Bridging two translation gaps: A new informatics research agenda for telemonitoring of chronic disease

A Systematic Review of Clinician and Staff Views on the Acceptability of Incorporating Remote Monitoring Technology into Primary Care

“…1). 11,[13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] Six studies provided perspectives from primary care…”

“…16,[19][20][21][22][23] Four studies published in five reports provided perspectives from clinical specialties including but not limited to primary care. 11,17,[25][26][27] Seven studies reported perspectives from primary care staff, administrators, or unspecified healthcare professionals. Table 1 summarizes key details of the included studies, describing the target patients, RMT used, mode of data transfer and processing, informant characteristics, and methods used to gather perspectives.…”

“…11,16,17,[19][20][21][22][23][25][26][27] Three studies were conducted in the United States, 11,16,19 one in Canada, 21 one in Denmark, 20 two in Germany, 22,23 and one in Korea, 25 and two studies in the United Kingdom were published in three reports. 17,26,27 Clinicians in several studies conveyed positive views about RMT, and some reported RMT resulted in a decrease in workload due to delegation of activities to ancillary staff. Emerging themes included concerns about the potential for lower quality of care due to fewer face-to-face patient visits, increased provider burden and insufficient staffing for monitoring and responding to data, inconvenience resulting from poor…”

“…Participants included individuals from a range of healthcare services (e.g., nursing, medicine, mental health), academic (e.g., medicine, informatics) and nonacademic settings (e.g., policy-making, medical technology development). 11,17,[25][26][27] These informants conveyed concerns about collecting excessive data without clinical relevance and that monitoring for ongoing care (e.g., an alert to caregivers or family members for a onetime missed dose of medication) should be differentiated from monitoring for clinical practice (e.g., an alert for a pattern of multiple missed doses of medications). 11,17,27 Some informants expressed concern that RMTs could lead to fewer patients visit and reduce quality of care 25 or worsen the isolation, loneliness, and morale of elderly patients.…”

“…17,25,27 Informants suggested protocols with response hierarchies related to RMT alert severity should be developed. 17,27 In one study, however, the interpretation of a threshold trigger varied with the context of the individual patient, and clinicians raised concerns about the risks of overtreatment and adverse effects from increased prescribing. 26 Challenges associated with implementing RMTs that are not integrated with EHR systems, as well as insufficient resources for …”