Critical appraisal of remote vital-sign telemonitoring

Background: Patient self-monitoring with telehealth technologies has not demonstrated savings to secondary care budgets but there remains optimism regarding potential benefit for people with long-term conditions. Aim: To critically assess whether remote vital-sign telemonitoring is perceived to have derived benefits for patients. Design: Mixed methods research was adopted with questionnaire distribution to service users and their informal carers and with semi-structured one-to-one interviews conducted with clinical practitioners and senior managers. Sample: Questionnaires were distributed to 274 patients living with long-term conditions who were using telemonitoring provided by one integrated health and social care organisation in Northern Ireland. Data from 97 patients and 49 carers were analysed. A total of 16 clinical practitioners experienced with the use of remote vital-sign telemonitoring in their therapeutic regimens, across a range of professions, were interviewed along with eight senior managers or commissioners. Results: The great majority of patients (90.7%) were supportive of technology and agreed that the remote monitoring system assisted me in managing my health on a day-to-day basis. They reported that telehealth technology gave them control for self-management, better understanding, timely access to support, peace of mind and empowerment. These observations were echoed by clinicians who were equally supportive and saw greater future use of innovative technologies in the delivery of health and care. They did not view remote monitoring as any diminution of care. Conclusion: Whilst not necessarily saving money, remote vital-sign telemonitoring enabled collaboration between patients, carers and the clinicians where patients were empowered to actively self-manage their long-term conditions. Patients accepted technology and support increased use as part of their care regime in the future. Healthcare systems should become open to the exploitation of new technologies in order to realise the real patient benefit.