JMIR Publications

ABSTRACT

Background:

Evaluation of patients with serious mental illness (SMI) relies largely on patient or caregiver self-reported symptoms. New digital technologies are being developed to better quantify the longitudinal symptomology of patients with SMI and better facilitate disease management. As these new technologies become more widely available, however, psychiatrists may be uncertain how to integrate them into daily practice. To better understand how digital tools might be integrated into the treatment of patients with SMI, this study examines one case study of a successful technology adoption by physicians: endocrinologists’ adoption of digital glucometers.

Objective:

This study aimed to understand the key facilitators of and barriers to clinician and patient adoption of digital glucose monitoring technologies in order to identify lessons that may be applicable across other chronic diseases, including serious mental illnesses.

Methods:

We conducted focus groups with practicing endocrinologists from two large metropolitan areas using a semi-structured discussion guide designed to elicit perspectives of and experiences with technology adoption. Thematic analysis identified barriers to and facilitators of integrating digital glucometers into clinical practice. Participants also provided recommendations for integrating digital health technologies into clinical practice more broadly.

Results:

Ten endocrinologists enrolled in the study. Participants stated that digital glucometers represented a significant change in the treatment paradigm for diabetes care and facilitated more effective care delivery and patient engagement. Barriers to the adoption of digital glucometers included lack of coverage, provider reimbursement and data management support, as well as patient heterogeneity. Participant recommendations to increase use of digital health technologies included expanding reimbursement for clinician time, streamlining data management processes, and customizing the technologies to patient needs.

Conclusions:

Digital glucose monitoring technologies facilitated more effective, individualized care delivery and improved patient engagement and health outcomes. However, key challenges faced by the endocrinologists included lack of reimbursement for clinician time and non-standardized data management across devices. Key recommendations that may be relevant for other diseases include improved data analytics to quickly and accurately synthesize data for patient care management and streamlined software and standardized metrics.