Chain of Trust Patients' Focus group on telehealth

The focus group will involve up to 10 participants. To ensure a right balance the selection of particpnats will be made according to selection criteria such as gender, age, country of residence, desease, use or not use of telehealth services.

All information provided will be treated as strictly confidential.

Please answer carefully to the following questions:

  
PERSONNAL DETAILS 
  
First name *
Family name *
Address *
Telephone *
Mobile
E-mail *
  
  
SELECTION CRITERIA 
  
Country of residence *
City *
Sex *
Age *
I have a good working knowledge of English enabling me to actively engage in discussions with other particpants *
Do you have any long term chronic condition? *
If yes, please specify (only if you wish):
  
  
Telehealth refers to the provision of health care across a distance, using telecommunications technology, and specially adapted equipment. 
Telehealth services allow healthcare professionals to diagnose, treat, assess and monitor patients without requiring both individuals to be physically in the same location. 
Examples of telehealth services are: 
• Video conferencing, which is used for real-time patient-provider consultations, provider-to-provider discussions, and language translation services. 
• Patient monitoring and self-management tools, in which electronic devices transmit patient health information to health care providers. 
• Health promotion and educational health support through ICT 
• Use of video conference technology by pharmacists to provide pharmacy services to remote locations, including dispensing prescription medication and counseling as well as supervising remote pharmacy operations. 
  
How familiar are you with telehealth service? *
Have you ever received health services with the support of telehealth? *
If yes, what type of telehealth service have you used?
For how long have you received health service(s) with the support of telehealth? *
  
Please motivate in a few sentences the main reason(s) why you are interested in participating actively in this focus group: *
  
Please click on the "send my registration" button below. You should then receive a thank you message. 
If this is not the case and you can still see the registration form on your screen that means that some mandotary fields are not filled. Please check and fill the mandatory fields marked by a star *. 
Should you encounter any problems, please contact project manager at walter.atzori@eu-patient.eu 
Your registration will be reviewed and confirmed by EPF by Friday 18 November.