Table 1. Elements of RPM Integrated Care Implementation That Emerged From the Analysis of the Conceptual Model Studies .
| SELFIE Framework’s Components | Elements of Integrated Care Implementation of RPM | Code | Good Practices and/or Recommendations From Studies |
| Individual & environment | Collaborative design process | (a) | Conduct interviews with patients and caregivers to develop end-user-tailored interventions39,46,48 |
| Apply co-design techniques to engage all relevant stakeholders in the cocreation process39 | |||
| Patient-centred implementation | (b) | Technology Acceptance Model and digital divide theory30 | |
| Consider the impact of physical impairments on technology usage30,40 | |||
| Consider in-home limitations and difficulties to assemble/operate TM equipment36 | |||
| Geographical and community context role in technological acceptance and digital literacy39,46 | |||
| Service delivery | Patient education and self-monitoring promotion | (c) | Continuously instruct patients (and caregivers) on how to correctly use the TM equipment30,36,39,40,43,46,48–50 |
| Promote education on the patient’s health condition and on self-monitoring opportunities48,50 | |||
| Promote online classrooms, social networking, online simulation/gaming, quizzes to assess self-care knowledge, support group sessions36,40 | |||
| Multi-morbidity care | (d) | Consider adjacent health manifestations when designing care delivery pathways49,50 | |
| Micro-level coordination role in improving patient navigation within this complex care setting43,48 | |||
| Dynamic trajectory of illness | (e) | Individuals can engage in different RPM levels according to their needs50 | |
| H2H vs 2HT | (f) | Communication takes place between the home-located patient and a hospital-based team vs a TM centre coordinating all stakeholders involved43 | |
| Leadership & governance | Coordination pivot | (g) | Main actor responsible for coordinating care delivery between the multidisciplinary team and the patient46,48,50 |
| Shared decision-making culture | (h) | Patient, informal caregivers and multidisciplinary care team members all take part on the care process40,49,50 | |
| Stages vs actors’ coordination | (i) | Program coordination is achieved between places of activity vs between participants in the activity43 | |
| Workforce | Multidisciplinary core workforce | (j) | Informal caregivers, nurses, GPs, and central condition specialists are the main responsible actors30,36,40,43,46,48–50 |
| Supporting workforce | (k) | Other specialty physicians (eg, endocrinologists, psychologists, psychiatrists), dieticians, social workers, pharmacists43,46,49,50 | |
| Financing | Coverage and/or reimbursement model | (l) | Public-private arrangements along the trajectory of illness50 |
| Consider new reimbursement models (eg, pay-for-performance, direct fees to TM centres)30,43 | |||
| B2B vs B2C | (m) | Financing/payment flow between two businesses vsdirectly with the end-user43 | |
| Technologies & medical products |
ICTs and TM devices | (n) | Integration of synchronous communication services (eg, VC), two-way interface mobile-based apps/patient portals and TM devices39,48,49 |
| Consider recommendations for comprehensive, unobtrusive (eg, BT-enabled devices), intuitive application and device design30,39 | |||
| Health data centre | (o) | Interoperable information system that allows information sharing with all the relevant actors49,50 | |
| Information & research |
Health indicators measurement | (p) | For example, BP, heart rate, ECG, weight, glycaemia, dyspnoea, blood oxygenation, sleep patterns, anxiety, physical activity, e-PROs, symptom scores36,40 |
| Clinical dashboards | (q) | Allows a health status comprehensive monitoring in a user-friendly manner39,50 | |
| Allows monitoring several patients at the same time43 | |||
| Access shall be granted to all stakeholders involved, to allow shared decision-making40 | |||
| Monitoring | Outcome measurements | (r) | For example, admissions/readmissions, ED visits, inpatient LoS, all-cause mortality, HRQoL, patient satisfaction, SUS, cost savings, cost/benefit analysis, ROI36,39 |
Abbreviations: RPM, Remote patient monitoring; SELFIE, Sustainable intEgrated chronic care modeLs for multi-morbidity: delivery, FInancing, and performancE; TM, telemonitoring; H2H, hospital-to-home; 2HT, high-touch-high-tech; GP, general practitioner; VC, videoconferencing; BT, Bluetooth; BP, blood pressure; ECG, electrocardiogram; e-PROs, electronic patient reported outcomes; ED, emergency department; LoS, length of stay; SUS, system usability score; HRQoL, health-related quality of life; ROI, return on investment.