A qualitative case study of telehealth for in-home monitoring to support the management of type 2 diabetes

Abstract

The present study formed part of a randomised controlled trial of telehealth for in-home monitoring to support people with poorly controlled type 2 diabetes. We explored the experiences of patients and healthcare practitioners, and their perceptions of the telehealth model of care used in the trial. In addition to their usual diabetes care, participants receive diabetes care from a diabetes educator nurse via an in-home broadband communication device. On average, each patient participated in 14 videoconferences with a diabetes care coordinator during the 12-month trial period. Qualitative data was collected from two general practices and included semi-structured interviews and document review of patient clinical notes. A total of 12 people were interviewed: 8 health practitioners and 4 patients. Patients and health practitioners expressed a high level of satisfaction with the model of care provided. Patients also reported positive health and social outcomes as a result of being involved in the trial and indicated that in the main they had achieved their goals and were happy with their progress over the 12-month period. Analysis of interviews revealed three broad elements associated with the implementation of telehealth: interpersonal factors, operational problems and the wider health system context within which the general practices and trial team were operating. The findings suggest that adopting telehealth in the management of type 2 diabetes can lead to improved diabetes control, but more support is required to ensure sustainability and widespread implementation.

Factors Impacting Clinicians’ Adoption of a Clinical Photo Documentation App and its Implications for Clinical Workflows and Quality of Care: Qualitative Case Study

“…Usefulness was the most prominent technical factor relating to the app’s features. In alignment with previous research, perceived usefulness was closely related to time-saving and efficacy resulting from the usage of the app [ 2 , 47 , 48 , 86 ], its positive impact on the quality of patient care [ 66 , 72 , 87 , 88 ], and the potential benefit for research and scientific evidence because of better data availability [ 42 , 89 ]. Perceived ease of use is an equally important facilitator that has been widely reported in similar studies [ 2 , 90 - 93 ].…”

The Provider’s Experience of Delivering an Education-based Wellness Program via Telehealth

“…Despite the number of concerns providers report, there are factors that lead to provider satisfaction with telehealth. A good relationship with an information technology support team (Carlisle & Warren, 2013), familiarity with telehealth software through repeated use (Holland et al, 2014), previous experience with telehealth (Shulver et al, 2016), a younger age and more recent training (Sinclair et al, 2013), a video aspect to the telehealth technology (Collier et al, 2016), and a clear vision that telehealth will provide valuable services to clients (Carlisle & Warren, 2013; Collier et al, 2016; Levy & Neil, 2013; Shulver et al, 2016) are all factors associated with provider satisfaction with telehealth.…”

“…Providers who decide to participate in service delivery via telehealth often indicate this decision is based on client need (Carlisle & Warren, 2013; Levy & Neil, 2013). An Australian survey of healthcare providers found rural providers expressed a strong interest in telehealth regardless of their experience with technology, with a goal to provide better client outcomes (Shulver et al, 2016).…”

A Mobile Telehealth Intervention for Adults With Insulin-Requiring Diabetes: Early Results of a Mixed-Methods Randomized Controlled Trial

“…Recruiting MTH participants for interviews continued until data saturation occurred and no new themes emerged from the data on five successive interviews. Previous qualitative TH studies included fewer than 20 patient interviews [ 44 , 45 ], therefore, we expected to conduct between 10 and 25 interviews.…”