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Lessons learned from piloting a heart failure-based remote management care system in a general internal medicine
Sarah Vc Lawrason1,2, Heather J Ross1,3, Anne Simard1
1Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada.
Digital Health
|May 1, 2026
Summary
This study explored staff factors for implementing remote patient management (RPM) for heart failure (HF) in general internal medicine (GIM). Key enablers included staff communication, leadership engagement, and adapting the tool for GIM settings.
Area of Science:
- Healthcare technology adoption
- Implementation science in medicine
- Digital health interventions
Background:
- Medly is a remote patient management (RPM) tool for heart failure (HF) patients, standard-of-care in Cardiology since 2016.
- HF patients are often managed in general internal medicine (GIM), but HF RPM programs are scarce in this setting.
- A pilot of Medly for GIM-discharged patients occurred in summer 2023.
Purpose of the Study:
- To identify staff factors influencing the spread and scale of Medly into a GIM setting.
- To understand barriers and enablers for adopting an RPM tool across different clinical contexts.
- To inform future implementation strategies for RPM in GIM.
Main Methods:
- Semistructured interviews were conducted with 13 staff members involved in Medly's GIM implementation.
- Interviews were audio-recorded and transcribed verbatim.
- Data analysis employed deductive thematic analysis, guided by the Consolidated Framework for Implementation Research.
Main Results:
- Key implementation factors included communicative staff, Medly's adaptability, and the need for sustained funding.
- Leadership engagement and a learning-centered culture were crucial.
- Patient sociodemographic characteristics also influenced implementation.
Conclusions:
- RPM tools can be adopted from Cardiology to GIM settings with specific considerations.
- Enablers include adequate staff resources, early leadership involvement, tool modification, and addressing equity issues like language barriers.
- Further scaling requires a larger pilot embedded within the GIM pathway.
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