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Table 3 Themes and sub themes

From: Implementing telemonitoring in primary care: learning from a large qualitative dataset gathered during a series of studies

Theme

Associated sub themes

Using data

BP data

 • Measurement more trusted than surgery measurement

 • Patients and professionals confident to use as a basis for treatment change

Blood sugar data

 • Not used by all professionals, some waited for HbA1c

 • Useful when treatment change contemplated

 • Sharing data motivated patients – diet and medication

COPD data (O2 saturation, symptoms, FEV1)

 • Not discriminatory for severe exacerbation/ lots of false alarms

 • Complex, need to know the patient – can change fast

 • Overtreatment

 • Other symptoms

Patients use of data

 • Previously not told their readings.

 • Understanding their normal

 • Reduced dependency on readings

 • Data providing motivation

 • Sharing data motivated patients

 • Not willing to keep manual record of self monitoring

Empowering patients

 • Empowering patients

  ○ Use shared readings to actively negotiate care

  ○ Self management and reassurance

 • Confidence - patients/ families

  ○ Reassurance

  ○ Guardian angel/ access to care

 • Potential negative effects

  ○ Anxiety

  ○ Concern about dependency

 • Valuing convenience

Adjusting the model of care

 • Scaling up

 • Workloads:

  ○ Fitting telemonitoring into practice workflows

  ○ Increasing or decreasing workloads

 • Communication channels with patient and within the team

 • Letting go

 • ‘How does this affect my role?’

System design

 • Hardware

 • Reliability

 • Professional interface

 • Easy access via patient records

 • Easy two way communication

 • Feedback and decision support