Continuity, but at what cost? The impact of telemonitoring COPD on continuities of care: a qualitative study

摘要: Continuity of care is widely regarded as an important marker quality in the management patients with long-term conditions. New services that integrate telemonitoring into pathways have potential to change aspects continuity both positive and negative ways. A service for chronic obstructive pulmonary disease (COPD) was introduced Lothian, Scotland, 2009. qualitative study, nested within TELESCOT COPD randomised control trial, undertaken explore views professionals on telemonitoring. The perceived impact investigated part research. Semi-structured interviews were 38 (47% male, mean age 67.5 years). maximum variation sample relation age, sex, socio-economic background, severity, compliance recruited. Thirty-two stakeholders (healthcare managers) interviewed. Transcribed coded data analysed thematically using framework approach. Interpretation supported by multidisciplinary discussion. Patients healthcare considered relationship-based delivery services. Managers placed emphasis improved clinical a means reducing costs. However, described many operational challenges arising from ‘bolting-on’ provision existing usual which, they considered, resulted proliferation additional managerial discontinuities. face major meeting demands relationship development