TY - JOUR
AU - R. J. Koopman
AU - B. J. Wakefield
AU - J. L. Johanning
AU - L. E. Keplinger
AU - R. L. Kruse
AU - M. Bomar
AU - B. Bernt
AU - D. S. Wakefield
AU - D. R. Mehr
A1 - 
AB - Abstract Background: Prior telemonitoring trials of blood pressure and blood glucose have shown improvements in blood pressure and glycemic targets. However, implementation of telemonitoring in primary care practices may not yield the same results as research trials with extra resources and rigid protocols. In this study we examined the process of implementing home telemonitoring of blood glucose and blood pressure for patients with diabetes in six primary care practices. Materials and Methods: Grounded theory qualitative analysis was conducted in parallel with a randomized controlled effectiveness trial of home telemonitoring. Data included semistructured interviews with 6 nurse care coordinators and 12 physicians in six participating practices and field notes from exit interviews with 93 of 108 randomized patients. Results: The three stakeholder groups (patients, nurse care coordinators, and physicians) exhibited some shared themes and some unique to the particular stakeholder group. Major themes were that practices should (1) understand the capabilities and limitations of the technology and the willingness of patient and physician stakeholders to use it, (2) understand the workflow, flow of information, and human factors needed to optimize use of the technology, (3) engage and prepare the physicians, and (4) involve the patient in the process. Although there was enthusiasm for a patient-centered medical home model that included between-visit telemonitoring, there was concern about the support and resources needed to provide this service to patients. Conclusions: As with many technology interventions, careful consideration of workflow and information flow will help enable effective implementations.
BT - Telemedicine journal and e-health : the official journal of the American Telemedicine Association
C5 - HIT & Telehealth
DO - 10.1089/tmj.2013.0188
JF - Telemedicine journal and e-health : the official journal of the American Telemedicine Association
N2 - Abstract Background: Prior telemonitoring trials of blood pressure and blood glucose have shown improvements in blood pressure and glycemic targets. However, implementation of telemonitoring in primary care practices may not yield the same results as research trials with extra resources and rigid protocols. In this study we examined the process of implementing home telemonitoring of blood glucose and blood pressure for patients with diabetes in six primary care practices. Materials and Methods: Grounded theory qualitative analysis was conducted in parallel with a randomized controlled effectiveness trial of home telemonitoring. Data included semistructured interviews with 6 nurse care coordinators and 12 physicians in six participating practices and field notes from exit interviews with 93 of 108 randomized patients. Results: The three stakeholder groups (patients, nurse care coordinators, and physicians) exhibited some shared themes and some unique to the particular stakeholder group. Major themes were that practices should (1) understand the capabilities and limitations of the technology and the willingness of patient and physician stakeholders to use it, (2) understand the workflow, flow of information, and human factors needed to optimize use of the technology, (3) engage and prepare the physicians, and (4) involve the patient in the process. Although there was enthusiasm for a patient-centered medical home model that included between-visit telemonitoring, there was concern about the support and resources needed to provide this service to patients. Conclusions: As with many technology interventions, careful consideration of workflow and information flow will help enable effective implementations.
PY - 2013
SN - 1556-3669; 1530-5627
T1 - Implementing Home Blood Glucose and Blood Pressure Telemonitoring in Primary Care Practices for Patients with Diabetes: Lessons Learned
T2 - Telemedicine journal and e-health : the official journal of the American Telemedicine Association
TI - Implementing Home Blood Glucose and Blood Pressure Telemonitoring in Primary Care Practices for Patients with Diabetes: Lessons Learned
U1 - HIT & Telehealth
U2 - 24350806
U3 - 10.1089/tmj.2013.0188
VO - 1556-3669; 1530-5627
Y1 - 2013
ER -