Review of current telemedicine applications for chronic diseases. Toward a more integrated system?

The current trend in aging population will likely result in a future increase of chronic diseases occurrences as well as a future increase of chronic diseases comorbidities. In this context, telemedicine can improve the management of these diseases by using information and communication technologies. The advantages cover more regular follow-ups and fewer unnecessary travels. To guarantee quality in the patient's care, a typical telemedicine application combines three systems: the patient system for the medical monitoring, the data transmission system between the two structures (e.g., the patient's home and a healthcare facility) and the data processing and archiving system, which is generally located in the hospital. In this contribution, we focus on four main chronic diseases, i.e. cardiovascular diseases, diabetes, respiratory diseases and kidney diseases. We surveyed the main current telemedicine applications for these diseases. The analysis revealed that the applications shared some common functionalities for each of three systems. It also revealed that each application relied on its own implementation of these common functionalities. This situation creates two intrinsic limitations for the use of telemedicine applications in a context of comorbidities. The first limitation is the unnecessary duplication of portions of the implementation. The second limitation is that information produced when monitoring one disease cannot be systematically reused for another one. The implementation of a common data transmission system and a single integrated data processing and archiving platform would provide a unified environment for covering several chronic diseases and their comorbidities. (C) 2015 Elsevier Masson SAS. All rights reserved.