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Implementing telemonitoring in primary care: learning from a large qualitative dataset gathered during a series of studies

Hanley, Janet; Pinnock, Hilary; Paterson, Mary; McKinstry, Brian

Authors

Hilary Pinnock

Brian McKinstry



Abstract

Background: Telemonitoring for long term conditions such as hypertension and diabetes has not been widely adopted despite evidence of efficacy in trials and policy support. The Telescot programme comprised a series of seven trials and observational studies of telemonitoring for long term conditions in primary care, all with an explanatory qualitative component which had been analysed
and published separately. There were changes to the models of care within and between studies and combining datasets would provide a longitudinal view of the evolution of primary care based telemonitoring services that was not available in the individual studies, as well as allowing comparison across the different conditions monitored. We aimed to explore what drove changes to the way telemonitoring was implemented, compare experience of telemonitoring across the range of long term conditions, and identify what issues, in the experience of the participants, need to be
considered in implementing new telemonitoring systems.

Method: Synthesis and thematic reanalysis of transcribed qualitative interview and focus group data from the Telescot programme adopting an interpretive description approach. All transcribed and
coded text was re-read and data relating to the experience of the telemonitoring services, perceptions of future use and strategies for implementation were recoded into one consistent system. This was analysed thematically.

Results: The combined dataset contained transcribed qualitative interview and focus group data from 181 patients and 109 professionals. Four major themes were identified, using data, empowering patients, adjusting the model of care and system design.

Conclusion: Telemonitoring was valued by patients who found it empowering and convenient. This, combined with initial professional concern that increased surveillance may create dependency led to
the development of a more patient led service. However, despite a number of initial concerns being addressed as the service evolved, primary care professionals identified a number of barriers to widespread routine adoption of telemonitoring, many of which could be addressed by improved system design.

Keywords: Qualitative research, E-health, Primary care, Telemonitoring, Diabetes, Chronic Obstructive Pulmonary Disease
(COPD), Hypertension

Citation

Hanley, J., Pinnock, H., Paterson, M., & McKinstry, B. (2018). Implementing telemonitoring in primary care: learning from a large qualitative dataset gathered during a series of studies. BMC Family Practice, 19(1), 118. https://doi.org/10.1186/s12875-018-0814-6

Journal Article Type Article
Acceptance Date Jun 29, 2018
Online Publication Date Jul 18, 2018
Publication Date 2018-12
Deposit Date Jul 19, 2018
Publicly Available Date Mar 29, 2024
Journal BMC Family Practice
Print ISSN 1471-2296
Publisher BMC
Peer Reviewed Peer Reviewed
Volume 19
Issue 1
Pages 118
DOI https://doi.org/10.1186/s12875-018-0814-6
Keywords Qualitative research, E-health, Primary care, Telemonitoring, Diabetes, Chronic Obstructive Pulmonary Disease (COPD), Hypertension
Public URL http://researchrepository.napier.ac.uk/Output/1252167

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Publisher Licence URL
http://creativecommons.org/licenses/by/4.0/

Copyright Statement
© The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0
International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated






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