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Evaluating the Implementation of a Mobile Phone-Based Telemonitoring Program: Longitudinal Study Guided by the
Patrick Ware1,2, Heather J Ross3,4,5, Joseph A Cafazzo1,2,6
1Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
JMIR Mhealth and Uhealth
|August 2, 2018
Summary
This study shows that a mobile phone-based telemonitoring program for heart failure was successfully implemented, with strong facilitators found in the clinical setting. Identifying implementation barriers and facilitators informs future telemonitoring services.
Area of Science:
- Health Services Research
- Digital Health
- Cardiology
Background:
- Telemonitoring shows potential for managing heart failure (HF) and reducing healthcare system burdens.
- Sustained, real-world implementation of telemonitoring programs remains a challenge.
Purpose of the Study:
- To evaluate the implementation of a mobile phone-based telemonitoring program within standard care.
- To identify barriers and facilitators influencing program implementation.
Main Methods:
- A longitudinal single case study design was employed.
- Implementation success was assessed using adoption, penetration, feasibility, and fidelity metrics.
- Semistructured interviews utilizing the Consolidated Framework for Implementation Research (CFIR) were conducted with 12 staff members over 12 months.
Main Results:
- After one year, 98 patients and 8 clinicians were enrolled, with the intervention used as intended despite minor technical issues.
- Twelve CFIR constructs, primarily related to the inner setting and individual characteristics, facilitated implementation.
- Minor barriers included intervention complexity, cost, communication gaps, and lack of a formal implementation plan.
Conclusions:
- This comprehensive evaluation highlights the high acceptability of the telemonitoring system.
- Implementation context proved to be the most significant factor in program success.
- Findings provide insights for designing future telemonitoring services and implementation strategies.
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