Seto Emily, Leonard Kevin J, Masino Caterina, Cafazzo Joseph A, Barnsley Jan, Ross Heather J
Centre for Global eHealth Innovation, University Health Network, Toronto, ON, Canada.
J Med Internet Res. 2010 Nov 29;12(4):e55. doi: 10.2196/jmir.1627.
Mobile phone-based remote patient monitoring systems have been proposed for heart failure management because they are relatively inexpensive and enable patients to be monitored anywhere. However, little is known about whether patients and their health care providers are willing and able to use this technology.
The objective of our study was to assess the attitudes of heart failure patients and their health care providers from a heart function clinic in a large urban teaching hospital toward the use of mobile phone-based remote monitoring.
A questionnaire regarding attitudes toward home monitoring and technology was administered to 100 heart failure patients (94/100 returned a completed questionnaire). Semi-structured interviews were also conducted with 20 heart failure patients and 16 clinicians to determine the perceived benefits and barriers to using mobile phone-based remote monitoring, as well as their willingness and ability to use the technology.
The survey results indicated that the patients were very comfortable using mobile phones (mean rating 4.5, SD 0.6, on a five-point Likert scale), even more so than with using computers (mean 4.1, SD 1.1). The difference in comfort level between mobile phones and computers was statistically significant (P< .001). Patients were also confident in using mobile phones to view health information (mean 4.4, SD 0.9). Patients and clinicians were willing to use the system as long as several conditions were met, including providing a system that was easy to use with clear tangible benefits, maintaining good patient-provider communication, and not increasing clinical workload. Clinicians cited several barriers to implementation of such a system, including lack of remuneration for telephone interactions with patients and medicolegal implications.
Patients and clinicians want to use mobile phone-based remote monitoring and believe that they would be able to use the technology. However, they have several reservations, such as potential increased clinical workload, medicolegal issues, and difficulty of use for some patients due to lack of visual acuity or manual dexterity.
基于手机的远程患者监测系统已被提议用于心力衰竭管理，因为它们相对便宜，并且能够在任何地点对患者进行监测。然而，对于患者及其医疗服务提供者是否愿意且能够使用这项技术，人们知之甚少。
我们研究的目的是评估一家大型城市教学医院心脏功能诊所的心力衰竭患者及其医疗服务提供者对使用基于手机的远程监测的态度。
向100名心力衰竭患者发放了一份关于对家庭监测和技术态度的问卷（100份问卷中有94份返回了完整问卷）。还对20名心力衰竭患者和16名临床医生进行了半结构化访谈，以确定使用基于手机的远程监测的感知益处和障碍，以及他们使用该技术的意愿和能力。
调查结果表明，患者对使用手机非常得心应手（在五点李克特量表上的平均评分为4.5，标准差为0.6），甚至比使用电脑更得心应手（平均分为4.1，标准差为1.1）。手机和电脑在舒适程度上存在显著差异（P <.001）。患者对使用手机查看健康信息也很有信心（平均分为4.4，标准差为0.9）。只要满足几个条件，患者和临床医生就愿意使用该系统，这些条件包括提供一个易于使用且有明显实际益处的系统、保持良好的医患沟通以及不增加临床工作量。临床医生列举了实施这样一个系统的几个障碍，包括与患者进行电话沟通缺乏报酬以及存在法医学问题。
患者和临床医生希望使用基于手机的远程监测，并认为他们能够使用这项技术。然而，他们有一些保留意见，例如可能增加临床工作量、法医学问题以及一些患者由于视力或手部灵活性问题而使用困难。
