NIVEL Netherlands Institute for Health Services Research, Utrecht, Netherlands.
Department of Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands.
J Med Internet Res. 2021 May 3;23(5):e24908. doi: 10.2196/24908.
Telemonitoring could offer solutions to the mounting challenges for health care and could improve patient self-management. Studies have addressed the benefits and challenges of telemonitoring for certain patient groups.
This paper will examine the nationwide uptake of telemonitoring in chronic care in the Netherlands from 2014 to 2019 by means of an annual representative survey among patients and health care professionals.
Between 2014 and 2019, approximately 2900 patients with chronic diseases, 700 nurses, and 500 general practitioners (GPs) and medical specialists received a questionnaire. About 30 questions addressed topics about the use of eHealth and experiences with it, including data about telemonitoring.
Between 2014 and 2019, the use of telemonitoring remained stable for all groups except medical specialists. In medical specialist departments, the use of telemonitoring increased from 11.2% (18/161) in 2014 to 19.6% (36/184) in 2019 (χ=12.3; P=.02). In 2019, telemonitoring was used by 5.8% (28/485) of people with chronic disease. This was 18.2% (41/225) in GP organizations and 40.4% (44/109), 38.0% (78/205), and 8.9% (29/325) in the organizations of nurses working in primary, secondary, and elderly care, respectively. Up to 10% of the targeted patient group such as diabetics were regarded by health care professionals as suitable for using telemonitoring. The main benefits mentioned by the patients were "comfort" (421/1043, 40.4%) and "living at home for longer/more comfortably" (334/1047, 31.9%). Health care professionals added "improvement of self-management" (63/176, 35.8% to 57/71, 80.3%), "better understanding of the patient's condition" (47/176, 26.7% to 42/71, 59.2%), "reduction of workload" (53/134, 39.6% of nurses in elderly care), "better tailoring of care plan to the patient's situation" (95/225, 42.2% of GPs), and "saves time for patients/caregivers" (61/176, 34.7% of medical specialists). Disadvantages mentioned by professionals were that "it takes time to monitor data" (13/130, 10% to 108/225, 48.0%), "it takes time to follow up alerts" (15/130, 11.5% to 117/225, 52.0%), and "it is difficult to estimate which patients can work with telemonitoring" (22/113, 19.5% to 94/225, 41.8%).
The uptake of telemonitoring in Dutch chronic care remained stable during 2014-2019 but increased among medical specialists. According to both patients and professionals, telemonitoring improves the quality of life and quality of care. Skills for suitably including eligible patients and for allocating the tasks of data monitoring and follow-up care within the team would help to further increase the use of telemonitoring.
远程监测可以为医疗保健带来解决方案，并可以改善患者的自我管理。已有研究探讨了远程监测对某些患者群体的益处和挑战。
本文通过对荷兰慢性护理中 2014 年至 2019 年期间患者和医疗保健专业人员的年度代表性调查，研究全国范围内远程监测的采用情况。
在 2014 年至 2019 年期间，大约 2900 名患有慢性疾病的患者、700 名护士以及 500 名全科医生（GP）和医学专家接受了问卷调查。大约 30 个问题涉及电子健康使用情况和经验，包括有关远程监测的数据。
除医学专家外，所有群体的远程监测使用情况在 2014 年至 2019 年期间保持稳定。在医学专家科室中，远程监测的使用从 2014 年的 11.2%（18/161）增加到 2019 年的 19.6%（36/184）（χ=12.3；P=.02）。在 2019 年，有 5.8%（28/485）的慢性疾病患者使用远程监测。这一比例在 GP 组织中为 18.2%（41/225），在初级、二级和老年护理护士组织中分别为 40.4%（44/109）、38.0%（78/205）和 8.9%（29/325）。高达 10%的目标患者群体，如糖尿病患者，被医疗保健专业人员认为适合使用远程监测。患者提到的主要好处是“舒适”（421/1043，40.4%）和“在家中更舒适地生活更长时间”（334/1047，31.9%）。医疗保健专业人员补充说，“改善自我管理”（63/176，35.8%至 57/71，80.3%）、“更好地了解患者的病情”（47/176，26.7%至 42/71，59.2%）、“减轻工作量”（53/134，老年护理护士的 39.6%）、“更好地根据患者的情况定制护理计划”（95/225，GP 的 42.2%）和“为患者/护理人员节省时间”（61/176，医学专家的 34.7%）。专业人员提到的缺点是“监测数据需要时间”（13/130，10%至 108/225，48.0%）、“跟进警报需要时间”（15/130，11.5%至 117/225，52.0%）和“难以估计哪些患者可以使用远程监测”（22/113，19.5%至 94/225，41.8%）。
2014 年至 2019 年期间，荷兰慢性护理中的远程监测采用率保持稳定，但在医学专家中有所增加。根据患者和专业人员的说法，远程监测可以提高生活质量和护理质量。具备适当纳入合格患者的技能，并在团队内分配数据监测和随访护理任务的技能，将有助于进一步增加远程监测的使用。
