Table 1.
Summary of empirical case studies and data sources (adapted from J Med Internet Res. 2017; 19: e367)
| Study site(s) | Technology/ies | Participants | Data sources |
|---|---|---|---|
| Case A. Video outpatient consultations | |||
| A1: Acute hospital trust (3 specialties — diabetes, antenatal, cancer — on different sites) A2: Nurse-led heart failure service run from community hospital |
Skype™ (acute hospital) and FaceTime™ (community hospital) together with commercially available blood pressure and heart rate monitors, weighing scales and oximeter | A1: 24 staff (9 clinicians, 10 support staff, 5 managers); 27 patients A2: 10 staff (8 nurses, one manager, one administrator); 8 patients Plus 48 national stakeholders and wider informants on remote consulting |
35 formal semi-structured interviews plus ~ 100 informal interviews; 150+ hours of ethnographic observation; 40 videotaped remote consultations (12 diabetes, 6 antenatal diabetes, 12 cancer, 10 heart failure); 500+ emails; 30 local documents, e.g. business plans, protocols; 50 national-level documents |
| Case B. GPS tracking for cognitive impairment | |||
| Social care organisation in deprived borough in inner London | GPS tracking devices supplied by 5 different technology companies, includes GPS tracking with virtual map and ‘geo-fence’ alert functions | 7 index cases; 8 lay carers; 5 formal carers, 3 social care staff; 3 healthcare staff; 3 call centre staff | 22 ethnographic visits and ‘go-along’ interviews with index cases (~ 50 h); 15 ethnographic visits with health and social care staff; 6 staff interviews; 5 team meetings; 3 local protocols |
| Case C. Pendant alarms | |||
| C1: Healthcare commissioning organisation in deprived borough in outer London C2: Social care organisation in mixed borough in the Midlands |
In both sites, pendant alarms and base units were supplied by multiple different technology companies and supported by local councils, each with a different set of arrangements with providers and an ‘arms-length management organisation’ alarm support service | C1: 8 index cases; 7 lay carers; 12 professional staff C2: 11 index cases; 9 health/social care staff from frontline service delivery to senior board level; 3 representatives from telecare industry |
50 semi-structured and narrative interviews; 61 ethnographic visits (~ 80 h of observation) including needs assessments and reviews; 20 h of observation at team meetings |
| Case D. Remote biomarker monitoring in heart failure | |||
| Acute hospital trusts in six different cities in UK | Tablet computer and Bluetooth-enabled commercially available sensing devices (blood pressure and heart rate monitor, weighing scales) | 7 research staff including principal investigator and research coordinator for SUPPORT-HF trial; 7 clinical staff involved in trial; 4 clinical staff not involved in trial; (to date) 18 patient participants and one spouse | 1 patient focus group; 8 patient interviews; 24 additional semi-structured interviews; SUPPORT-HF study protocol and ethics paperwork; material properties and functionality of biomarker database |
| Case E. Care organising software | |||
| E1: Healthcare commissioning organisation in northern England E2: National carer support charity in UK |
Product A: Web-based portal developed by small tech company for use by families to help them organise and coordinate the care of (typically) an older relative Product B: Smartphone app co-designed by carer support charity for same purpose |
Product A: 2 technology developers and CEO of technology company; 4 social care commissioners; 30 health and social care staff considering using the device; 4 users of the device, one non-user Product B (to date): 2 members of care charity (including CEO); 10 qualitative case studies of users undertaken by another academic team |
22 semi-structured and narrative interviews; 16 h ethnographic observations of meetings; auto-ethnographic testing of functionality and usability of devices; secondary analysis of 3rd party evaluation of Product B |
| Case F. Data warehouse for integrated case management | |||
| 1 acute hospital trust, 1 community health trust, 3 local councils, 3 healthcare commissioning organisations | Integrated data warehouse incorporating predictive risk modelling (in theory interoperable with record systems in participating organisations) | 14 staff; 20 patient participants | 14 semi-structured interviews; 50 ethnographic visits (~ 80 h); 12 h shadowing community staff; 4 h observation of interdisciplinary meetings; 12 local protocols/documents |