PMID- 23305645
OWN - NLM
STAT- MEDLINE
DCOM- 20130624
LR  - 20220330
IS  - 1438-8871 (Electronic)
IS  - 1439-4456 (Print)
IS  - 1438-8871 (Linking)
VI  - 15
IP  - 1
DP  - 2013 Jan 10
TI  - Health professionals' expectations versus experiences of internet-based 
      telemonitoring: survey among heart failure clinics.
PG  - e4
LID - 10.2196/jmir.2161 [doi]
LID - e4
AB  - BACKGROUND: Although telemonitoring is increasingly used in heart failure care, 
      data on expectations, experiences, and organizational implications concerning 
      telemonitoring are rarely addressed, and the optimal profile of patients who can 
      benefit from telemonitoring has yet to be defined. OBJECTIVE: To assess the 
      actual status of use of telemonitoring and to describe the expectations, 
      experiences, and organizational aspects involved in working with telemonitoring 
      in heart failure in the Netherlands. METHODS: In collaboration with the 
      Netherlands Organization for Applied Scientific Research (TNO), a 19-item survey 
      was sent to all outpatient heart failure clinics in the Netherlands, addressed to 
      cardiologists and heart failure nurses working in the clinics. RESULTS: Of the 
      109 heart failure clinics who received a survey, 86 clinics responded (79%). In 
      total, 31 out of 86 (36%) heart failure clinics were using telemonitoring and 12 
      heart failure clinics (14%) planned to use telemonitoring within one year. The 
      number of heart failure patients receiving telemonitoring generally varied 
      between 10 and 50; although in two clinics more than 75 patients used 
      telemonitoring. The main goals for using telemonitoring are "monitoring physical 
      condition", "monitoring signs of deterioration" (n=39, 91%), "monitoring 
      treatment" (n=32, 74%), "adjusting medication" (n=24, 56%), and "educating 
      patients" (n=33, 77%). Most patients using telemonitoring were in the New York 
      Heart Association (NYHA) functional classes II (n=19, 61%) and III (n=27, 87%) 
      and were offered the use of the telemonitoring system "as long as needed" or 
      without a time limit. However, the expectations of the use of telemonitoring were 
      not met after implementation. Eight of the 11 items about expectations versus 
      experiences were significantly decreased (P<.001). Health care professionals 
      experienced the most changes related to the use of telemonitoring in their work, 
      in particular with respect to "keeping up with current development" (before 7.2, 
      after 6.8, P=.15), "being innovative" (before 7.0, after 6.1, P=.003), and 
      "better guideline adherence" (before 6.3, after 5.3, P=.005). Strikingly, 20 out 
      of 31 heart failure clinics stated that they were considering using a different 
      telemonitoring system than the system used at the time. CONCLUSIONS: One third of 
      all heart failure clinics surveyed were using telemonitoring as part of their 
      care without any transparent, predefined criteria of user requirements. Prior 
      expectations of telemonitoring were not reflected in actual experiences, possibly 
      leading to disappointment.
FAU - de Vries, Arjen E
AU  - de Vries AE
AD  - University Medical Center Groningen, Cardiology, Groningen, Netherlands. 
      a.e.de.vries@thorax.umcg.nl
FAU - van der Wal, Martje H L
AU  - van der Wal MH
FAU - Nieuwenhuis, Maurice M W
AU  - Nieuwenhuis MM
FAU - de Jong, Richard M
AU  - de Jong RM
FAU - van Dijk, Rene B
AU  - van Dijk RB
FAU - Jaarsma, Tiny
AU  - Jaarsma T
FAU - Hillege, Hans L
AU  - Hillege HL
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20130110
PL  - Canada
TA  - J Med Internet Res
JT  - Journal of medical Internet research
JID - 100959882
SB  - IM
MH  - Adult
MH  - Ambulatory Care Facilities
MH  - Female
MH  - Health Personnel
MH  - *Heart Failure/classification/physiopathology/therapy
MH  - Humans
MH  - *Internet
MH  - Male
MH  - Middle Aged
MH  - *Monitoring, Ambulatory
MH  - Netherlands
MH  - Surveys and Questionnaires
MH  - *Telemedicine
PMC - PMC3636294
COIS- Conflicts of Interest: RB van Dijk is partner of Curit B.V., a Dutch company 
      involved in the development of information and communication technology-guided 
      disease management systems and telemedicine. The other authors declared no 
      conflict of interest.
EDAT- 2013/01/12 06:00
MHDA- 2013/06/26 06:00
PMCR- 2013/01/10
CRDT- 2013/01/12 06:00
PHST- 2012/05/17 00:00 [received]
PHST- 2012/09/24 00:00 [accepted]
PHST- 2012/07/27 00:00 [revised]
PHST- 2013/01/12 06:00 [entrez]
PHST- 2013/01/12 06:00 [pubmed]
PHST- 2013/06/26 06:00 [medline]
PHST- 2013/01/10 00:00 [pmc-release]
AID - v15i1e4 [pii]
AID - 10.2196/jmir.2161 [doi]
PST - epublish
SO  - J Med Internet Res. 2013 Jan 10;15(1):e4. doi: 10.2196/jmir.2161.