Key Stakeholder Barriers and Facilitators to Implementing Remote Monitoring Technologies: Protocol for a Mixed Methods Analysis

Fahad Mujtaba Iqbal, Meera Joshi, Sadia Khan, Mike Wright, Hutan Ashrafian, Ara Darzi, Fahad Mujtaba Iqbal, Meera Joshi, Sadia Khan, Mike Wright, Hutan Ashrafian, Ara Darzi

Abstract

Background: The implementation of novel digital solutions within the National Health Service has historically been challenging. Since the start of the COVID-19 pandemic, there has been a greater push for digitization and for operating remote monitoring solutions. However, the implementation and widespread adoption of this type of innovation have been poorly studied.

Objective: We aim to investigate key stakeholder barriers and facilitators to implementing remote monitoring solutions to identify factors that could affect successful adoption.

Methods: A mixed methods approach will be implemented. Semistructured interviews will be conducted with high-level stakeholders from industry and academia and health care providers who have played an instrumental role in, and have prior experience with, implementing digital solutions, alongside the use of an adapted version of the Technology Acceptance Model questionnaire.

Results: Enrollment is currently underway, having started in February 2022. It is anticipated to end in July 2022, with data analysis scheduled to commence in August 2022.

Conclusions: The results of our study may highlight key barriers and facilitators to implementing digital remote monitoring solutions, thereby allowing for improved widespread adoption within the National Health Service in the future.

Trial registration: ClinicalTrials.gov NCT05321004; https://ichgcp.net/clinical-trials-registry/NCT05321004.

Keywords: barriers; digital solutions; digitization; health care industry; health plan implementation; implementation; implementation science; mobile health; remote monitoring; stakeholder.

Conflict of interest statement

Conflicts of Interest: AD is chair of the Health Security initiative, and HA is chief scientific officer at Flagship Pioneering UK Ltd. Flagship Pioneering had no role in the development, conduct, or analysis of the study.

©Fahad Mujtaba Iqbal, Meera Joshi, Sadia Khan, Mike Wright, Hutan Ashrafian, Ara Darzi. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 21.07.2022.

References

    1. Watson AR, Wah R, Thamman R. The value of remote monitoring for the COVID-19 pandemic. Telemed J E Health. 2020 Sep;26(9):1110–1112. doi: 10.1089/tmj.2020.0134.
    1. Mehrotra A, Chernew ME, Linetsky D, Hatch H, Cutler DA, Schneider EC. The impact of the COVID-19 pandemic on outpatient visits: Changing patterns of care in the newest COVID-19 hot spots. The Commonwealth Fund. 2020. Aug 13, [2020-09-19]. .
    1. Xu S, Li Y. Beware of the second wave of COVID-19. Lancet. 2020 Apr 25;395(10233):1321–1322. doi: 10.1016/S0140-6736(20)30845-X. S0140-6736(20)30845-X
    1. WHO coronavirus (COVID-19) dashboard. World Health Organization. [2020-09-19]. .
    1. Martirosyan M, Caliskan K, Theuns DAMJ, Szili-Torok T. Remote monitoring of heart failure: benefits for therapeutic decision making. Expert Rev Cardiovasc Ther. 2017 Jul;15(7):503–515. doi: 10.1080/14779072.2017.1348229.
    1. Annis T, Pleasants S, Hultman G, Lindemann E, Thompson JA, Billecke S, Badlani S, Melton GB. Rapid implementation of a COVID-19 remote patient monitoring program. J Am Med Inform Assoc. 2020 Aug 01;27(8):1326–1330. doi: 10.1093/jamia/ocaa097. 5835871
    1. Ford D, Harvey JB, McElligott J, King K, Simpson KN, Valenta S, Warr EH, Walsh T, Debenham E, Teasdale C, Meystre S, Obeid JS, Metts C, Lenert LA. Leveraging health system telehealth and informatics infrastructure to create a continuum of services for COVID-19 screening, testing, and treatment. J Am Med Inform Assoc. 2020 Dec 09;27(12):1871–1877. doi: 10.1093/jamia/ocaa157. 5865271
    1. O'Carroll O, MacCann R, O'Reilly A, Dunican EM, Feeney ER, Ryan S, Cotter A, Mallon PW, Keane MP, Butler MW, McCarthy C. Remote monitoring of oxygen saturation in individuals with COVID-19 pneumonia. Eur Respir J. 2020 Aug 13;56(2):2001492. doi: 10.1183/13993003.01492-2020. 13993003.01492-2020
    1. Medina M, Babiuch C, Card M, Gavrilescu R, Zafirau W, Boose E, Giuliano K, Kim A, Jones R, Boissy A. Home monitoring for COVID-19. Cleve Clin J Med. Epub ahead of print. 2020 Jun 11; doi: 10.3949/ccjm.87a.ccc028. ccjm.87a.ccc028
    1. Joshi M, Ashrafian H, Aufegger L, Khan S, Arora S, Cooke G, Darzi A. Wearable sensors to improve detection of patient deterioration. Expert Rev Med Devices. 2019 Feb;16(2):145–154. doi: 10.1080/17434440.2019.1563480.
    1. Iqbal MH, Aydin A, Brunckhorst O, Dasgupta P, Ahmed K. A review of wearable technology in medicine. J R Soc Med. 2016 Oct;109(10):372–380. doi: 10.1177/0141076816663560. 109/10/372
    1. Hentschel MA, Haaksma ML, van de Belt TH. Wearable technology for the elderly: Underutilized solutions. Eur Geriatr Med. 2016 Sep;7(5):399–401. doi: 10.1016/j.eurger.2016.07.008.
    1. Chan M, Estève D, Fourniols JY, Escriba C, Campo E. Smart wearable systems: current status and future challenges. Artif Intell Med. 2012 Nov;56(3):137–156. doi: 10.1016/j.artmed.2012.09.003.S0933-3657(12)00118-2
    1. Appelboom G, Camacho E, Abraham ME, Bruce SS, Dumont EL, Zacharia BE, D'Amico R, Slomian J, Reginster JY, Bruyère O, Connolly ES Jr. Smart wearable body sensors for patient self-assessment and monitoring. Arch Public Health. 2014 Aug 22;72(1):28. doi: 10.1186/2049-3258-72-28. 2049-3258-72-28
    1. Tarassenko L, Hann A, Young D. Integrated monitoring and analysis for early warning of patient deterioration. Br J Anaesth. 2006 Jul;97(1):64–68. doi: 10.1093/bja/ael113. S0007-0912(17)35184-X
    1. Downey CL, Brown JM, Jayne DG, Randell R. Patient attitudes towards remote continuous vital signs monitoring on general surgery wards: An interview study. Int J Med Inform. 2018 Jun;114:52–56. doi: 10.1016/j.ijmedinf.2018.03.014.S1386-5056(18)30250-8
    1. Weenk M, Bredie SJ, Koeneman M, Hesselink G, van Goor H, van de Belt TH. Continuous monitoring of vital signs in the general ward using wearable devices: Randomized controlled trial. J Med Internet Res. 2020 Jun 10;22(6):e15471. doi: 10.2196/15471. v22i6e15471
    1. Tran VT, Riveros C, Ravaud P. Patients' views of wearable devices and AI in healthcare: findings from the ComPaRe e-cohort. NPJ Digit Med. 2019 Jun;2:53. doi: 10.1038/s41746-019-0132-y. doi: 10.1038/s41746-019-0132-y.132
    1. Joshi M, Archer S, Morbi A, Ashrafian H, Arora S, Khan S, Cooke G, Darzi A. Perceptions on the use of wearable sensors and continuous monitoring in surgical patients: Interview study among surgical staff. JMIR Form Res. 2022 Feb 11;6(2):e27866. doi: 10.2196/27866. v6i2e27866
    1. Iqbal FM, Joshi M, Fox R, Koutsoukou T, Sharma A, Wright M, Khan S, Ashrafian H, Darzi A. Outcomes of vital sign monitoring of an acute surgical cohort with wearable sensors and digital alerting systems: A pragmatically designed cohort study and propensity-matched analysis. Front Bioeng Biotechnol. 2022 Jun 27;10:895973. doi: 10.3389/fbioe.2022.895973. doi: 10.3389/fbioe.2022.895973.895973
    1. About NHS Digital. NHS Digital. [2020-09-19]. .
    1. NHS Digital annual report and accounts 2019 to 2020. NHS Digital. [2020-09-19]. .
    1. A digital framework for allied health professionals. NHS England. 2019. [2022-07-15]. .
    1. Supporting information: Virtual ward including hospital at home. NHS England. 2022. [2022-06-07].
    1. Gagnon MP, Orruño E, Asua J, Abdeljelil AB, Emparanza J. Using a modified technology acceptance model to evaluate healthcare professionals' adoption of a new telemonitoring system. Telemed J E Health. 2012;18(1):54–59. doi: 10.1089/tmj.2011.0066.
    1. Chau PYK, Hu PJ. Examining a model of information technology acceptance by individual professionals: An exploratory study. J Manag Inf Syst. 2014 Dec 23;18(4):191–229. doi: 10.1080/07421222.2002.11045699.
    1. Davis FD. Perceived usefulness, perceived ease of use, and user acceptance of information technology. MIS Q. 1989 Sep;13(3):319. doi: 10.2307/249008.
    1. Fishbein MA, Ajzen I. Belief, Attitude, Intention and Behaviour: An Introduction to Theory and Research. Reading, MA: Addison-Wesley; 1975.
    1. Triandis HC. Values, attitudes, and interpersonal behavior. Nebr Symp Motiv. 1980;27:195–259.
    1. Simblett S, Greer B, Matcham F, Curtis H, Polhemus A, Ferrão J, Gamble P, Wykes T. Barriers to and facilitators of engagement with remote measurement technology for managing health: Systematic review and content analysis of findings. J Med Internet Res. 2018 Jul 12;20(7):e10480. doi: 10.2196/10480. v20i7e10480
    1. Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006 Jan;3(2):77–101. doi: 10.1191/1478088706qp063oa.
    1. Alboksmaty A, Beaney T, Elkin S, Clarke JM, Darzi A, Aylin P, Neves AL. Effectiveness and safety of pulse oximetry in remote patient monitoring of patients with COVID-19: a systematic review. Lancet Digit Health. 2022 Apr;4(4):e279–e289. doi: 10.1016/S2589-7500(21)00276-4. S2589-7500(21)00276-4
    1. Golinelli D, Boetto E, Carullo G, Nuzzolese AG, Landini MP, Fantini MP. Adoption of digital technologies in health care during the COVID-19 pandemic: Systematic review of early scientific literature. J Med Internet Res. 2020 Nov 06;22(11):e22280. doi: 10.2196/22280. v22i11e22280
    1. Whitelaw S, Mamas MA, Topol E, Van Spall HGC. Applications of digital technology in COVID-19 pandemic planning and response. Lancet Digit Health. 2020 Aug;2(8):e435–e440. doi: 10.1016/S2589-7500(20)30142-4. S2589-7500(20)30142-4
    1. Joshi M, Archer S, Morbi A, Arora S, Kwasnicki R, Ashrafian H, Khan S, Cooke G, Darzi A. Short-term wearable sensors for in-hospital medical and surgical patients: Mixed methods analysis of patient perspectives. JMIR Perioper Med. 2021 Apr 22;4(1):e18836. doi: 10.2196/18836. v4i1e18836

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