REMOTE MONITORING TECHNOLOGIES IN LONG-TERM CARE CARE TEAM ORGANIZATION AND TRAINING

摘要

Remote monitoring programs aim to enhance the patient’s and provider’s surveillance of chronic conditions to anticipate and identify exacerbations, thus avoiding unnecessary emergency room visits, re-hospitalizations, surgeries, premature death, and excess costs. This study, which reports newly-completed qualitative data analysis, examines how remote monitoring programs are preparing and leveraging the health care workforce to manage patients with chronic illness and long-term care needs who are living at home. We conducted 20 semi-structured interviews with health care providers, managers/administrators, and technicians who are part of care teams that utilize remote monitoring technologies, and with authors of research trials investigating remote monitoring technologies. A multidisciplinary team approach was associated with more positive biometric and health care system outcomes. Because registered nurses’ experience allows them the independence to perform assessments while simultaneously communicating and acting upon data, they are the primary health professionals involved in remote monitoring programs in the United States, with lower-skill health workers providing support. A range of clinical experience and skills are critical for successful telemonitoring programs. Nurses must rely on critical thinking skills and their ability to verbally assess patients, ask the right questions, and make clinical judgments. Protocols that include customizing parameters to the patient, close monitoring, and case management with input from the whole care team appear to be the best approach. To fully achieve the potential of remote monitoring, programs should invest robustly in training. An expanded effort to share information across remote monitoring programs would accelerate learning and enhance success.