Nurse perspectives on the implementation of routine telemonitoring for high-risk diabetes patients in a primary care setting

Vest, Bonnie M.; Hall, Victoria M.; Kahn, Linda S.; Heider, Arvela R.; Maloney, Nancy; Singh, Ranjit

doi:10.1017/s1463423616000190

Cited by 21 publications

(24 citation statements)

References 27 publications

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“…The nurses also believed that the TM system provided a greater awareness of their patients’ health status, information to help decide on when a visit to the patient’s home was necessary, and trending information that they could discuss with the patients. These results are in alignment with what other researchers have identified when using TM for patients with diabetes [36]. For half of the home visits, the nurses thought that by using the TM system, telephone calls could have replaced physical home visits, which could lead to potential financial savings.…”

Section: Discussionsupporting

confidence: 86%

Implementation of a Heart Failure Telemonitoring System in Home Care Nursing: Feasibility Study

et al. 2019

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Background Telemonitoring (TM) of heart failure (HF) patients in a clinic setting has been shown to be effective if properly implemented, but little is known about the feasibility and impact of implementing TM through a home care nursing agency. Objective This study aimed to determine the feasibility of implementing a mobile phone–based TM system through a home care nursing agency and to explore the feasibility of conducting a future effectiveness trial. Methods A feasibility study was conducted by recruiting, through community cardiologists and family physicians, 10 to 15 HF patients who would use the TM system for 4 months by taking daily measurements of weight and blood pressure and recording symptoms. Home care nurses responded to alerts generated by the TM system through either a phone call and/or a home visit. Patients and their clinicians were interviewed poststudy to determine their perceptions and experiences of using the TM system. Results Only one community cardiologist was recruited who was willing to refer patients to this study, even after multiple attempts were made to recruit further physicians, including family physicians. The cardiologist referred only 6 patients over a 6-month period, and half of the patients dropped out of the study. The identified barriers to implementing the TM system in home care nursing were numerous and led to the small recruitment in patients and clinicians and large dropout rate. These barriers included challenges in nurses contacting patients and physicians, issues related to retention, and challenges related to integrating the TM system into a complex home care nursing workflow. However, some potential benefits of TM through a home care nursing agency were indicated, including improved patient education, providing nurses with a better understanding of the patient’s health status, and reductions in home visits. Conclusions Lessons learned included the need to incentivize physicians, to ensure streamlined processes for recruitment and communication, to target appropriate patient populations, and to create a core clinical group. Barriers encountered in this feasibility trial should be considered to determine their applicability when deploying innovations into different service delivery models.

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Section: Discussionsupporting

confidence: 86%

Implementation of a Heart Failure Telemonitoring System in Home Care Nursing: Feasibility Study

et al. 2019

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“… 11 For example, local ecological cascade has been used in addressing programs among hard to reach men who have sex with men in resistant communities. 14 Based on the PCE ecological model, community interventions have been found associated with greater awareness and healthier behavioral outcomes. 15…”

Section: Resultsmentioning

confidence: 99%

Impact of telemonitoring approaches on integrated HIV and TB diagnosis and treatment interventions in sub-Saharan Africa: a scoping review

Yah

Tambo²,

Khayeka–Wandabwa³

et al. 2017

Health Promot Perspect

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Background: This paper explores telemonitoring/mhealth approaches as a promising real time and contextual strategy in overhauling HIV and TB interventions quality access and uptake, retention,adherence and coverage impact in endemic and prone-epidemic prevention and control in sub-Sahara Africa. Methods: The scoping review method was applied in acknowledged journals indexing platforms including Medline, Embase, Global Health, PubMed, MeSH PsycInfo, Scopus and Google Scholar to identify relevant articles pertaining to telemonitoring as a proxy surrogate method in reinforcing sustainability of HIV/TB prevention/treatment interventions in sub-Saharan Africa. Full papers were assessed and those selected that fosters evidence on telemonitoring/mhealth diagnosis, treatment approaches and strategies in HIV and TB prevention and control were synthesized and analyzed. Results: We found telemonitoring/mhealth approach as a more efficient and sustained proxy in HIV and TB risk reduction strategies for early diagnosis and prompt quality clinical outcomes. It can significantly contribute to decreasing health systems/patients cost, long waiting time in clinics, hospital visits, travels and time off/on from work. Improved integrated HIV and TB telemonitoring systems sustainability hold great promise in health systems strengthening including patient centered early diagnosis and care delivery systems, uptake and retention to medications/services and improving patients’ survival and quality of life. Conclusion: Telemonitoring/mhealth (electronic phone text/video/materials messaging)acceptability, access and uptake are crucial in monitoring and improving uptake, retention,adherence and coverage in both local and national integrated HIV and TB programs and interventions. Moreover, telemonitoring is crucial in patient-providers-health professional partnership, real-time quality care and service delivery, antiretroviral and anti-tuberculous drugs improvement, susceptibility monitoring and prescription choice, reinforcing cost effective HIV and TB integrated therapy model and survival rate.

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“…Most likely, the shared perceptions of the system’s use, interpreted from both sides as useful for transmitting information from professionals to patients, laid a foundation for asymmetrical interactions in which professionals analyze the data input by the patients. Clinicians and administrative staff often express concerns about using telemonitoring technologies because of the possible increase in patient requests [12-15]; however, in the considered cases, it is mainly the diabetes center that decides if a text message conversation is necessary, choosing when and how to begin a conversation with a patient.…”

Section: Discussionmentioning

confidence: 99%

“…The diffusion of information and communication technologies (ICTs) in health care has generated a polycentric debate on how ICTs can support patients with diabetes, providing services that empower them in self-management (eg, electronic logbooks or reminder functions for medications), enable communication with health care professionals (eg, messaging systems and rule-based alarms), and offer information on self-management (eg, tutorials for blood glucose tests). In particular, this debate has addressed issues such as the clinical impact of ICTs [2-9], the effects of ICTs on the patient-professional relationship [10,11], and their consequences on the workload of hospital staff [12-15].…”

Section: Introductionmentioning

confidence: 99%

Text Messaging and Type 1 Diabetes Management: Qualitative Study Exploring Interactions Among Patients and Health Care Professionals

Miele

Clementi

Gennaro³

et al. 2019

JMIR Diabetes

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Background The diffusion of information and communication technologies (ICTs) in type 1 diabetes (T1D) management has generated a debate on the ways in which ICTs can support the patient-provider relationship. Several studies have focused on text messages. Most of the literature proposes quantitative analysis of the impact of text messaging on the clinical conditions of patients and/or their satisfaction with the technology, while the qualitative studies have focused mainly on patients’ perceptions about strengths and weaknesses of this technology. Objective In contrast to past studies, we adopted a qualitative approach for the in-depth examination of patient-health care professionals’ interactions in text messaging. Methods The study focused on the use of the Trento Cartella Clinica del Cittadino Diabetes System (TreC-DS), a digital platform with a built-in messaging system, in two diabetes centers, integrating message analysis with interviews with patients and health care professionals. Each center focused on a specific patient profile: the first one focused on pregnant women with T1D and the second one focused on adult patients with poorly controlled diabetes. Results The main results of the study were as follows: (1) Health care professionals and patients perceived the messaging system as useful for sharing information (ie, pregnant women for prescriptions and adults with poorly controlled diabetes for advice); (2) The content and communication styles of the two centers differed: in the case of pregnant women, interactions via text messaging were markedly prescriptive, while in the case of adult patients with poorly controlled diabetes, they were conceived as open dialogues; and (3) Conversations were initiated mainly by professionals; in the cases considered, it was mainly the diabetes center that decided whether a messaging conversation was needed. Conclusions The results show how the features of interactions of text messaging changed based on the patient profiles in two different centers. In addition, in both diabetes centers that were involved, the system seems to have laid a foundation for a closer relationship between patients and health care professionals.

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Nurse perspectives on the implementation of routine telemonitoring for high-risk diabetes patients in a primary care setting

Cited by 21 publications

References 27 publications

Implementation of a Heart Failure Telemonitoring System in Home Care Nursing: Feasibility Study

Implementation of a Heart Failure Telemonitoring System in Home Care Nursing: Feasibility Study

Impact of telemonitoring approaches on integrated HIV and TB diagnosis and treatment interventions in sub-Saharan Africa: a scoping review

Text Messaging and Type 1 Diabetes Management: Qualitative Study Exploring Interactions Among Patients and Health Care Professionals

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