Patients' and healthcare professionals' experiences regarding patient safety when using telemonitoring of chronic diseases at home

Introduction: Chronic diseases and multi-morbidity are increasing worldwide and the complexity of disease management is putting new demands on safe and secure healthcare. eHealth technology such as telemonitoring (TM) for people with chronic diseases living at home can provide opportunities to improve self-care management through the support of healthcare professionals (HCPs). However, when using TM, patients and HCPs need to feel safe in handling the technology. Since the implementation of TM increases rapidly into healthcare settings, we need to better understand whether and how TM usage affects the experience of safety among patients and HCPs. Aim and Method: To provide a deeper understanding of patients' and HCPs' experiences regarding patient safety when using telemonitoring of chronic diseases at home. The study had a descriptive design with a qualitative approach. Between March and May 2020, semi-structured interviews were conducted with 20 patients and 9 HCPs (nurses and physicians) working in a region in southern Sweden. Inductive content analysis guided by Graneheim and Lundman was used to analyse the interview text in Nvivo. Highlights: Our findings show that TM increased the feeling of shared responsibility and engaged both patients and HCPs. TM can increase the safety awareness of both patients and HCPs and enable them to create care together when monitoring the patients' disease from home. The regular measurements and close contact with HCPs increased the sense of availability to healthcare and enhanced for patients to understand their own health values, provided with insights into their own health and increased engagement in self-care. However, if the telehealth devices were used incorrectly, patient safety risks could emerge. Low health and/or digital literacy may jeopardize the benefits of TM. If the patients do not understand their own health values, they may not understand when to act if their values are deteriorating. Conclusions: This study suggests that TM has potential to enhance patient safety at home through patient's activation in own health and interaction with engaged HCP. It is important to focus on the patients' individual needs, preconditions, and health status to avoid risks and to use the full potential of the service. Implications for applicability/transferability, sustainability, and limitations: The key strength is that both HCPs and patients were involved, enabling several divergent perspectives to be included. One limitation is that the HCPs chose which patients to include, which might have biased the recruitment and limited transferability to groups with lower digital literacy than the included patients