Factors Affecting Clinician Readiness to Adopt Smart Home Technology for Remote Health Monitoring: A Systematic Review.

Abstract

Background: The population of older adults across the world continues to increase, placing higher demands on primary health care and long-term care. The costs of housing older people in care facilities have economic and societal impacts which are unsustainable without innovative solutions. Many older people wish to remain independent in their homes and age-in-place. Assistive technology such as health-assistive smart homes with clinician monitoring could be a widely adopted alternative to aged care facilities in the future. Whilst studies have found that older persons have demonstrated a readiness to adopt health-assistive smart homes, little is known about clinician readiness to adopt this technology to support older adults to age as independently as possible. Objective: The purpose of this systematic review was to identify the factors that affect clinician readiness to adopt smart home technology for remote health monitoring. Methods: The review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO, CRD42020195989) prior to the commencement of the database searches. This review was conducted in accordance with the Joanna Briggs Institute Methodology for Systematic Reviews and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for reporting. Results: Several factors affected clinicians' perspectives on their readiness to adopt smart home technology for remote health monitoring including challenges such as patient privacy and dignity, data security, and ethical use of 'invasive' technologies. Perceived benefits included enhancing the quality of care and outcomes. Conclusion: Clinicians including nurses reported both challenges and benefits to adopt smart home technology for remote health monitoring. Clear strategies and frameworks to allay fears and overcome professional concerns and misconceptions form key parts of the Readiness to Adoption Pathway proposed. The use of more rigorous scientific methods and reporting is needed to advance the state of the science. The review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO, CRD42020195989) prior to the commencement of the database searches.