Table 3.

Patient and Provider Perceptions of Chronic Disease Remote Monitoring

Thematic DomainPatientaPrimary Care Provider
Behavioral intentionIf they don’t want that accountability and they’re really not ready to do anything, then they’re just going to say, “I’m not going to do that.” But there's some that are excited about it and so they get more engaged.
Perceived behavioral control (subdomain facilitating conditions)Half the people I’ve put on the hypertension or digital medicine stuff, at least 25% refused because of lack of access to internet. [The readings] won’t upload to Epic until they get connected to Wi-Fi…I think that's part of it. If they are on a plan with limited amount of data or something like that…those charges still apply. That's not free.
Perceived behavioral control (subdomain self-efficacy)Nonuser: My husband would really need something like that. Every time he goes to the doctor, his pressure is high. But once again, we’re in our 60s, and those computer things….Some of them get gifted smartphones…but I would say even within that, there's not that decision. Like, I’m not going to log in to take my blood pressure, because I don’t want [to]. It's like, I don’t know how, and I don’t have people around me that value that, and so it's more of, like, I can’t do it.
Perceived ease of useUser: It beats taking it and writing it down and putting in a log. And then they’ll add to a sheet on MyChart so they can read it.The hypertension is way easier. It's just a blood pressure check; it uploads. Once you get through that first technology difficulty, get them the cuff, it seems like they can do it better. The touchpoints are less, even though I have a lot of disenrollment because they’re just like, “I can’t deal with the people calling me.” But the diabetes one is, like, orders of magnitude more….
Perceived usefulnessUser: I take my blood pressure, pulse, blood sugar, temperature, and O2 sat, and I put them all into the app and it directly links to her along with the MyChart. And then if I have an abnormal blood pressure, they’ll send me a text asking me to retake it after 15 minutes and I retake it and it goes back to them. And I can put notes in about why I think my blood pressure was high or, you know, I hadn’t taken my medicine yet.I have some that have been loyal users. I think the ones that tend to be a little bit more anxious about it and not really as comfortable with taking their blood pressure at home on their own like the touch points. Some people prefer to have someone checking on them if their blood pressure is up or if their sugar goes up or down.
  • aUser indicates that the patient uses digital technology, defined as patient portal, chronic disease remote monitoring, and/or telemedicine.

  • app, application; O2 sat, oxygen saturation.