Table 2.
Overview of included articles
| Author and year | Purpose of study | Study design (& methods) | Study participants | Type of telecare service/system described | Source of potential risk to patient safety |
|---|---|---|---|---|---|
| Brewer et al. (2010) [ 57 ] | To investigate perceptions of the safety, security and privacy of a telecare monitoring system | Survey | 127 different stakeholders | Telecare monitoring for adults with developmental disabilities | Change in nature of clinical work |
| Brewster et al. (2014) [ 53 ] | To analyse the impact of telehealth implementation on front-line nursing staff | Systematic review | Nursing staff | Telehealth technologies for the management of COPD and CHF | Change in nature of clinical work |
| Changes to staff workload | |||||
| de Lusignan et al. (2001) [ 72 ] | To examine the acceptability, effectiveness and reliability of home telemonitoring | Controlled pilot study | 20 patients | Pulse and blood pressure devices, video consultation equipment | Technology issues |
| Patient dependency | |||||
| Essén & Conrick (2008) [ 71 ] | To explore constituents and challenges related to innovation of technology-based services in the long-term homecare sector | Case study (Focus groups, interviews, observation) | Home-help managers and home-help staff and 10 operational/managerial staff | Sensor-based telemonitoring system | Lack of user knowledge (patients and staff) |
| Changes to workload | |||||
| Lack of guidelines | |||||
| Hanley et al. (2013) [ 74 ] | To explore experiences of users taking part in a RCT of remote blood pressure (BP) tele-monitoring. To identify facilitators or barriers to the effectiveness and routine uptake of the intervention | Qualitative interview study | 25 patients, 11 nurses and 9 doctors | A home BP monitor and mobile phone technology for transfer of BP readings via SMS to a secure website | Patient anxiety |
| Patient dependency | |||||
| Poor system integration | |||||
| Changes to workload | |||||
| Accessibility issues | |||||
| Hibbert et al. (2004) [ 65 ] | To document responses of nurses using telehealth equipment and identify service integration issues | Ethnography (observation) | 12 nurses | A home telehealth nursing service for COPD patients, using videophone and vital signs monitoring | Technology issues |
| Change in nature of clinical work | |||||
| Hopp et al. (2006) [ 68 ] | To examine staff perceptions of opportunities and barriers of home-based telemedicine services for chronic illness care | Qualitative interview study | 37 direct telemedicine providers, primary care providers and hospital administrators | Store-and-forward devices, video conferencing devices | Lack of user knowledge (patients and staff) |
| Technology issues | |||||
| Poor patient compliance | |||||
| Change in nature of clinical work | |||||
| Changes to workload | |||||
| Horton (2008) [ 69 ] | To evaluate a home telecare service for COPD patients | Qualitative study (focus groups and case study) | 4 home care team and social care staff and 6 patients | Daily monitoring of patients’ condition via call centre with community response service | Technology issues |
| Lack of user knowledge (patients and staff) | |||||
| Lu et al. (2014) [ 70 ] | To describe the use of home telehealth care for chronic disease management from users’ perspective | Qualitative study (focus groups and interviews) | 20 patients | Telemonitoring of BP and/or blood sugar, provision of health care/consultations with healthcare professionals via computer or telephone | Lack of user knowledge (patients) |
| Mair et al. (2008) [ 60 ] | To perform a process evaluation of a RCT of home telecare for the management of COPD | Qualitative interview study | 9 patients and 11 nurses | A videophone link and attachments for remote physiological monitoring of vital signs | Change in nature of clinical work |
| Changes to workload | |||||
| Marziali et al. (2005) [ 77 ] | To assess frequencies of reporting adherence to professional practice standards and research ethics in studies of technology-based home healthcare programmes | Systematic review | 107 articles describing studies on the use of telecare, featuring a variety of staff and/or service users | Medical symptom monitoring using synchronous technology | Lack of guidelines |
| Nilsson et al. (2010) [ 73 ] | To describe two district nurses’ experiences of using ICT to communicate with chronically ill people in their homes | Qualitative interview study | 2 district nurses | An electronic messaging system to communicate with patients | Technology issues |
| Radhakrishnan et al. (2012) [ 61 ] | To explore perceptions on effectiveness of telehealth for heart failure management in a homecare setting | Mixed-methods (focus groups, interviews and questionnaire) | 44 nurses and 4 patients | A centralized model of daily telemonitoring of vital signs by a telehealth nurse, with in-person follow-up if needed | Patient anxiety |
| Patient dependency | |||||
| Lack of user knowledge (patients) | |||||
| Changes to workload | |||||
| Change in nature of clinical work | |||||
| Lack of guidelines | |||||
| Roberts et al. (2012) [ 75 ] | To evaluate a telehealth programme for long-term conditions | Mixed-methods (questionnaire and interview) | Patients, carers and 10 medical, healthcare and managerial staff | Home-based touch screen facilities for clinical monitoring for COPD and hypertension patients | Changes to workload |
| Sandberg et al. (2009) [ 62 ] | To understand the experiences of providers and the factors perceived to contribute to the success of telehealth interventions and user satisfaction | Qualitative interview study | 10 telemedicine providers (nurses and dietitians) | A telemedicine unit with video-conferencing, blood glucose and blood pressure readings and educational materials | Technology issues |
| Lack of user knowledge (patients) | |||||
| Change in nature of clinical work | |||||
| Shea & Chamoff (2012) [ 67 ] | To examine the relationship between communication and information integration into the daily lives of patients with chronic illnesses and offer best practice recommendations for telehomecare nurses | Descriptive, correlational study | 43 patients and 9 telehomecare nurses | Telemonitoring; patients interact with nurses using a telestation that collects and transfers data via telephone lines | Lack of user knowledge (patients and staff) |
| Sicotte & Paré (2011) [ 58 ] | To investigate how project risk management was applied in 9 mobile computing projects and how it shaped project outcomes | Case studies (mixed-methods) | 57 project leaders, nurse users and nurse pilots from 9 homecare units | Mobile technology software for planning and organization of homecare nursing activities | Technology issues |
| Poor system integration | |||||
| Changes to workload | |||||
| Skär & Söderberg (2011) [ 63 ] | To describe influences, benefits, and limitations in using ICT to meet chronically ill patients’ needs when living at home | A descriptive, exploratory pilot study | 2 patients, 1 relative, 1 district nurse and 5 personal assistants | An application for information and communication between chronically ill people and the district nurse | Change in nature of clinical work |
| Technical issues | |||||
| Wälivaara et al. (2011) [ 64 ] | To describe the reasoning among general practitioners about the use of mobile distance-spanning technology (MDST) in care at home and in nursing homes | Qualitative interview study | 17 doctors | Mobile distance-spanning technology for communication and diagnostic purposes | Change in nature of clinical work |
| Lack of user knowledge (patients) | |||||
| Wälivaara et al. (2009) [ 66 ] | To describe how people in need of health care at home view technology | Qualitative interview study | 9 patients | Distance-spanning technology with mobile devices to measure vital signs | Poor patient compliance |
| Lack of user knowledge (patients) | |||||
| Accessibility issues | |||||
| Change in nature of clinical work | |||||
| Young et al. (2011) [ 76 ] | To seek accurate patient perspectives about benefits and challenges of a care coordination/home telehealth program | Mixed-methods (survey and interviews) | 25 patients | Messaging devices, monitoring and measuring devices, video-phones and PCs | Accessibility issues |
| Zayas-Cabán & Dixon (2010) [ 59 ] | To analyse human factors and ergonomics issues encountered during the design and implementation of home-based consumer IT applications | Case studies (analysis of documents and discussion notes) | 5 home-based consumer IT application projects | Various IT applications including videophone, messaging systems and health monitoring devices | Technology issues |
| Unsafe device arrangements |