Zelis Noortje, Westerman Dewa, Schevers Anouk, V Eldik Nicole, Stassen Patricia M
Department of Internal Medicine, Division General Medicine, Section Acute Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.
Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands.
PLOS Digit Health. 2025 Jul 31;4(7):e0000962. doi: 10.1371/journal.pdig.0000962. eCollection 2025 Jul.
Telemonitoring at home may be used to reduce acute hospital admissions via the emergency department (ED), but experience in this setting is scarce. We performed a pilot study to investigate the perspectives and experiences of ED patients and care professionals with telemonitoring, started in the ED and used as potential an alternative to acute hospital admission. In this prospective pilot study, we asked medical ED patients for their perspectives on home monitoring. Suitability for homemonitoring was assessed by ED patients and care professionals. In a subset of patients, we started and evaluated telemonitoring. In total, 98 patients answered a questionnaire. The facilitators for telemonitoring as an alternative to hospital admission were: guaranteed admission if necessary (indicated by 96.9% of patients), possibility to contact the treatment team 24/7 (by 90.8%), and presence of someone to watch over the patient (by 72.4%). Main barriers for telemonitoring as an alternative care form were: need for treatment that could not be provided at home, feeling too severely ill, and judging it unsafe to return home. In total, 11.2% of ED patients indicated that hospital admission could be avoided using telemonitoring, while another 6.1% thought this might be possible. Professionals judged fewer patients capable of being sent home with telemonitoring (physicians: 7.2% and 6.1%, resp.; nurses: 10.4% and 4.2%, resp.). Agreement on the capability of patients to be sent home with telemonitoring between patients and professionals was slight-fair. All telemonitored patients were satisfied with the ease of use and comfort of the system, which gave most patients reassurance and was considered an alternative to admission. In conclusion, telemonitoring at home was seen as an alternative to admission in a substantial proportion of medical ED patients. Facilitators for telemonitoring indicated by patients were guaranteed admission if telemonitoring failed and the possibility to contact the treatment team 24/7, while indicated barriers were related to disease severity and lack of someone to watch over the patient. Telemonitoring in acute care may serve as a potential alternative to admissions if facilitators are met.
家庭远程监测可用于减少通过急诊科（ED）的急性住院人数，但在这种情况下的经验很少。我们进行了一项试点研究，以调查急诊科患者和护理专业人员对远程监测的看法和体验，该监测始于急诊科，并用作急性住院的潜在替代方案。在这项前瞻性试点研究中，我们询问了急诊科患者对家庭监测的看法。急诊科患者和护理专业人员评估了家庭监测的适用性。在一部分患者中，我们启动并评估了远程监测。共有98名患者回答了问卷。将远程监测作为住院替代方案的促进因素包括：必要时保证入院（96.9%的患者表示）、全天候联系治疗团队的可能性（90.8%）以及有人照看患者（72.4%）。将远程监测作为替代护理形式的主要障碍包括：需要在家中无法提供的治疗、感觉病情太重以及认为回家不安全。共有11.2%的急诊科患者表示使用远程监测可以避免住院，另有6.1%的患者认为这有可能。专业人员认为能够通过远程监测送回家的患者较少（医生分别为7.2%和6.1%；护士分别为10.4%和4.2%）。患者和专业人员之间关于通过远程监测送患者回家能力的一致性为一般。所有接受远程监测的患者对系统的易用性和舒适度都很满意，这让大多数患者感到安心，并被视为住院的替代方案。总之，在相当一部分急诊科医疗患者中，家庭远程监测被视为住院的替代方案。患者指出的远程监测促进因素是如果远程监测失败保证入院以及全天候联系治疗团队的可能性，而指出的障碍与疾病严重程度和缺乏照看患者的人有关。如果满足促进因素，急性护理中的远程监测可能作为住院的潜在替代方案。
