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Table 2 Overview of included articles

From: Patient safety risks associated with telecare: a systematic review and narrative synthesis of the literature

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