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A Qualitative Study of Rural Primary Care Clinician Views on Remote Monitoring Technologies

Authors

  • Melinda M. Davis PhD,

    Corresponding author
    1. Oregon Rural Practice-based Research Network, Oregon Health & Science University, Portland, Oregon
    2. Department of Family Medicine, Oregon Health & Science University, Portland, Oregon
    • For further information, contact: Melinda M. Davis, PhD, 3181 SW Sam Jackson Park Road, Mail Code L222, Oregon Health & Science University, Portland, OR 97239; e-mail: davismel@ohsu.edu.

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  • Jillian M. Currey MPH,

    1. Oregon Rural Practice-based Research Network, Oregon Health & Science University, Portland, Oregon
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  • Sonya Howk MPA:HA,

    1. Oregon Rural Practice-based Research Network, Oregon Health & Science University, Portland, Oregon
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  • Molly R. DeSordi,

    1. Oregon Rural Practice-based Research Network, Oregon Health & Science University, Portland, Oregon
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  • Linda Boise PhD,

    1. Institute on Aging, School of Community Health, Portland State University, Portland, Oregon
    2. Layton Aging & Alzheimer's Disease Center, Oregon Health & Science University, Portland, Oregon
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  • Lyle J. Fagnan MD,

    1. Oregon Rural Practice-based Research Network, Oregon Health & Science University, Portland, Oregon
    2. Department of Family Medicine, Oregon Health & Science University, Portland, Oregon
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  • Nancy Vuckovic PhD

    1. Intel Corporation, Hillsboro, Oregon
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  • Funding: Funding for this project is provided by the Oregon Roybal Center for Translational Research on Aging (P30AG024978) at Oregon Health & Science University (OHSU), Portland, Oregon, and by a Clinical and Translational Science Award to OHSU (National Institute of Health/National Center for Research Resources Grant No. 1 UL1 RR024140 01). The authors report no conflicts of interest.

  • Acknowledgments: We thank the rural clinicians who participated in this research and the clinic staff who made it possible. We appreciate the input of Drs. Kaye and Eckstrom on study development. Nicole Larimer, Tracy Zitzelberger, and the Oregon Center for Aging and Technology (ORCATECH) provided training on emerging remote monitoring technologies (RMTs). Deborah Cohen, PhD provided assistance with study methods and manuscript revisions. The authors also gratefully acknowledge the editing and publication assistance from Ms. LeNeva Spires.

Abstract

Purpose

Remote monitoring technologies (RMTs) may improve the quality of care, reduce access barriers, and help control medical costs. Despite the role of primary care clinicians as potential key users of RMTs, few studies explore their views. This study explores rural primary care clinician interest and the resources necessary to incorporate RMTs into routine practice.

Methods

We conducted 15 in-depth interviews with rural primary care clinician members of the Oregon Rural Practice-based Research Network (ORPRN) from November 2011 to April 2012. Our multidisciplinary team used thematic analysis to identify emergent themes and a cross-case comparative analysis to explore variation by participant and practice characteristics.

Results

Clinicians expressed interest in RMTs most relevant to their clinical practice, such as supporting chronic disease management, noting benefits to patients of all ages. They expressed concern about the quantity of data, patient motivation to utilize equipment, and potential changes to the patient-clinician encounter. Direct data transfer into the clinic's electronic health record (EHR), availability in multiple formats, and review by ancillary staff could facilitate implementation. Although participants acknowledged the potential system-level benefits of using RMTs, adoption would be difficult without payment reform.

Conclusions

Adoption of RMTs by rural primary care clinicians may be influenced by equipment purpose and functionality, implementation resources, and payment. Clinician and staff engagement will be critical to actualize RMT use in routine primary care.

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