 4.02 b. complexity (the device use)3.19 c. Cost3.22

33. DISCUSSION Only 16% of the respondents had heard of telehomecare services. However research found that most respondent expressed higher intention to use Telehomecare. Government and private hospital should promote private acceptance and use of Telehomecare services actively and continuously. Many elderly prefer to stay at home (Hamid & Aizan, 2015) so effort must be made to make Telehomecare system available in their homes and community. As to diminish anxiety and improve acceptance of telehomecare among public, government and private hospital should provide training programs for caretakers to use telehomecare with tailored training components.

34. DISCUSSION Internet as a medium for communication and transmission of biological data and ICT literacy among caretakers’ are no longer barrier since research found that most respondents (61%) have internet access at home and used internet daily (86%). As to diminish anxiety and improve acceptance of telehomecare among public, government and private hospital should provide training programs for caretakers to use telehomecare with tailored training components. Finding are limited to the sample taken in urban area.

35. CONCLUSION In this study, we found that public perceptions of usefulness and ease of use of Telehomecare is high and most of the public have intension to use if provided with the service but there is very low information and awareness about Telehomecare among public.

36. CONCLUSION In line with the increase of older population in Malaysia, the implementation of Telehomecare helps to better manage the elderly with chronic health conditions such as stroke, heart disease, diabetes and hypertension with fewer visits to the hospitals

37. CONCLUSION The next research suggestion was to discover the deficiencies found in current technology transfer practices and then develop framework for the commercialization process.

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