Scaling-up digital follow-up care services: collaborative development and implementation of Remote Patient Monitoring pilot initiatives to increase access to follow-up care
BackgroundCOVID-19 increased the demand for Remote Patient Monitoring (RPM) services as a rapid solution for safe patient follow-up in a lockdown context. Time and resource constraints resulted in unplanned scaled-up RPM pilot initiatives posing risks to the access and quality of care. Scalability a...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-12-01
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| Series: | Frontiers in Digital Health |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fdgth.2022.1006447/full |
| _version_ | 1811297700061118464 |
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| author | Salomé Azevedo Salomé Azevedo Salomé Azevedo Federico Guede-Fernández Federico Guede-Fernández Francisco von Hafe Francisco von Hafe Pedro Dias Pedro Dias Inês Lopes Nuno Cardoso Pedro Coelho Pedro Coelho Jorge Santos José Fragata José Fragata Clara Vital Helena Semedo Ana Gualdino Ana Londral Ana Londral |
| author_facet | Salomé Azevedo Salomé Azevedo Salomé Azevedo Federico Guede-Fernández Federico Guede-Fernández Francisco von Hafe Francisco von Hafe Pedro Dias Pedro Dias Inês Lopes Nuno Cardoso Pedro Coelho Pedro Coelho Jorge Santos José Fragata José Fragata Clara Vital Helena Semedo Ana Gualdino Ana Londral Ana Londral |
| author_sort | Salomé Azevedo |
| collection | DOAJ |
| description | BackgroundCOVID-19 increased the demand for Remote Patient Monitoring (RPM) services as a rapid solution for safe patient follow-up in a lockdown context. Time and resource constraints resulted in unplanned scaled-up RPM pilot initiatives posing risks to the access and quality of care. Scalability and rapid implementation of RPM services require social change and active collaboration between stakeholders. Therefore, a participatory action research (PAR) approach is needed to support the collaborative development of the technological component while simultaneously implementing and evaluating the RPM service through critical action-reflection cycles.ObjectiveThis study aims to demonstrate how PAR can be used to guide the scalability design of RPM pilot initiatives and the implementation of RPM-based follow-up services.MethodsUsing a case study strategy, we described the PAR team’s (nurses, physicians, developers, and researchers) activities within and across the four phases of the research process (problem definition, planning, action, and reflection). Team meetings were analyzed through content analysis and descriptive statistics. The PAR team selected ex-ante pilot initiatives to reflect upon features feedback and participatory level assessment. Pilot initiatives were investigated using semi-structured interviews transcribed and coded into themes following the principles of grounded theory and pilot meetings minutes and reports through content analysis. The PAR team used the MoSCoW prioritization method to define the set of features and descriptive statistics to reflect on the performance of the PAR approach.ResultsThe approach involved two action-reflection cycles. From the 15 features identified, the team classified 11 as must-haves in the scaled-up version. The participation was similar among researchers (52.9%), developers (47.5%), and physicians (46.7%), who focused on suggesting and planning actions. Nurses with the lowest participation (5.8%) focused on knowledge sharing and generation. The top three meeting outcomes were: improved research and development system (35.0%), socio-technical-economic constraints characterization (25.2%), and understanding of end-user technology utilization (22.0%).ConclusionThe scalability and implementation of RPM services must consider contextual factors, such as individuals’ and organizations’ interests and needs. The PAR approach supports simultaneously designing, developing, testing, and evaluating the RPM technological features, in a real-world context, with the participation of healthcare professionals, developers, and researchers. |
| first_indexed | 2024-04-13T06:09:00Z |
| format | Article |
| id | doaj.art-a20bc311dcd04190933ec1ae79ee06de |
| institution | Directory Open Access Journal |
| issn | 2673-253X |
| language | English |
| last_indexed | 2024-04-13T06:09:00Z |
| publishDate | 2022-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Digital Health |
| spelling | doaj.art-a20bc311dcd04190933ec1ae79ee06de2022-12-22T02:59:09ZengFrontiers Media S.A.Frontiers in Digital Health2673-253X2022-12-01410.3389/fdgth.2022.10064471006447Scaling-up digital follow-up care services: collaborative development and implementation of Remote Patient Monitoring pilot initiatives to increase access to follow-up careSalomé Azevedo0Salomé Azevedo1Salomé Azevedo2Federico Guede-Fernández3Federico Guede-Fernández4Francisco von Hafe5Francisco von Hafe6Pedro Dias7Pedro Dias8Inês Lopes9Nuno Cardoso10Pedro Coelho11Pedro Coelho12Jorge Santos13José Fragata14José Fragata15Clara Vital16Helena Semedo17Ana Gualdino18Ana Londral19Ana Londral20Value for Health CoLAB, Lisbon, PortugalComprehensive Health Research Center, Nova Medical School, Nova University of Lisbon, Lisbon, PortugalCEG-IST, Instituto Superior Técnico, University of Lisbon, Lisbon, PortugalValue for Health CoLAB, Lisbon, PortugalLIBPhys (Laboratory for Instrumentation, Biomedical Engineering and Radiation Physics), NOVA School of Science and Technology, Campus de Caparica, Caparica, PortugalValue for Health CoLAB, Lisbon, PortugalComprehensive Health Research Center, Nova Medical School, Nova University of Lisbon, Lisbon, PortugalValue for Health CoLAB, Lisbon, PortugalComprehensive Health Research Center, Nova Medical School, Nova University of Lisbon, Lisbon, PortugalFraunhofer Portugal AICOS, Porto, PortugalFraunhofer Portugal AICOS, Porto, PortugalComprehensive Health Research Center, Nova Medical School, Nova University of Lisbon, Lisbon, PortugalHospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central, Lisbon, PortugalHospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central, Lisbon, PortugalComprehensive Health Research Center, Nova Medical School, Nova University of Lisbon, Lisbon, PortugalHospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central, Lisbon, PortugalHospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central, Lisbon, PortugalHospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central, Lisbon, PortugalHospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central, Lisbon, PortugalValue for Health CoLAB, Lisbon, PortugalComprehensive Health Research Center, Nova Medical School, Nova University of Lisbon, Lisbon, PortugalBackgroundCOVID-19 increased the demand for Remote Patient Monitoring (RPM) services as a rapid solution for safe patient follow-up in a lockdown context. Time and resource constraints resulted in unplanned scaled-up RPM pilot initiatives posing risks to the access and quality of care. Scalability and rapid implementation of RPM services require social change and active collaboration between stakeholders. Therefore, a participatory action research (PAR) approach is needed to support the collaborative development of the technological component while simultaneously implementing and evaluating the RPM service through critical action-reflection cycles.ObjectiveThis study aims to demonstrate how PAR can be used to guide the scalability design of RPM pilot initiatives and the implementation of RPM-based follow-up services.MethodsUsing a case study strategy, we described the PAR team’s (nurses, physicians, developers, and researchers) activities within and across the four phases of the research process (problem definition, planning, action, and reflection). Team meetings were analyzed through content analysis and descriptive statistics. The PAR team selected ex-ante pilot initiatives to reflect upon features feedback and participatory level assessment. Pilot initiatives were investigated using semi-structured interviews transcribed and coded into themes following the principles of grounded theory and pilot meetings minutes and reports through content analysis. The PAR team used the MoSCoW prioritization method to define the set of features and descriptive statistics to reflect on the performance of the PAR approach.ResultsThe approach involved two action-reflection cycles. From the 15 features identified, the team classified 11 as must-haves in the scaled-up version. The participation was similar among researchers (52.9%), developers (47.5%), and physicians (46.7%), who focused on suggesting and planning actions. Nurses with the lowest participation (5.8%) focused on knowledge sharing and generation. The top three meeting outcomes were: improved research and development system (35.0%), socio-technical-economic constraints characterization (25.2%), and understanding of end-user technology utilization (22.0%).ConclusionThe scalability and implementation of RPM services must consider contextual factors, such as individuals’ and organizations’ interests and needs. The PAR approach supports simultaneously designing, developing, testing, and evaluating the RPM technological features, in a real-world context, with the participation of healthcare professionals, developers, and researchers.https://www.frontiersin.org/articles/10.3389/fdgth.2022.1006447/fullcollaborationfollow-up careimplementationparticipatory action researchremote patient monitoring |
| spellingShingle | Salomé Azevedo Salomé Azevedo Salomé Azevedo Federico Guede-Fernández Federico Guede-Fernández Francisco von Hafe Francisco von Hafe Pedro Dias Pedro Dias Inês Lopes Nuno Cardoso Pedro Coelho Pedro Coelho Jorge Santos José Fragata José Fragata Clara Vital Helena Semedo Ana Gualdino Ana Londral Ana Londral Scaling-up digital follow-up care services: collaborative development and implementation of Remote Patient Monitoring pilot initiatives to increase access to follow-up care Frontiers in Digital Health collaboration follow-up care implementation participatory action research remote patient monitoring |
| title | Scaling-up digital follow-up care services: collaborative development and implementation of Remote Patient Monitoring pilot initiatives to increase access to follow-up care |
| title_full | Scaling-up digital follow-up care services: collaborative development and implementation of Remote Patient Monitoring pilot initiatives to increase access to follow-up care |
| title_fullStr | Scaling-up digital follow-up care services: collaborative development and implementation of Remote Patient Monitoring pilot initiatives to increase access to follow-up care |
| title_full_unstemmed | Scaling-up digital follow-up care services: collaborative development and implementation of Remote Patient Monitoring pilot initiatives to increase access to follow-up care |
| title_short | Scaling-up digital follow-up care services: collaborative development and implementation of Remote Patient Monitoring pilot initiatives to increase access to follow-up care |
| title_sort | scaling up digital follow up care services collaborative development and implementation of remote patient monitoring pilot initiatives to increase access to follow up care |
| topic | collaboration follow-up care implementation participatory action research remote patient monitoring |
| url | https://www.frontiersin.org/articles/10.3389/fdgth.2022.1006447/full |
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