군 스마트 헬스 케어 시스템을 이용한 원격 건강관리 효과 = Efficacy of Remote health Care using Military Smart Health Care System

다국어 초록 (Multilingual Abstract)

Objectives: Medical Emergency Operation Center(MEOC) of Armed Forces Medical Command started a remote healthcare service using tele-medical system in 2015 and a total of 2807 personnel have been taking advantage of the service. However, limited data is available on the efficacy of remote healthcare service. Thus, we recruited a small number of volunteer who are able to be managed intensively by 4 consultants of MEOC using tele-medical healthcare system and tried to find out the efficacy of remote healthcare using military tele-medical healthcare system.
Methods: Out of the 2807 personnel, the applicants were asked again to seek the remote intensive healthcare, we recruited 109 volunteers from 7 different troops. We excluded 28 personnel who showed normal range of value in all four categories of obesity, blood pressure, blood sugar, and cholesterol, so we initially enrolled 81 personnel who had any abnormal values among those categories. We took care of 81 personnel intensively for 3 months from June 2016, but only 69 personnel finished the race since 13 applicants gave up halfway for private reasons. We developed new interventional operations of daily diet and exercise for prevention of metabolic syndrome, and made them check it weekly on health care diary after their doing it. We also provided a variety of information about health, metabolic synarome, and such a way of slimming down, diet, workout etc via daily group chat posting in online social media for the applicants to recognize our interventions were scientific evidence-based operations, and for not letting their daily attention to healthcare wander off. We estimated the efficacy of remote healthcare as improved” , “sustained” , or “deteriorated” by comparing the values between the initial estimation and the final one which measured at least a month later from initial records. The improved” result was a primary end-point in this study. We also carried out survey of satisfaction degree for both tele-medical hardware system itself and intensive remote healthcare service which provided by 4 consultants of MEOC.
Results: For 3 months of intervention, the 69 personnel's performance rate of daily healthcare diary was 49%, and positive answer rate to the question that if lifestyle had been modified or not was overall 90%. We provided a total of 357 councils and interventions to the 57 obese people, and except 10 applicants who gave up halfway, 27 among 47 (57.4%) applicants showed improved results. 47 people of high blood pressure had gotten a total of 305 councils and interventions from MEOC,
and except 3 people who quit the race, 21 out of 44 (47.7%) people reached the improved states. MEOC provided a total of 180 councils and interventions to the 28 people who had abnormal blood sugar level, and improved blood sugar level was shown in 9 (32.1%) personnel. 25 dyslipidemia people had received a total of 161 councils and intervention, and 4 (16%) applicants showed improved blood cholesterol level. 52 out of 69 applicants answered the question of the survey and it revealed 98% of respondent felt good about the overall intensive tele-medical healthcare service of MEOC.
Conclusions: Intensive tele-medical healthcare service provided by special consultants of MEOC might be effective in military society. Personal healthcare using tele-medical healthcare system and self-care contents itself might not be good enough to reach the desired goal of individual. To experience improvement of healthcare indicators and satisfaction of attendants, special manager might intervene the personal healthcare intensively using tele-medical healthcare system.