TY - JOUR
T1 - Operational Implementation of Remote Patient Monitoring Within a Large Ambulatory Health System
T2 - Multimethod Qualitative Case Study
AU - Lawrence, Katharine
AU - Singh, Nina
AU - Jonassen, Zoe
AU - Groom, Lisa L.
AU - Arias, Veronica Alfaro
AU - Mandal, Soumik
AU - Schoenthaler, Antoinette
AU - Mann, Devin
AU - Nov, Oded
AU - Dove, Graham
N1 - Funding Information:
This work is supported by the US National Science Foundation (grants 1928614 and 2129076) and the Swiss National Science Foundation (grant P500PS_202955).
Publisher Copyright:
© Katharine Lawrence, Nina Singh, Zoe Jonassen, Lisa L Groom, Veronica Alfaro Arias, Soumik Mandal, Antoinette Schoenthaler, Devin Mann, Oded Nov, Graham Dove.
PY - 2023
Y1 - 2023
N2 - Background: Remote patient monitoring (RPM) technologies can support patients living with chronic conditions through self-monitoring of physiological measures and enhance clinicians’ diagnostic and treatment decisions. However, to date, large-scale pragmatic RPM implementation within health systems has been limited, and understanding of the impacts of RPM technologies on clinical workflows and care experience is lacking. Objective: In this study, we evaluate the early implementation of operational RPM initiatives for chronic disease management within the ambulatory network of an academic medical center in New York City, focusing on the experiences of “early adopter” clinicians and patients. Methods: Using a multimethod qualitative approach, we conducted (1) interviews with 13 clinicians across 9 specialties considered as early adopters and supporters of RPM and (2) speculative design sessions exploring the future of RPM in clinical care with 21 patients and patient representatives, to better understand experiences, preferences, and expectations of pragmatic RPM use for health care delivery. Results: We identified themes relevant to RPM implementation within the following areas: (1) data collection and practices, including impacts of taking real-world measures and issues of data sharing, security, and privacy; (2) proactive and preventive care, including proactive and preventive monitoring, and proactive interventions and support; and (3) health disparities and equity, including tailored and flexible care and implicit bias. We also identified evidence for mitigation and support to address challenges in each of these areas. Conclusions: This study highlights the unique contexts, perceptions, and challenges regarding the deployment of RPM in clinical practice, including its potential implications for clinical workflows and work experiences. Based on these findings, we offer implementation and design recommendations for health systems interested in deploying RPM-enabled health care.
AB - Background: Remote patient monitoring (RPM) technologies can support patients living with chronic conditions through self-monitoring of physiological measures and enhance clinicians’ diagnostic and treatment decisions. However, to date, large-scale pragmatic RPM implementation within health systems has been limited, and understanding of the impacts of RPM technologies on clinical workflows and care experience is lacking. Objective: In this study, we evaluate the early implementation of operational RPM initiatives for chronic disease management within the ambulatory network of an academic medical center in New York City, focusing on the experiences of “early adopter” clinicians and patients. Methods: Using a multimethod qualitative approach, we conducted (1) interviews with 13 clinicians across 9 specialties considered as early adopters and supporters of RPM and (2) speculative design sessions exploring the future of RPM in clinical care with 21 patients and patient representatives, to better understand experiences, preferences, and expectations of pragmatic RPM use for health care delivery. Results: We identified themes relevant to RPM implementation within the following areas: (1) data collection and practices, including impacts of taking real-world measures and issues of data sharing, security, and privacy; (2) proactive and preventive care, including proactive and preventive monitoring, and proactive interventions and support; and (3) health disparities and equity, including tailored and flexible care and implicit bias. We also identified evidence for mitigation and support to address challenges in each of these areas. Conclusions: This study highlights the unique contexts, perceptions, and challenges regarding the deployment of RPM in clinical practice, including its potential implications for clinical workflows and work experiences. Based on these findings, we offer implementation and design recommendations for health systems interested in deploying RPM-enabled health care.
KW - RPM
KW - digital health
KW - human-centered design
KW - human-computer interaction
KW - implementation science
KW - remote patient monitoring
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U2 - 10.2196/45166
DO - 10.2196/45166
M3 - Article
AN - SCOPUS:85167504576
SN - 2292-9495
VL - 10
JO - JMIR Human Factors
JF - JMIR Human Factors
M1 - e45166
ER -