Accepted for/Published in: JMIR Research Protocols
Date Submitted: Dec 15, 2025
Date Accepted: Aug 31, 2026
A Study Protocol for Developing A Guideline to Adopt Wearable Device Telemonitoring System Into Hospital Systems for Chronic Disease Management: A Multiphase mixed method
ABSTRACT
Background:
The integration of wearable device-based telemonitoring into hospital systems presents a transformative opportunity for chronic disease management, particularly in settings like Indonesia facing a high burden of non-communicable diseases. However, widespread adoption is hindered by multifaceted operational barriers, including workflow integration, data management, and unclear adoption pathways, highlighting a critical need for structured, evidence-based guidance.
Objective:
This study aims to develop an expert-validated adoption guideline to facilitate the sustainable integration of consumer-grade wearable telemonitoring systems into Indonesian hospital settings for managing chronic diseases, with a focus on type 2 diabetes mellitus.
Methods:
An exploratory sequential mixed-methods design is employed across three phases. Phase one involves a Critical Interpretative Synthesis (CIS) of literature (2015 onward) to synthesize evidence on adoption factors, guided by the NASSS and TFA frameworks. Phase two comprises qualitative semi-structured interviews with 30 key stakeholders (administrators, IT staff, clinicians) from four purposively selected hospitals in Yogyakarta, Indonesia, to explore contextual barriers and facilitators. Phase three utilizes a modified Nominal Group Technique (NGT) with a panel of approximately 12 experts to build consensus and finalize the guideline.
Results:
As of December 13, 2025, this study is in progress. Ethical approval has been obtained. The CIS (Phase 1) is completed, yielding preliminary thematic data on adoption factors. Data collection for the qualitative interviews (Phase 2) has commenced, with interviews conducted at one hospital and administrative permissions secured for two sites. Recruitment and data collection are ongoing.
Conclusions:
This protocol outlines a comprehensive methodology to develop a contextually grounded adoption guideline. By synthesizing evidence, engaging stakeholders, and establishing expert consensus, the study aims to bridge the gap between pilot projects and integration of wearable telemonitoring in hospital-based chronic disease routine care, with potential applicability to similar healthcare settings.
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