Facilitating and inhibiting factors to implement telemonitoring: A qualitative study

Objective: Despite the added value of telemonitoring (TM) in the management of chronic care, widespread implementation and continuation is failing. The aim of this qualitative study was to explore the facilitators and inhibitors for successful implementation among field experts and health care providers in the projects of TM in primary care. Methods: An exploratory qualitative design using semi-structured interviews with field experts of TM projects in Belgium. Results: The eight interviewees reported an overall positive perception on the actual use of TM. They emphasized that TM provides a promising approach to the ageing population with an increasing burden of chronic diseases. TM was said to increase disease awareness in patients with chronic heart failure. The interviewees were willing to use the new technology. Sharing patient data between health care professionals optimizes care continuity and transmural collaboration, with the focus on problem detection. However, TM in their projects was perceived as an additional task as it was not embedded in regular care. Coordination of care using TM was felt to be incomplete. Agreements on tasks and responsibilities in sharing patient data were unclear. The management and centralisation of data was difficult and impeded implementation in regular care. Furthermore, the interviewees noted that sustainability of their efforts was hampered as the projects would not be financed in the future. Conclusions: Field experts of pilot TM projects believe in benefits of TM and the willingness of health care providers to use the technology. To successfully implement TM in regular care the reported barriers need to be considered. Transmural collaboration with interaction and involvement of the chronic patient and a proactive team of care professionals is required. Efforts should be made to integrate TM in regular care, both structurally and financially.