Integrating telemedicine in routine heart failure management: Experiences of healthcare professionals - A qualitative study.

Abstract

Objective: To describe the experiences of healthcare professionals with integrating telemedicine in routine heart failure (HF) care.

Methods: Semi-structured interviews were conducted with healthcare professionals (n = 19) in the Netherlands who were involved in decision-making, implementation or routine use of telemedicine in HF management. Using purposive sampling, nurses, cardiologists and managers were selected to be interviewed. Interviews were performed in-person, recorded and transcribed verbatim. Interview data were analysed using a reflexive thematic analysis.

Results: This study identified four themes: (1) Responsibility - the lack of a clear delineation of roles and responsibilities among healthcare professionals, patients and suppliers in telemedicine. (2) Confidence and safety - telemedicine is seen by healthcare professionals as capable of enhancing safety, yet also introduces the risk of fostering a false sense of security among patients. (3) Collaboration - actively involving end-users in the development and implementation of telemedicine promotes the adoption. (4) Processes and mutual agreements - rather than replacing traditional care, telemedicine is perceived as an adjunct to it. Structured care pathways support telemedicine implementation, and personalised telemedicine can empower patients in self-care.

Conclusions: Telemedicine is a promising intervention in the management of HF. However, existing systems and care pathways have resulted in limited adoption. Improvements in the collaboration and establishing clear agreements on responsibilities between professional, patient and supplier can lead to more confidence in adopting telemedicine. Structured care pathways can be supportive. A personalised telemedicine approach can ensure that telemedicine remains manageable for patient and professional.