Enablers and obstacles to implementing remote monitoring technology in cardiac care: A report from an interactive workshop

Abstract

An ageing population and chronic disease are putting pressure on the Irish health system. The field of eHealth is rapidly evolving and has the potential to become an important component of healthcare, but there appears to be a gap currently between research in this field and the integration of eHealth technology into clinical practice. During the eHealth Ireland Ecosystem Conference held in April 2018, a workshop was conducted to explore the barriers and facilitators to the adoption of eHealth technology, particularly remote monitoring systems in community and home cardiac care. Participants included clinicians, academic researchers, technologists, patient advocates, policy makers, and representatives from the health service. The conversations in the workshop pivoted around why technology systems in cardiac care rarely moved beyond the research project stage and what can be done to address this issue. The discussions in the workshop focused around the lack of funding available, the need for reimbursement models, the lack of awareness about remote monitoring, the angst about who is responsible for the data generated, the design of systems, regulatory standards, and the increasing demand on services, education, and patient empowerment.

Enablers and barriers in upscaling telemonitoring across geographic boundaries: a scoping review

“…The general characteristics of the included studies are presented in table 2. Eleven out of 19 articles described a survey,21 22 25 28–30 33 34 36–38 four described focus group interviews,27 31 35 39 three articles were narrative reviews24 26 32 and one article described the results of a workshop 40. A total of 89 enabler or barrier factors were mentioned 202 times in 19 studies.…”

“…Another important barrier for the diffusion of telemonitoring is the lack of awareness of the possibilities and opportunities for providing care using remote monitoring among both healthcare management and clinical staff 40…”

“…Eleven studies reported on organisational items 21 24–28 32 35–37 40. Adoption of telemonitoring requires an infrastructural investment that will take several years to implement and will involve a complete overhaul of existing practice, clinically, financially and managerially 40. An elaborate programme of change management is described as an enabler in the upscaling and implementation of telemonitoring 24 40.…”

“…Adoption of telemonitoring requires an infrastructural investment that will take several years to implement and will involve a complete overhaul of existing practice, clinically, financially and managerially 40. An elaborate programme of change management is described as an enabler in the upscaling and implementation of telemonitoring 24 40. Change management is described as continuous evaluation and assessment in the refining of patient selection criteria for remote monitoring and personalising care pathways 24…”

“…Security and privacy aspects influence implementation 21 24 28 32 37. Setting up appropriate vendor agreements and protocols is described as an enabler concerning responsibility for incoming data 21 24 28 35 36 40…”