Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Jan 10;15(1):e4.
doi: 10.2196/jmir.2161.

Health professionals' expectations versus experiences of internet-based telemonitoring: survey among heart failure clinics

Arjen E de Vries  1 , Martje H L van der Wal, Maurice M W Nieuwenhuis, Richard M de Jong, Rene B van Dijk, Tiny Jaarsma, Hans L Hillege
Affiliations

Health professionals' expectations versus experiences of internet-based telemonitoring: survey among heart failure clinics

Arjen E de Vries et al. J Med Internet Res. .

Abstract

Background: Although telemonitoring is increasingly used in heart failure care, data on expectations, experiences, and organizational implications concerning telemonitoring are rarely addressed, and the optimal profile of patients who can benefit from telemonitoring has yet to be defined.

Objective: To assess the actual status of use of telemonitoring and to describe the expectations, experiences, and organizational aspects involved in working with telemonitoring in heart failure in the Netherlands.

Methods: In collaboration with the Netherlands Organization for Applied Scientific Research (TNO), a 19-item survey was sent to all outpatient heart failure clinics in the Netherlands, addressed to cardiologists and heart failure nurses working in the clinics.

Results: Of the 109 heart failure clinics who received a survey, 86 clinics responded (79%). In total, 31 out of 86 (36%) heart failure clinics were using telemonitoring and 12 heart failure clinics (14%) planned to use telemonitoring within one year. The number of heart failure patients receiving telemonitoring generally varied between 10 and 50; although in two clinics more than 75 patients used telemonitoring. The main goals for using telemonitoring are "monitoring physical condition", "monitoring signs of deterioration" (n=39, 91%), "monitoring treatment" (n=32, 74%), "adjusting medication" (n=24, 56%), and "educating patients" (n=33, 77%). Most patients using telemonitoring were in the New York Heart Association (NYHA) functional classes II (n=19, 61%) and III (n=27, 87%) and were offered the use of the telemonitoring system "as long as needed" or without a time limit. However, the expectations of the use of telemonitoring were not met after implementation. Eight of the 11 items about expectations versus experiences were significantly decreased (P<.001). Health care professionals experienced the most changes related to the use of telemonitoring in their work, in particular with respect to "keeping up with current development" (before 7.2, after 6.8, P=.15), "being innovative" (before 7.0, after 6.1, P=.003), and "better guideline adherence" (before 6.3, after 5.3, P=.005). Strikingly, 20 out of 31 heart failure clinics stated that they were considering using a different telemonitoring system than the system used at the time.

Conclusions: One third of all heart failure clinics surveyed were using telemonitoring as part of their care without any transparent, predefined criteria of user requirements. Prior expectations of telemonitoring were not reflected in actual experiences, possibly leading to disappointment.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: RB van Dijk is partner of Curit B.V., a Dutch company involved in the development of information and communication technology–guided disease management systems and telemedicine. The other authors declared no conflict of interest.

Figures

Figure 1
Figure 1
Expectations of applying telemonitoring and experienced differences after implementation of telemonitoring.
See this image and copyright information in PMC

References

    1. Seto E, Leonard KJ, Cafazzo JA, Barnsley J, Masino C, Ross HJ. Perceptions and experiences of heart failure patients and clinicians on the use of mobile phone-based telemonitoring. J Med Internet Res. 2012;14(1):e25. doi: 10.2196/jmir.1912. http://www.jmir.org/2012/1/e25/ - DOI - PMC - PubMed
    1. Seto E, Leonard KJ, Cafazzo JA, Barnsley J, Masino C, Ross HJ. Mobile phone-based telemonitoring for heart failure management: a randomized controlled trial. J Med Internet Res. 2012;14(1):e31. doi: 10.2196/jmir.1909. http://www.jmir.org/2012/1/e31/ - DOI - PMC - PubMed
    1. Bahaadinbeigy K, Yogesan K, Wootton R. Gaps in the systematic reviews of the telemedicine field. J Telemed Telecare. 2010;16(7):414–6. doi: 10.1258/jtt.2010.100505. - DOI - PubMed
    1. Institute of Medicine (US) Committee on Evaluating Clinical Applications of Telemedicine . In: Telemedicine: a guide to assessing telecommunications in health care. Field MJ, editor. Washington, DC: National Academies Press; 1996. - PubMed
    1. Klersy C, De Silvestri A, Gabutti G, Regoli F, Auricchio A. A meta-analysis of remote monitoring of heart failure patients. J Am Coll Cardiol. 2009 Oct 27;54(18):1683–94. doi: 10.1016/j.jacc.2009.08.017. - DOI - PubMed

Publication types