title: A systematic review of clinician and staff views on the acceptability of incorporating remote monitoring technology into primary care.
abstract: OBJECTIVE
  Remote monitoring technology (RMT) may enhance healthcare quality and reduce costs. RMT adoption depends on perceptions of the end-user (e.g., patients, caregivers, healthcare providers). We conducted a systematic review exploring the acceptability and feasibility of RMT use in routine adult patient care, from the perspectives of primary care clinicians, administrators, and clinic staff.
  
  
  METHODS
  We searched the databases of Medline, IEEE Xplore, and Compendex for original articles published from January 1996 through February 2013. We manually screened bibliographies of pertinent studies and consulted experts to identify English-language studies meeting our inclusion criteria.
  
  
  RESULTS
  Of 939 citations identified, 15 studies reported in 16 publications met inclusion criteria. Studies were heterogeneous by country, type of RMT used, patient and provider characteristics, and method of implementation and evaluation. Clinicians, staff, and administrators generally held positive views about RMTs. Concerns emerged regarding clinical relevance of RMT data, changing clinical roles and patterns of care (e.g., reduced quality of care from fewer patient visits, overtreatment), insufficient staffing or time to monitor and discuss RMT data, data incompatibility with a clinic's electronic health record (EHR), and unclear legal liability regarding response protocols.
  
  
  CONCLUSIONS
  This small body of heterogeneous literature suggests that for RMTs to be adopted in primary care, researchers and developers must ensure clinical relevance, support adequate infrastructure, streamline data transmission into EHR systems, attend to changing care patterns and professional roles, and clarify response protocols. There is a critical need to engage end-users in the development and implementation of RMT.
authors.affiliation: 1 Oregon Rural Practice-Based Research Network, Oregon Health & Science University , Portland, Oregon.
authors.forename: Melinda M
authors.initials: MM
authors.lastname: Davis
authors.forename: Michele
authors.initials: M
authors.lastname: Freeman
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Kaye
authors.forename: Nancy
authors.initials: N
authors.lastname: Vuckovic
authors.forename: David I
authors.initials: DI
authors.lastname: Buckley
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D017046:Cost Savings; D057286:Electronic Health Records / Q000706:statistics & numerical data; D005260:Female; D006282:Health Personnel / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000458:organization & administration; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000191:economics / Q000379:methods*; D010818:Practice Patterns, Physicians' / Q000458:organization & administration; D011320:Primary Health Care / Q000458:organization & administration*; D011787:Quality of Health Care; D019114:Remote Consultation / Q000191:economics / Q000379:methods*; D019035:Rural Health Services / Q000458:organization & administration; D017216:Telemedicine / Q000191:economics / Q000379:methods; D014481:United States
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