Key challenges in the development and implementation of telehealth projects

Joseph, Victor; West, Robert; Shickle, Darren; Keen, Justin; Clamp, Susan

doi:10.1258/jtt.2010.100315

Cited by 95 publications

(80 citation statements)

References 4 publications

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“…The impact of telehealth innovations on staff workload is also an important consideration; the amount of time needed has been underestimated ( Joseph et al, 2011). Some staff perceived telehealth as burden due to the accompanying extra work and responsibility (Brewster et al, 2013, p. 28).…”

Section: Discussionmentioning

confidence: 99%

“…additional, bolt on innovations rather than being core services) (Taylor et al, 2015;Vuononvirta et al, 2011;Wade et al, 2010);  inappropriate selection of patients (Taylor et al, 2015); and  lack of staff acceptance (Brewster et al, 2013;Buck, 2009;Joseph et al, 2011;Odeh et al, 2014;Segar et al, 2013;Taylor et al, 2015;Vuononvirta et al, 2009;Vuononvirta et al, 2011;Wade et al, 2010).…”

Section: Introductionmentioning

confidence: 99%

“…A lack of acceptance amongst staff is seen as a major barrier to the adoption of telehealth solutions; attitudes can range from resistance to enthusiasm which results in contrasting theories about the motives for and impacts of telehealth ( Joseph et al, 2011;Taylor et al, 2015;Vuononvirta et al, 2009). …”

Section: Introductionmentioning

confidence: 99%

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“Teleswallowing”: a case study of remote swallowing assessment

Bidmead

Reid

Marshall

et al. 2015

Clinical Governance: An International Journal

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Purpose -Telemedicine has enabled speech and language therapists (SLTs) to remotely assess swallowing difficulties (dysphagia) experienced by nursing home residents. The new technique, "teleswallowing", was designed by the Speech and Language Therapy Service at Blackpool Teaching Hospitals NHS Foundation Trust. It allows prompt assessment, avoiding potential risks of aspiration pneumonia, malnutrition, poor rehabilitation, increased hospital stays and reduced quality of life (Hinchey et al., 2005;Langmore et al., 1998). The purpose of this paper is to report on a second pilot of teleswallowing and the concomitant adoption study. Design/methodology/approach -The adoption study employed qualitative methods, including consultations with senior managers, semi-structured interviews with nursing home matrons/managers and nurses, two focus groups and semi-structured interviews with SLTs. The project clinical lead kept an activity log, which was used to estimate resource savings. Findings -Over a three-month period, six SLTs and 17 patients in five nursing homes participated in teleswallowing assessments. Teleswallowing benefited both patients and participating nursing homes. Better use of therapist time and cost savings were demonstrated and evidence showed that the service could be successfully scaled up. Despite this, a number of barriers to service transformation were identified. Originality/value -This is the first implementation of teleswallowing in the UK, but it has been used in Australia (Ward et al., 2012). The approach to engaging stakeholders to understand and address barriers to adoption is novel. The value lies in the lessons learned for future innovations.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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“Teleswallowing”: a case study of remote swallowing assessment

Bidmead

Reid

Marshall

et al. 2015

Clinical Governance: An International Journal

View full text Add to dashboard Cite

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“…This point was reiterated by many interviewees who articulated clear benefits to using telehealth as a remote means to support their patients. However, as was noted by others (Joseph et al, 2011), (Finch et al, 2007) clinicians were cognisant of pressures such as 'time targets' or financial constraints and reviewed telehealth within this context.…”

Section: Discussionmentioning

confidence: 99%

Staff perceptions of Telehealth Adoption: Lessons learned from Care at Home pilot in Scotland

Levy

2016

Electronic Workshops in Computing

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Telehealth technologies harbour the premise of transforming care practices and delivering person centred care closer to home. The care at home project was set to explore remote support and care for children with palliative and complex care needs. Aim: To articulate clinicians' perspectives on and experiences of embedding telehealth to professional practice in different settings. Design: Descriptive qualitative evaluation using focus groups and semi structured interviews. Setting/participants: The study was conducted in four locations across Scotland and included staff from the National Health Service and a Third Sector organisation. Participants were mainly clinicians involved in the delivery of specialist paediatric palliative care and continence specialists. Results: Significant differences were found between the way telehealth was explored and used within the public and voluntary sectors. Clinicians see clear benefits in and potential risks of telehealth to their patients and own practice. Conclusion: A strong strategic steer towards a culture of innovation is needed to support effective use of telehealth. Senior managers in the NHS should facilitate and support staff and 'unleash' the good will of professionals who are eager to exploit innovation in clinical practice.

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“…However there is currently limited knowledge about the influences and determinants of home telehealth compliance in frail elderly people and their carers [22]. Their ability to adhere to a strict regime of tele-monitoring has been identified as an important influence on the success of telemonitoring programs [23] and there is a perception that patients will not adhere to a monitoring protocol and will often abandon the program [24,25].…”

Section: Introductionmentioning

confidence: 99%

Patient Adherence to Scheduled Vital Sign Measurements During Home Telemonitoring: Analysis of the Intervention Arm in a Before and After Trial (Preprint)

Celler¹,

Argha²,

Varnfield³

et al. 2017

Preprint

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Background This paper presents findings on patient compliance with scheduled vital signs measurements in the recently completed Commonwealth Scientific and Industrial Research Organization (CSIRO) national trial of home telemonitoring of patients with chronic conditions, carried out at five locations along the east coast of Australia. ObjectivesTo investigate the ability of chronically ill patients to carry out a daily schedule of vital signs measurements as part of a chronic disease management care plan, over prolonged periods exceeding six months, and to explore different levels of compliance for different measurements, as a function of age, gender and supervisory models. MethodsPatients were required to monitor on a daily basis a range of vital signs determined by their chronic condition and co-morbidities. Vital signs included non-invasive blood pressure, pulse oximetry, spirometry, ECG, blood glucose level, body temperature and body weight.Compliance was calculated as the number days during which at least one measurement was taken over all days where measurements were scheduled. ResultsPatients were monitored on average for 302 days although some continued beyond 12 months. The overall compliance rate for all measurements was 64.8%. The compliance rates of patients monitored in hospital settings relative to those monitored in community settings were significantly higher for spirometry (69.3 versus 41.0%, p<0.001), body weight (64.5 versus 40.5%, p=<0.001) and body temperature (66.8 versus 55.2%, p=0.026), and the compliance rates for blood pressure (68.5 versus 59.7%, p=0.042), ECG (65.6 versus 56.5%, p=0.047) and pulse oximetry (67.0 versus 56.4%, p=0.018) were significantly higher in male relative to female subjects. Compliance with blood glucose measurements (58.1 versus 50.2%, p=0.237) was not significantly different overall. No statistical differences were observed between rates of compliance for younger patients group (≤70 years old) and older patient group (>70 yo). ConclusionsPatients with chronic conditions were able to record their vital signs at home at least once every two days over prolonged periods of time. Surprisingly, male patients maintained a higher compliance than female patients over time, and patients supervised by hospital based care coordinators reported higher levels of compliance with their measurement schedule relative to patients supervised in community settings. This was most noticeable for spirometry.

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Key challenges in the development and implementation of telehealth projects

Cited by 95 publications

References 4 publications

“Teleswallowing”: a case study of remote swallowing assessment

“Teleswallowing”: a case study of remote swallowing assessment

Staff perceptions of Telehealth Adoption: Lessons learned from Care at Home pilot in Scotland

Patient Adherence to Scheduled Vital Sign Measurements During Home Telemonitoring: Analysis of the Intervention Arm in a Before and After Trial (Preprint)

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