Towards A Framework for Implementing Remote Patient Monitoring From an Integrated Care Perspective: A Scoping Review

Document Type : Review Article

Authors

1 Centro de Estudos de Gestão do Instituto Superior Técnico (CEG-IST), Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal

2 Enterprise Services, Siemens Healthineers Portugal, Lisboa, Portugal

3 iBB - Institute for Bioengineering and Biosciences and i4HB - Associate Laboratory Institute for Health and Bioeconomy, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal

4 Instituto de Medicina Preventiva e Saúde Pública, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal

5 Comprehensive Health Research Center (CHRC), Universidade NOVA de Lisboa, Lisboa, Portugal

Abstract

Background 
Remote patient monitoring (RPM) has been increasingly adopted over the last decade, with the COVID-19 pandemic fostering its rapid development. As RPM implementation is recognised as complex and highly demanding in terms of resources and processes, there are multiple challenges in providing RPM in an integrated logic.

Methods 
To examine the structural elements that are relevant for implementing RPM integrated care, a scoping review was conducted in PubMed, Scopus, and Web of Science, leveraging a search strategy that combines terms relative to (1) conceptual models and real-life initiatives; (2) RPM; and (3) care integration.

Results 
28 articles were included, covering nine conceptual models and 19 real-life initiatives. Eighteen structural elements of RPM integrated care implementation were identified among conceptual models, defining a structure for assessing real-life initiatives. 78.9% of those initiatives referred to at least ten structural elements, with patient education and self-monitoring promotion, multidisciplinary core workforce, ICTs (information and communications technologies) and telemonitoring (TM) devices, and health indicators measurement being present in all studies, and therefore being core elements to the design of RPM initiatives.

Conclusion 
RPM goes far beyond technology, with underlying processes and involved actors playing a central role in care provision. The structural elements identified can guide RPM implementation and promote maturity in adoption. Future research may focus on assessing design completeness, evaluating impacts, and analysing related financial arrangements.

Keywords

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History

  • Receive Date: 31 March 2022
  • Revise Date: 22 October 2022
  • Accept Date: 28 January 2023
  • First Publish Date: 30 January 2023

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