Operational Implementation of Remote Patient Monitoring Within a Large Ambulatory Health System: Multimethod Qualitative Case Study.

Autor:	Lawrence K; Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States.; Medical Center Information Technology, NYU Langone Health, New York, NY, United States., Singh N; Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States., Jonassen Z; Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States., Groom LL; Rory Meyers College of Nursing, New York University, New York, NY, United States., Alfaro Arias V; Medical Center Information Technology, NYU Langone Health, New York, NY, United States., Mandal S; Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States., Schoenthaler A; Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States., Mann D; Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States.; Medical Center Information Technology, NYU Langone Health, New York, NY, United States., Nov O; Tandon School of Engineering, New York University, New York, NY, United States., Dove G; Tandon School of Engineering, New York University, New York, NY, United States.
Jazyk:	angličtina
Zdroj:	JMIR human factors [JMIR Hum Factors] 2023 Jul 27; Vol. 10, pp. e45166. Date of Electronic Publication: 2023 Jul 27.
DOI:	10.2196/45166
Abstrakt:	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. (©Katharine Lawrence, Nina Singh, Zoe Jonassen, Lisa L Groom, Veronica Alfaro Arias, Soumik Mandal, Antoinette Schoenthaler, Devin Mann, Oded Nov, Graham Dove. Originally published in JMIR Human Factors (https://humanfactors.jmir.org), 27.07.2023.)
Databáze:	MEDLINE
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