Abstract
Background Remote Patient Monitoring Systems (RPMS) based on e-health, Nurse Navigators (NNs) and patient engagement can improve patient follow-up and have a positive impact on quality of care (by limiting adverse events) and costs (by reducing readmissions). However, the extent of this impact depends on effective implementation which is often restricted. This is partly due to the lack of attention paid to the RPMS design phase prior to implementation. The content of the RPMS can be carefully designed at this stage and various obstacles anticipated. Our aim was to report on an RPMS process design to provide an insight into the methodology required in order to manage this phase and the ultimate outcome in terms of RPMS content. Methods This study was carried out at Gustave Roussy, a comprehensive cancer centre in France. A multidisciplinary team comprising hospital managers, healthcare professionals and health service researchers coordinated the CAPRI RPMS design process (2013-2015). It is based on data collected during eight studies conducted in accordance with the principle framework of the UK Medical Research Council (MRC). This project was approved by the French National Data Protection Authorities. Results Based on the study results, the multidisciplinary team defined strategies for resolving obstacles and risks prior to the implementation of CAPRI. Consequently, the final CAPRI design includes a web app with two interfaces (patient and health care professionals) and two NNs. The NNs provide regular follow-up via telephone and/or email to manage patients' symptoms and toxicity, treatment compliance and care packages. Patients contact the NNs via a secure messaging system. Eighty graduation and orientation algorithms enable NNs to prioritise and decide on the course of action to be taken. Conclusion In our experience, the RPMS design process and, more generally, that of any complex intervention programme, is an important phase that requires a sound methodological basis. This study also suggests that an RPMS is more than a technological innovation. Indeed, it is an organisational innovation, the merits of which will depend on the precise definition given to the action taken by NNs and other healthcare professionals as well as patients throughout their interactions.
How to Design a Remote Patient Monitoring System A French Case Study
