Implementation of a Multidevice Telemonitoring Program for Home-Based Nursing Care in Quebec: Qualitative Report

Area of Science:

• Digital Health
• Implementation Science
• Home Care Services

Background:

• Home care faces pressure from aging populations and chronic diseases.
• Digital health, like telemonitoring, can improve early detection and reduce hospitalizations.
• Limited real-world data exists on implementing telemonitoring in public home care.

Purpose of the Study:

• To document the real-world implementation of a multidevice telemonitoring program.
• To identify barriers, enablers, and strategies for adaptation and sustainability.
• To assess feasibility and acceptability from home care nurses' and managers' perspectives.

Main Methods:

• Qualitative study using the iCHECK-DH framework and implementation science principles.
• 30 semistructured interviews with home care nurses (n=19) and managers (n=11).
• Multidevice telemonitoring intervention (scale, smartwatch, adherence system, tablet) monitored via Virtuose dashboard.

Main Results:

• Nurses accessed the dashboard frequently but faced alert fatigue and workflow disruption.
• Mixed initial reactions to telemonitoring; hands-on training and clear workflows were crucial.
• Sustained use depended on local adaptation, digital literacy support, and system integration.

Conclusions:

• Successful telemonitoring implementation in public home care needs strong leadership, training, and adaptive workflows.
• Relational care remains central, even with digital support.
• Lessons learned can inform future scale-up of digital health in public systems.