Appl Clin Inform - Contributors to frequent telehealth alerts including false alerts for patients with heart failure: a mixed methods exploration.

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Resumo

CKGROUND: Telehealth data overload through high alert generation is a significant barrier to sustained adoption of telehealth for managing HF patients.OBJECTIVE: To explore the factors contributing to frequent telehealth alerts including false alerts for Medicare heart failure (HF) patients admitted to a home health agency.MATERIALS AND METHODS: A mixed methods design that combined quantitative correlation analysis of patient characteristic data with number of telehealth alerts and qualitative analysis of telehealth and visiting nurses' notes on follow-up actions to patients' telehealth alerts was employed. All the quantitative and qualitative data was collected through retrospective review of electronic records of the home heath agency.RESULTS: Subjects in the study had a mean age of 83 (SD = 7.6); 56% were female. Patient co-morbidities (p<0.05) of renal disorders, anxiety, and cardiac arrhythmias emerged as predictors of telehealth alerts through quantitative analysis (n = 168) using multiple regression. Inappropriate telehealth measurement technique by patients (54%) and home healthcare system inefficiencies (37%) contributed to most telehealth false alerts in the purposive qualitative sub-sample (n = 35) of patients with high telehealth alerts.CONCLUSION: Encouraging patient engagement with the telehealth process, fostering a collaborative approach among all the clinicians involved with the telehealth intervention, tailoring telehealth alert thresholds to patient characteristics along with establishing patient-centered telehealth outcome goals may allow meaningful generation of telehealth alerts. Reducing avoidable telehealth alerts could vastly improve the efficiency and sustainability of telehealth programs for HF management.

Resumo Limpo

ckground telehealth data overload high alert generat signific barrier sustain adopt telehealth manag hf patientsobject explor factor contribut frequent telehealth alert includ fals alert medicar heart failur hf patient admit home health agencymateri method mix method design combin quantit correl analysi patient characterist data number telehealth alert qualit analysi telehealth visit nurs note followup action patient telehealth alert employ quantit qualit data collect retrospect review electron record home heath agencyresult subject studi mean age sd femal patient comorbid p renal disord anxieti cardiac arrhythmia emerg predictor telehealth alert quantit analysi n use multipl regress inappropri telehealth measur techniqu patient home healthcar system ineffici contribut telehealth fals alert purpos qualit subsampl n patient high telehealth alertsconclus encourag patient engag telehealth process foster collabor approach among clinician involv telehealth intervent tailor telehealth alert threshold patient characterist along establish patientcent telehealth outcom goal may allow meaning generat telehealth alert reduc avoid telehealth alert vast improv effici sustain telehealth program hf manag

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