Homecare Nurses' Experiences with Telemonitoring Systems

Abstract

The promise of telehealth in modern healthcare centers on reduction of costs via utilization of the latest communications technology to deliver quality healthcare services to underserved populations. Telemonitoring in particular has held the promise of helping reducing costly hospital readmissions and improving overall health while the patient continues to remain at home. This type of intervention has been targeted primarily towards patients living with chronic diseases requiring long term care and timely follow-up.

Results from clinical trials investigating this hypothesis, however, have been mixed at best. The majority of the studies utilizing a more rigorous research design seem to indicate no significant difference in outcomes between patients receiving telemonitoring vs. standard post-discharge home care. It should be noted, however, that several of these studies reported some secondary benefits for patients receiving home telemonitoring. Additionally, qualitative studies of the experiences of both staff and patients involved with home telemonitoring programs indicate that when implemented properly these programs can empower patients’ self-care and improve health status. The research also indicates that the attitudes and style of staff implementing the program have a significant impact on its acceptance and effectiveness.

 Exactly what leads to successful implementation of a telemonitoring program is still unclear and requires further investigation. The focus of this study is to describe the lived experiences of homecare nurses involved with the day-to-day operation of telemonitoring systems in the homecare setting, and describe their perceptions of what makes a telemonitoring system a beneficial addition to patient homecare. Two to six one-on-one semi structured interviews with nurses employed by agencies utilizing home telemonitoring systems will be conducted. Nurses’ responses will be audio recorded and analyzed for themes such as benefits of home telemonitoring for patients, characteristics of system efficacy, technical and implementation challenges for providers, and staff acceptance and satisfaction with the system. Implications for successful implementation of home telemonitoring programs will be discussed.