Operational Implementation of Remote Patient Monitoring Within a Large Ambulatory Health System: Multimethod Qualitative Case Study
BackgroundRemote 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...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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JMIR Publications
2023-07-01
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| Series: | JMIR Human Factors |
| Online Access: | https://humanfactors.jmir.org/2023/1/e45166 |
| _version_ | 1797733996948357120 |
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| author | Katharine Lawrence Nina Singh Zoe Jonassen Lisa L Groom Veronica Alfaro Arias Soumik Mandal Antoinette Schoenthaler Devin Mann Oded Nov Graham Dove |
| author_facet | Katharine Lawrence Nina Singh Zoe Jonassen Lisa L Groom Veronica Alfaro Arias Soumik Mandal Antoinette Schoenthaler Devin Mann Oded Nov Graham Dove |
| author_sort | Katharine Lawrence |
| collection | DOAJ |
| description |
BackgroundRemote 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.
ObjectiveIn 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.
MethodsUsing 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.
ResultsWe 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.
ConclusionsThis 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. |
| first_indexed | 2024-03-12T12:36:43Z |
| format | Article |
| id | doaj.art-e365c5863a2a436699d051e7c01b9c1b |
| institution | Directory Open Access Journal |
| issn | 2292-9495 |
| language | English |
| last_indexed | 2024-03-12T12:36:43Z |
| publishDate | 2023-07-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | JMIR Human Factors |
| spelling | doaj.art-e365c5863a2a436699d051e7c01b9c1b2023-08-29T00:08:16ZengJMIR PublicationsJMIR Human Factors2292-94952023-07-0110e4516610.2196/45166Operational Implementation of Remote Patient Monitoring Within a Large Ambulatory Health System: Multimethod Qualitative Case StudyKatharine Lawrencehttps://orcid.org/0000-0001-5640-2138Nina Singhhttps://orcid.org/0000-0002-4623-2451Zoe Jonassenhttps://orcid.org/0000-0002-3780-3267Lisa L Groomhttps://orcid.org/0000-0002-7075-0216Veronica Alfaro Ariashttps://orcid.org/0009-0003-7825-2152Soumik Mandalhttps://orcid.org/0000-0003-3602-703XAntoinette Schoenthalerhttps://orcid.org/0000-0003-4905-5136Devin Mannhttps://orcid.org/0000-0002-2099-0852Oded Novhttps://orcid.org/0000-0001-6410-2995Graham Dovehttps://orcid.org/0000-0002-3551-0209 BackgroundRemote 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. ObjectiveIn 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. MethodsUsing 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. ResultsWe 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. ConclusionsThis 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.https://humanfactors.jmir.org/2023/1/e45166 |
| spellingShingle | Katharine Lawrence Nina Singh Zoe Jonassen Lisa L Groom Veronica Alfaro Arias Soumik Mandal Antoinette Schoenthaler Devin Mann Oded Nov Graham Dove Operational Implementation of Remote Patient Monitoring Within a Large Ambulatory Health System: Multimethod Qualitative Case Study JMIR Human Factors |
| title | Operational Implementation of Remote Patient Monitoring Within a Large Ambulatory Health System: Multimethod Qualitative Case Study |
| title_full | Operational Implementation of Remote Patient Monitoring Within a Large Ambulatory Health System: Multimethod Qualitative Case Study |
| title_fullStr | Operational Implementation of Remote Patient Monitoring Within a Large Ambulatory Health System: Multimethod Qualitative Case Study |
| title_full_unstemmed | Operational Implementation of Remote Patient Monitoring Within a Large Ambulatory Health System: Multimethod Qualitative Case Study |
| title_short | Operational Implementation of Remote Patient Monitoring Within a Large Ambulatory Health System: Multimethod Qualitative Case Study |
| title_sort | operational implementation of remote patient monitoring within a large ambulatory health system multimethod qualitative case study |
| url | https://humanfactors.jmir.org/2023/1/e45166 |
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