Domains and Methods Used to Assess Home Telemonitoring Scalability: Systematic Review

Area of Science:

• Health Services Research
• Digital Health
• Health Technology Assessment

Background:

• The COVID-19 pandemic accelerated home telemonitoring adoption, demonstrating benefits in healthcare capacity, patient empowerment, and treatment adherence.
• While effective for some conditions, scaling up telemonitoring requires assessing real-world feasibility beyond clinical outcomes.
• Scalability assessment is crucial for ensuring broad access to advanced home telemonitoring services.

Purpose of the Study:

• To systematically review domains and methods used in research assessing the real-world scalability of home telemonitoring interventions.
• To identify gaps in current scalability assessment practices for home telemonitoring.

Main Methods:

• Systematic review following PRISMA guidelines, searching multiple databases (PubMed, Scopus, Web of Science, EconLit).
• Integrative synthesis of 13 eligible studies, classifying study designs by evidence strength.
• Narrative and thematic analyses to identify domains and methods for scalability assessment.

Main Results:

• Most studies focused on problem, intervention, effectiveness, and costs/benefits domains for scalability.
• Cost-effectiveness was the most common method, though seven other cost analyses were identified.
• Sociopolitical context, workforce, and technological infrastructure were under-examined domains, with varied methods used across studies.

Conclusions:

• Current scalability assessments for home telemonitoring prioritize intervention-specific domains over contextual, technological, and environmental factors.
• Inconsistent evaluation methods across studies hinder comparisons and informed decision-making for large-scale implementation.
• Future research needs to define essential scalability domains and standardize methods for remote telemonitoring services.