Organizing Telemonitoring-Decision-Making Between Centralized and Distributed Models in the Netherlands, Using the...

Area of Science:

• Healthcare Management
• Digital Health Implementation
• Health Services Research

Background:

• Telemonitoring offers centralized or distributed organizational models.
• Limited research compares these models or guides selection.
• Understanding decision factors is crucial for effective telemonitoring implementation.

Purpose of the Study:

• Investigate decision-making factors for selecting telemonitoring models.
• Examine technological, personal, and organizational domains influencing model choice.
• Provide insights for optimizing telemonitoring strategy.

Main Methods:

• Conducted a multiple case study across 4 hospitals.
• Utilized document analysis, 13 semistructured interviews, and a focus group.
• Applied the NASSS framework to analyze decision factors.

Main Results:

• Organizational strategy dictates model choice (centralized vs. distributed).
• Technology (notification volume) and value proposition (cost-effectiveness) influence preference.
• Adopter roles (tele-nurses), organizational structures, and reimbursement systems impact implementation.
• Advancements in AI may favor centralized models.

Conclusions:

• Telemonitoring model selection is context-dependent, influenced by multiple interacting factors.
• Patient group selection, technology design, and value proposition are key decision drivers.
• Aligning strategy with operational realities is essential for successful telemonitoring implementation.