How can we support primary care staff to use remote monitoring technology?

One of the most widely implemented examples of remote monitoring technology during the last year has been the use of pulse oximeters, which enabled home monitoring for people with COVID-19 and earlier detection and intervention for those who developed more serious complications.

Remote monitoring technology has fantastic potential to benefit both patients and staff, but with the increasing amount of tech available, it’s essential healthcare staff feel comfortable using it.

At UCLPartners we worked with Care City to conduct a survey of primary care staff to understand what could support them in using remote monitoring technology, with some interesting findings. Here, I’ll share the some of the learning from our work.

1. Be clear about what ‘Remote Monitoring Technology’ means

The survey revealedthere was a wide range of views about what remote monitoring technology meant to the workforce. This ranged from primary care digital platforms (e.g. eConsult, AccuRx, AirMid) to web resources and tools. This mixed understanding has implications for all training materials and how these are highlighted to staff.

2. Address barriers such as digital literacy, low confidence and data protection concerns

Participants felt remote monitoring technology could exacerbate health inequalities, as low digital literacy and low confidence were barriers to patients using the tech. At the opposite end of the scale people with good digital literacy were far more likely to report a positive experience in using digital technology. Questions were also raised about information governance and data protection as those with poor digital literacy had to rely on family and friends to use such technologies, forcing them to share information that they may not usually share. For respondents, some of the hesitance to take up remote monitoring tools and training opportunities related to the fact that they perceived many digital programmes to be transient and short-lived. Enthusiasm was often tempered by concerns that the effort of implementing new technologies, even with demonstrable success, is often not rewarded with longer-term funding or sustainable commissioning plans.

3. Consider investing in patient education as much as staff education

A key theme from the survey was that unless adequate technical support and resources were provided for patients alongside remote monitoring implementation this could create unsustainable work for primary care staff. Participants described low digital confidence in some patients often translates into increased demands on primary care staff. The additional help and support needed for patients to use the tools can be frustrating for staff who are already stretched.

4. Give staff time to undertake training and make it digestible

Participants frequently described the need to tailor training content, support and approaches for staff working in different roles. There was a divide, with clinical staff reporting being more pro remote digital technologies whilst operational staff reported the tech as harder to become accustomed to. Some participants noted that training sessions and learning opportunities aimed for staff are often held outside of working hours or within their lunch break. While they welcome the opportunity to learn, this expectation to attend outside of their contracted hours felt unfair and unsustainable. Blended learning models, bitesize learning with clear learning objectives and succinct learning summaries and quick view guides could all be beneficial. As would protected time for staff to dedicate to learning.

5. Invest in tech champions and support peer-to-peer learning

The final theme that emerged was on implementation science and coaching support. Participants reflected that when a member of staff wants to ‘champion’ digital tech, there is a need for coaching and support. It requires time and energy from adopters to drive a technology project forward to successful completion, this cannot be underestimated. There is a risk that initial enthusiasm and passion for the technology may be lost when the project encounters challenges and difficulties.

What next?

The insights gathered through this work are important in helping to inform how best to support the successful adoption of remote monitoring technology. Despite a small sample size, feedback was gathered from across four Integrated Care Systems, suggesting that similar needs are reflected nationwide. At a time when there is an increased focus on self-management it is vital that the primary care workforce are competent and confident to support patients with digital technology for remote monitoring.

More work is needed to build on this research and findings, but it’s clear that there is a need for workforce competency mapping as part of any digital technology rollout.

I’m excited to be working to support workforce development though the UCLPartners Proactive Care Frameworks. The frameworks were developed to restore routine care by prioritising patients at highest risk of deterioration, with pathways that mobilise the wider workforce and digital/tech, to optimise remote care and self-care, releasing clinician capacity and helping manage workload in practices. These valuable insights will be crucial to informing our future training development.

Read the full research report here

Footnote:

Insights were gathered through

• Digital survey using a mix of quantitative and qualitative questionnaires
• 2 semi-structured focus group interviews
• A series of one-to-one interviews

One of the key limitations of this research was that it has a relatively small sample size with a total of 28 primary care staff members taking part in the research.

This research targeted a national primary care workforce audience with participation from 4 Integrated Care Systems.

Participants comprised GP, Nurses, Clinical Pharmacists, Social Link Prescribers, Care Coordinators and Healthcare Assistants.