Establishingethical guidelines for telehomecareresearch on chronic diseases

Telehomecare technologies are applications designed to be used in patients' personal living spaces ranging from private homes to assisted-living facilities. The goal of these technologies is to help physically and/or mentally vulnerable people live more safely, more capably, and longer in their location of choice. The technologies support a person's ability to conduct normal activities of daily living and maintain well-being. This is usually accomplished by integrating the technologies into the home environment, thereby creating a homecare that proactively monitors and reports undesirable events. The technologies focus on disease management and the monitoring of physiologic data for aberrant indicators necessitating clinical treatment. Such technologies have been developed for a wide range of clinical applications to manage mostly chronic diseases (CD), such as monitoring of asthma (eg, a home asthma tele-monitoring system, which assists patients in the daily routine of asthma care with personalized interventions), diabetes (eg, a diabetes care management support system to support care delivery to diabetic patients), and coronary heart disease and sleep apnea (eg, a tele-device which monitors throughout the nights as patient sleeps, and sends information to a diagnostic testing facility, where a report is run and delivered to patient's physician.) Most previous research on telehomecare technology has focused on the effectiveness of the devices, and very little of it specifically addresses the ethical issues in research. This paper employs an ethical perspective, and offers guidelines to apply an ethical model to telehomecare research.