Table 3.

Overview of risk-reduction strategies regarding remote patient monitoring (RPM) interventions for clinical staff.

Theme and description			Studies
Planning and implementation
	Develop an integrated governance structure Involve all actors concerned with patient management (co-design and participatory practices) Set clear objectives, success metrics, and methods to measure them	Das et al [22] Harsha et al [21] Ke et al [24] Leppla et al [25] McMullen et al [33] Parkes et al [29] Sanger et al [26] Semple et al [40] Timmerman et al [27]
	Determine health care resource use in terms of the following: Clinical staff and skills Tasks and their timing (to avoid invisible or additional work, time, roles or teams, or an inadequate alert response) Awareness of the multidisciplinary environment Plan for problem solving and changes needed Time for solving technical or general problems Devices and structure	Brophy [35] Das et al [22] Ke et al [24] Leppla et al [25] Parkes et al [29] Richards et al [39] Timmerman et al [27] Wiadji et al [28]
	Define practice standards, policies, and best practices in terms of the following: Workflow Documentation Communication pathways Measurements Types of data collected Impact on the clinical staff’s well-being (clinical staff’s attitudes, performance, and overall service satisfaction)	Augestad et al [38] Das et al [22] Harsha et al [21] Jansson et al [41] Ke et al [24] Leppla et al [25] Sanger et al [26] Semple et al [40] Timmerman et al [27] Wiadji et al [28]
	Risk assessment Perform adequate device testing Contemplate technical or general problems (extra time)	Brophy [35] Das et al [22] Leppla et al [25] Richards et al [39] Timmerman et al [27]
	Consider current state and context Plan according to resources, program, location, dynamics (within the hospital and among clinical staff), and schedules (consider “less busy” and “very busy” times) Customize interventions for integration with existing clinical dynamics and tools	Brophy [35] Das et al [22] Davoody and Hägglund [23] Jansson et al [41] McMullen et al [33] Richards et al [39] Sousa et al [37]
	Definition of reimbursement policies Automatically track time for standardization Consider financial or nonfinancial options (awards and acknowledgments) Automatically measure time to determine billing Include billing functionalities in the intervention	Das et al [22] Wiadji et al [28]
	Training staff on tools and protocols Promote enthusiasm, value, and importance among medical staff regarding RPM	Brophy [35] Das et al [22] Downey et al [32] Jansson et al [41] Leppla et al [25] Makhni et al [31] McMullen et al [33] Rothgangel et al [30] Semple et al [40] Sousa et al [37] Timmerman et al [27] Wiadji et al [28]
Workload and logistics
	Devise a primary nursing-based model (physicians for emergencies and medical decisions)	Leppla et al [25]
	Allow for easy collaboration between the different actors	Davoody and Hägglund [23] Leppla et al [25]
	Create dedicated teams for RPM interventions	Leppla et al [25]
	Include planning tools for routines and tasks Define goals for tasks to make progress clear	Davoody and Hägglund [23]
	Externalize tasks Have specialized centers for data analysis and alarm reviews	Leppla et al [25]
	Ensure accessibility to patients’ contact details (to facilitate appointment scheduling and remote consultations)	Jansson et al [41] Ke et al [24]
	Make e-tools available in different languages	Brophy [35]
Technology
	Provide appropriate support and access to software and technology for both patients and specialists Ensure compatibility with different smartphones and tablets	Dunphy et al [36] Rothgangel et al [30] Wiadji et al [28]
	Ensure QoSa support	Harsha et al [21]
	Integrate with current technologies Interoperable and compatible with other or existing devices and systems Guarantee a seamless connection between RPM platform and staff’s EMRb system	Harsha et al [21] Leppla et al [25] McMullen et al [33] Rothgangel et al [30]
	Ensure automatic measurements and documentation	Das et al [22] Ke et al [24] Sanger et al [26]
	Develop user-friendly tools for clinical staff and patients	Augestad et al [38] Brophy [35] Davoody and Hägglund [23] Leppla et al [25] McMullen et al [33] Timmerman et al [27]
Data
	Alert-based follow-up protocol Continuous data collection (24-hour data) but data analysis focused on alerts by patient prioritization and event-triggered assessment (identify main events to follow) Automatic event classification and suggestions for corrective actions Providing memory aids to staff for interrupted tasks	Dunphy et al [36] Ke et al [24] McMullen et al [33] Richards et al [39] Sanger et al [26]
	Customizable data collection According to treatment, acuity, goal, progress, and diagnosis (identify high-risk patients to determine extra measures needed)	Das et al [22] Davoody and Hägglund [23] Downey et al [32] Jansson et al [41] Ke et al [24] McMullen et al [33] Rothgangel et al [30]
	Present easy-to-interpret and actionable data Filter data (“noise cancellation” and false positives) Provide comparison of individual scores with “standard values” of comparable patients	Dunphy et al [36] Leppla et al [25] McMullen et al [33] Rothgangel et al [30] Sanger et al [26]
	Incorporate different kinds of measurements (from different physiological variables) Include historical patients’ data	Davoody and Hägglund [23] Dunphy et al [36] Jansson et al [41] McMullen et al [33] Rothgangel et al [30] Sanger et al [26]
	More effective use of patients’ data Use RPM data to guide future medical appointments Use RPM data to assess eligibility for procedures, possible risks, and outcomes	Dunphy et al [36] Jansson et al [41] Parkes et al [29] Sharif et al [34] Wiadji et al [28]
	Collect data on patient and staff feedback on the intervention for improvement purposes	Jansson et al [41] Leppla et al [25]
	Provide patients with tools to help assess, interpret, and act upon symptoms	Leppla et al [25]

^aQoS: quality of service.

^bEMR: electronic medical record.