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Accepted for/Published in: JMIR Human Factors

Date Submitted: Dec 18, 2022
Open Peer Review Period: Dec 18, 2022 - Jan 1, 2023
Date Accepted: Apr 15, 2023
(closed for review but you can still tweet)

The final, peer-reviewed published version of this preprint can be found here:

Operational Implementation of Remote Patient Monitoring Within a Large Ambulatory Health System: Multimethod Qualitative Case Study

Lawrence K, Singh N, Jonassen Z, Groom LL, Alfaro-arias V, Mandal S, Schoenthaler A, Mann D, Nov O, Dove G

Operational Implementation of Remote Patient Monitoring Within a Large Ambulatory Health System: Multimethod Qualitative Case Study

JMIR Hum Factors 2023;10:e45166

DOI: 10.2196/45166

PMID: 37498668

PMCID: 10415949

Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.

Human-Computer Interaction Challenges and Considerations in the Implementation of Remote Patient Monitoring: A Multi-method Qualitative Study

  • Katharine Lawrence; 
  • Nina Singh; 
  • Zoe Jonassen; 
  • Lisa L. Groom; 
  • Veronica Alfaro-arias; 
  • Soumik Mandal; 
  • Antoinette Schoenthaler; 
  • Devin Mann; 
  • Oded Nov; 
  • Graham Dove

ABSTRACT

Background:

Remote patient monitoring (RPM) technologies can support patients living with chronic conditions through self-monitoring of physiological measures and enhance clinicians’ diagnostic and treatment decisions. However, to date scaled RPM implementation within health systems has been limited, and understanding of the impacts of RPM technologies on health information technology infrastructure design and workflows is lacking.

Objective:

In this study, we evaluate the early implementation of a large-scale RPM initiative within the ambulatory network of an academic medical center in New York City, focusing on human-computer interaction (HCI) impacts and challenges.

Methods:

Utilizing a multi-method qualitative approach, we conducted 1) interviews with 13 clinicians across 9 specialties considered “early adopters” and supporters of RPM, and 2) speculative design sessions exploring the future of RPM in clinical care with 21 patients and patient-representatives.

Results:

We identified themes related to HCI considerations for RPM within the following areas: (1) data collection and practices, including impacts of taking real-world measures and issues of data sharing, security, and privacy; (2) proactive and preventive care, including proactive and preventing monitoring, and proactive interventions and support; and (3) health disparities and equity, including tailored and flexible care, and implicit bias. We also identified evidence for mitigation and support to address challenges in each of these areas.

Conclusions:

This study highlights the unique contexts and human-computer interaction concerns regarding the implementation of RPM in clinical practice and its potential implications for clinical workflows and work experiences. Based on these findings, we offer design recommendations for health systems interested in deploying RPM-enabled healthcare. Clinical Trial: N/a


 Citation

Please cite as:

Lawrence K, Singh N, Jonassen Z, Groom LL, Alfaro-arias V, Mandal S, Schoenthaler A, Mann D, Nov O, Dove G

Operational Implementation of Remote Patient Monitoring Within a Large Ambulatory Health System: Multimethod Qualitative Case Study

JMIR Hum Factors 2023;10:e45166

DOI: 10.2196/45166

PMID: 37498668

PMCID: 10415949

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