“I felt that I had some people who cared about me.” The impact of real-time remote patient monitoring on clinical practice: experiences of patients and clinicians participating in the eSMART study


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Lisa McCann1,Liane Lewis1,Olubukola Oduntan1,Morven Miller1,Grigorios Kotronoulas2,Eileen Furlong3,Patricia Fox3,Andrew Darley3,Alison Buick3,Aidrian Flowerday4,Emma Ream5,Jo Armes5,Elizabeth Patiraki6,Stylianos Katsaragakis6,Alexander Gaiger7,Geir Berg8,Paul McCrone9,Christine Miaskowski10,Peter Donnan11,Roma Maguire1
1University of Strathclyde,2University of Glasgow,3University College Dublin,4Docobo,5University of Surrey,6University of Athens,7Medical University Vienna,8Sykehuset-Innlandet Hospital Trust,9King's College London,10University of california,11University of Dundee

Abstract

Background

The eSMART study concluded in July 2019; it is one of the largest digital health and supportive care projects of its kind. A 5-year RCT recruited over 800 patients diagnosed with breast, colorectal or haematological cancers from n=12 clinical sites over n=5 countries (Austria, Greece, Ireland, Norway and the UK). Patients allocated to the intervention group used a real-time remote monitoring system called ASyMS to monitor and manage their chemotherapy-related symptoms during treatment and clinically driven algorithms alerted clinicians at their hospital of problematic symptoms. To understand the impact of using this technology and model of care on clinical practice, a series of interviews were completed across partner countries after sustained exposure to the intervention.

Method

Semi-structured 1-1 interviews with n=29 patients and n=18 clinicians from the 5 partner countries. Interviews were conducted in native language, transcribed and translated into English prior to analysis. A thematic analysis approach was adopted on the patient and clinician data sets prior to synthesis to develop insights and understandings of the impact of ASyMS on clinical practice.

Results

A main orienting theme, ‘ASyMS as a facilitator for change’ illustrated the positive impact of ASyMS on clinical practice across the partner countries. This orienting theme was supported by a number of sub-themes including reassurance, enhanced communication and relationships, normalising symptom experiences and developments to facilitate future deployment. There were commonalities in these themes across patients, clinicians and countries, although some specific in-country nuances were observed.

Conclusion

This large data set demonstrated that patients and clinicians were very responsive to the use of the ASyMS remote patient monitoring system deployed in chemotherapy care services across a range of countries and health service contexts. Understanding the experiences of people who have used this system is crucial to facilitate its successful future routine deployment, scalability and adoption.