JMIR Publications

ABSTRACT

Background:

Telemonitoring (TM) of heart failure 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:

The goal of this study was to determine the feasibility of implementing a smartphone-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, aiming to recruit 10-15 heart failure 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 either through a phone call and/or home visit.

Results:

Only six patients were recruited over a six-month period due to lack of referrals from physicians. Potential benefits of TM through a home care nursing agency were indicated, including through improved patient education, providing nurses with a better understanding of the patient’s health status, and reductions in home visits. Barriers to implementation included challenges in nurses contacting patients and physicians, retention issues, and integrating the TM system into a complex home care nursing workflow.

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.