Int J Med Inform - Bridging two translation gaps: a new informatics research agenda for telemonitoring of chronic disease.

Tópicos

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Resumo

JECTIVE: To propose a research agenda that addresses technological and other knowledge gaps in developing telemonitoring solutions for patients with chronic diseases, with particular focus on detecting deterioration early enough to intervene effectively.DESIGN: A mixed methods approach incorporating literature review, key informant, and focus group interviews to gain an in-depth, multidisciplinary understanding of current approaches, and a roadmapping process to synthesise a research agenda.RESULTS: Counter to intuition, the research agenda for early detection of deterioration in patients with chronic diseases is not only primarily about advances in sensor technology but also much more about the problems of clinical specification, translation, and interfacing. The ultimate aim of telemonitoring is not fully agreed between the actors (patients, clinicians, technologists, and service providers). This leads to unresolved issues such as: (1) How are sensors used by patients as part of daily routines? (2) What are the indicators of early deterioration and how might they be used to trigger alerts? (3) How should alerts lead to appropriate levels of responses across different agencies and sectors?CONCLUSION: Attempts to use telemonitoring to improve the care of patients with chronic diseases over the last two decades have so far failed to lead to systems that are embedded in routine clinical practice. Attempts at implementation have paid insufficient attention to understanding patient and clinical needs and the complex dynamics and accountabilities that arise at the level of service models. A suggested way ahead is to co-design technology and services collaboratively with all stakeholders.

Resumo Limpo

jectiv propos research agenda address technolog knowledg gap develop telemonitor solut patient chronic diseas particular focus detect deterior earli enough interven effectivelydesign mix method approach incorpor literatur review key inform focus group interview gain indepth multidisciplinari understand current approach roadmap process synthesis research agendaresult counter intuit research agenda earli detect deterior patient chronic diseas primarili advanc sensor technolog also much problem clinic specif translat interfac ultim aim telemonitor fulli agre actor patient clinician technologist servic provid lead unresolv issu sensor use patient part daili routin indic earli deterior might use trigger alert alert lead appropri level respons across differ agenc sectorsconclus attempt use telemonitor improv care patient chronic diseas last two decad far fail lead system embed routin clinic practic attempt implement paid insuffici attent understand patient clinic need complex dynam account aris level servic model suggest way ahead codesign technolog servic collabor stakehold

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