Abstract
BackgroundTelemonitoring could offer solutions to the mounting challenges for health care and could improve patient self-management. Studies have addressed the benefits and challenges of telemonitoring for certain patient groups.ObjectiveThis paper will examine the nationwide uptake of telemonitoring in chronic care in the Netherlands from 2014 to 2019 by means of an annual representative survey among patients and health care professionals.MethodsBetween 2014 and 2019, approximately 2900 patients with chronic diseases, 700 nurses, and 500 general practitioners (GPs) and medical specialists received a questionnaire. About 30 questions addressed topics about the use of eHealth and experiences with it, including data about telemonitoring.ResultsBetween 2014 and 2019, the use of telemonitoring remained stable for all groups except medical specialists. In medical specialist departments, the use of telemonitoring increased from 11.2% (18/161) in 2014 to 19.6% (36/184) in 2019 (χ24=12.3; P=.02). In 2019, telemonitoring was used by 5.8% (28/485) of people with chronic disease. This was 18.2% (41/225) in GP organizations and 40.4% (44/109), 38.0% (78/205), and 8.9% (29/325) in the organizations of nurses working in primary, secondary, and elderly care, respectively. Up to 10% of the targeted patient group such as diabetics were regarded by health care professionals as suitable for using telemonitoring. The main benefits mentioned by the patients were “comfort” (421/1043, 40.4%) and “living at home for longer/more comfortably” (334/1047, 31.9%). Health care professionals added “improvement of self-management” (63/176, 35.8% to 57/71, 80.3%), “better understanding of the patient’s condition” (47/176, 26.7% to 42/71, 59.2%), “reduction of workload” (53/134, 39.6% of nurses in elderly care), “better tailoring of care plan to the patient’s situation” (95/225, 42.2% of GPs), and “saves time for patients/caregivers” (61/176, 34.7% of medical specialists). Disadvantages mentioned by professionals were that “it takes time to monitor data” (13/130, 10% to 108/225, 48.0%), “it takes time to follow up alerts” (15/130, 11.5% to 117/225, 52.0%), and “it is difficult to estimate which patients can work with telemonitoring” (22/113, 19.5% to 94/225, 41.8%).ConclusionsThe uptake of telemonitoring in Dutch chronic care remained stable during 2014-2019 but increased among medical specialists. According to both patients and professionals, telemonitoring improves the quality of life and quality of care. Skills for suitably including eligible patients and for allocating the tasks of data monitoring and follow-up care within the team would help to further increase the use of telemonitoring.
Highlights
Added Value of TelemonitoringTelemonitoring could broaden access to health care and offer solutions to the mounting challenges for the health care system such as an ageing population, which is creating a demand for long-term care, rising expectations from patients who are better informed about health issues, and the pressure on national health care budgets due to these demands [1-4]
Written and online questionnaires on eHealth were sent to general practitioner health care professionals (HCPs) (GP), medical specialists, nurses, and people with chronic diseases
Participants Over the years, data were used from 485-633 people with a chronic disease, 322-607 nurses working in elderly care, 220-367 nurses working in the curative disciplines, 225-396 GPs, and 184-386 medical specialists who answered questions about telemonitoring (Table 1)
Summary
Telemonitoring could broaden access to health care and offer solutions to the mounting challenges for the health care system such as an ageing population, which is creating a demand for long-term care, rising expectations from patients who are better informed about health issues, and the pressure on national health care budgets due to these demands [1-4]. Telemonitoring uses technology such as videoconferencing, email, remote electronic monitoring equipment, social network apps, and internet portals to allow monitoring and self-monitoring of health data by patients and health-related education and long-distance interventions by health care professionals (HCPs) [5-7]. Studies have addressed the benefits and challenges of telemonitoring for certain patient groups
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