Uptake and Scalability of a Peritoneal Dialysis Virtual Care Solution: Qualitative Study.

chronic kidney disease patient-centric care peritoneal dialysis qualitative research virtual care solutions

Journal

JMIR human factors
ISSN: 2292-9495
Titre abrégé: JMIR Hum Factors
Pays: Canada
ID NLM: 101666561

Informations de publication

Date de publication:
16 Apr 2019
Historique:
received: 27 12 2017
accepted: 06 01 2019
revised: 29 11 2018
entrez: 17 4 2019
pubmed: 17 4 2019
medline: 17 4 2019
Statut: epublish

Résumé

Early research in the area of virtual care solutions with peritoneal dialysis (PD) patients has focused on evaluating the outcomes and impact of these solutions. There has been less attention focused on understanding the factors influencing the uptake, usability, and scalability of virtual care for chronic kidney disease (CKD) patients receiving PD at home. In this context, a study was undertaken to (1) assess and understand the factors influencing the uptake of a virtual care solution and (2) provide recommendations for the scalability of a virtual care solution aimed at enhancing CKD patients' outcomes and experiences. This study used a qualitative design with semistructured interviews and a thematic analysis approach. A total of 25 stakeholders-6 patients and 3 caregivers, 6 health care providers, 2 vendors, and 8 health system decision makers-participated in this study. The following three primary mechanisms emerged to influence the usability of the virtual care solution: (1) receiving hands-on training and ongoing communication from a supportive team, (2) adapting to meet user needs and embedding them into workflow, and (3) being influenced by patient and caregiver characteristics. Further, two overarching recommendations were developed for considerations around scalability: (1) co-design locally, embed into the daily workflow, and deploy over time and (2) share the benefits and build the case. Study findings can be used by key stakeholders in their future efforts to enhance the implementation, uptake, and scalability of virtual care solutions for CKD and managing PD at home.

Sections du résumé

BACKGROUND BACKGROUND
Early research in the area of virtual care solutions with peritoneal dialysis (PD) patients has focused on evaluating the outcomes and impact of these solutions. There has been less attention focused on understanding the factors influencing the uptake, usability, and scalability of virtual care for chronic kidney disease (CKD) patients receiving PD at home.
OBJECTIVE OBJECTIVE
In this context, a study was undertaken to (1) assess and understand the factors influencing the uptake of a virtual care solution and (2) provide recommendations for the scalability of a virtual care solution aimed at enhancing CKD patients' outcomes and experiences.
METHODS METHODS
This study used a qualitative design with semistructured interviews and a thematic analysis approach. A total of 25 stakeholders-6 patients and 3 caregivers, 6 health care providers, 2 vendors, and 8 health system decision makers-participated in this study.
RESULTS RESULTS
The following three primary mechanisms emerged to influence the usability of the virtual care solution: (1) receiving hands-on training and ongoing communication from a supportive team, (2) adapting to meet user needs and embedding them into workflow, and (3) being influenced by patient and caregiver characteristics. Further, two overarching recommendations were developed for considerations around scalability: (1) co-design locally, embed into the daily workflow, and deploy over time and (2) share the benefits and build the case.
CONCLUSIONS CONCLUSIONS
Study findings can be used by key stakeholders in their future efforts to enhance the implementation, uptake, and scalability of virtual care solutions for CKD and managing PD at home.

Identifiants

pubmed: 30990460
pii: v6i2e9720
doi: 10.2196/humanfactors.9720
pmc: PMC6488957
doi:

Types de publication

Journal Article

Langues

eng

Pagination

e9720

Informations de copyright

©Lianne Jeffs, Trevor Jamieson, Marianne Saragosa, Geetha Mukerji, Arsh K Jain, Rachel Man, Laura Desveaux, James Shaw, Payal Agarwal, Jennifer M Hensel, Maria Maione, Nike Onabajo, Megan Nguyen, R Bhatia. Originally published in JMIR Human Factors (http://humanfactors.jmir.org), 16.04.2019.

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Auteurs

Lianne Jeffs (L)

Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada.
Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada.

Trevor Jamieson (T)

St. Michael's Hospital, Toronto, ON, Canada.
Institute for Health System Solutions and Virtual Care, Women's College Hospital, Toronto, ON, Canada.

Marianne Saragosa (M)

Institute for Health System Solutions and Virtual Care, Women's College Hospital, Toronto, ON, Canada.

Geetha Mukerji (G)

Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada.
Institute for Health System Solutions and Virtual Care, Women's College Hospital, Toronto, ON, Canada.

Arsh K Jain (AK)

London Health Sciences Centre, London, ON, Canada.

Rachel Man (R)

London Health Sciences Centre, London, ON, Canada.

Laura Desveaux (L)

Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada.
Institute for Health System Solutions and Virtual Care, Women's College Hospital, Toronto, ON, Canada.

James Shaw (J)

Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada.
Institute for Health System Solutions and Virtual Care, Women's College Hospital, Toronto, ON, Canada.

Payal Agarwal (P)

Institute for Health System Solutions and Virtual Care, Women's College Hospital, Toronto, ON, Canada.
Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.

Jennifer M Hensel (JM)

Institute for Health System Solutions and Virtual Care, Women's College Hospital, Toronto, ON, Canada.

Maria Maione (M)

St. Michael's Hospital, Toronto ON, ON, Canada.

Nike Onabajo (N)

Institute for Health System Solutions and Virtual Care, Women's College Hospital, Toronto, ON, Canada.

Megan Nguyen (M)

Institute for Health System Solutions and Virtual Care, Women's College Hospital, Toronto, ON, Canada.

R Bhatia (R)

Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada.
Institute for Health System Solutions and Virtual Care, Women's College Hospital, Toronto, ON, Canada.

Classifications MeSH