SRFP078: Potential barriers for mHealth telemonitoring in primary care of COVID-19 and non COVID cases in assisted living facilities

Lukas Michaelis-Braun; Julia Korel; Quan Nha Hong; Andreas Jerrentrup, MD; Dorothe Balser; Judith Friedrich; Beate Müller, MD; Sebastian Kuhn, MD, Prof. Dr.; Michael Dreher; Gernot Rohde; Claus Franz Prof. Dr. Vogelmeier, MD; Nurlan Dauletbaev, MD, PhD

Abstract

Context: Mobile (m) Health telemonitoring describes remote patient monitoring (RPM) involving smartphones or tablets, dedicated mobile apps, and portable sensors. This technology is potentially beneficial for primary care of residents of assisted living facilities. Yet the implementation may encounter substantial barriers, including low digital literacy, residents’ lack of smartphones, reliance on support by caregivers, and other factors. Objective: To develop a viable concept for implementation of mHealth telemonitoring in primary care of COVID-19 and non COVID cases in assisted living facilities. Study Design: Mixed methods study. Setting: Primary care, assisted living facility. Population Studied: (i) Residents and (ii) caregivers of assisted living facilities, and (iii) responsible primary care providers. The residents will need to be able to understand and implement the instructions on the use of mHealth devices. Intervention: The residents will be asked to use Bluetooth-connected sensors (pulse oximeter, heart rate variability and blood pressure device, spirometer) on a daily base for two weeks (pilot study) and up to twelve weeks. Due to presumed low digital literacy among the residents, the caregivers will be asked to provide assistance with the use of mHealth devices. For RPM, smartphones will be purchased and distributed as rental units. To ensure the security of patients’ telemonitoring data, a dedicated standalone server has been set up. The rental smartphones will be operated on pretend accounts without direct association with patients’ personal data. The acceptance of mHealth telemonitoring will be evaluated by a mixed methods study, following the Technology Acceptance Model. Expected Results: Participants may experience difficulties learning the new digital technology. The caregivers may not be able to sufficiently support the residents due to routine workload. The primary care providers may find the technology overwhelming and difficult to combine with the usual patient care, not least because of an unclear reimbursement model for RPM in primary care. Conversely, the study, through observation and the mixed methods component, is expected to advance the concept on how to best integrate mHealth telemonitoring into the primary care of residents in assisted living facilities. Expected Outcomes: Identification of the barriers to mHealth telemonitoring will facilitate its integration into primary care of residents in assisted living facilities
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Jack Westfall
jwestfall@aafp.org 11/21/2021

This is a very important topic and research study. Nice work. Thanks

Diane Harper
harperdi@med.umich.edu 11/22/2021

Present your results in Phoenix next year! Thank you for sharing your work with NAPCRG!

William R. Phillips
wphllps@uw.edu 11/23/2021

Monitoring of patients in long-term care facilities is critical for patient care and public health. Several other studies presented this year at NAB Craig and demonstrated that new technology does not always improve care or outcomes. Your study is a very important step. Even if you start with a pilot study and a healthier patient group, you eventually need to do the pilot in this setting. The clinician issues may be the same but the patient issues will post extra challenges. Maybe it's best to solve the clinician side of the equation 1st. If this technology is not accepted or functional for them, it won't work for any patient group that relies upon the present organization of those practices. Thanks for sharing your work here at NAPCRG. - Bill Phillips

Andy Pasternak
avpiv711@sbcglobal.net 11/28/2021

Great work to get this study up and going. Keep up the great work

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