Meghan M Searl*, Partners Center for Connected Health, Boston, United States Kamal Jethwani, Partners Center for Connected Health, Boston, United States Khinlei Myint-u, Partners Center for Connected Health, Boston, United States Joseph Kvedar*, Partners Center for Connected Health, Boston, United States Track: Research Presentation Topic: Consumer empowerment, patient-physician relationship, and sociotechnical issues Presentation Type: Poster presentation Submission Type: Single Presentation Last modified: 2012-09-12

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Background: Many Primary Care Physicians (PCPs) report that their workload is overwhelming and unsustainable. At the same time, many patients with chronic diseases come in for office visits that are largely unnecessary. With the advent of innovative remote monitoring technologies (RMTs) that collect and transmit physiologic data (e.g., blood pressure, weight, blood sugar) online, it is now possible for providers to track health data at a population level, and intervene with patients only when there is a clear need. There is a growing evidence base demonstrating that the use of RMTs in chronic disease management can lead to cost savings, better health outcomes, and greater patient engagement. However, efforts to implement RMTs in medical practices have often met with resistance.

Objective: The purpose of this study was to better understand the reasons for this resistance and to investigate specific concerns related to the integration of RMTs in clinical practice.

Methods: We administered an online survey consisting of 22 items about attitudes toward technology in general and RMTs in particular to all PCPs affiliated with Partners Community Healthcare, Inc. (PCHI), a large hospital organization in Massachusetts. The survey assessed perceptions of the benefits vs. costs of RMTs, readiness to adopt RMTs, expectations regarding a likely timeframe of adoption, attitudes toward patient engagement, reasons for patient non-adoption and attitudes toward elements of healthcare reform.

Results: Of a total of 1200 PCPs who received the survey, the response rate was over 18% (n=218). An overwhelming majority of respondents (98%) stated that they perceived RMTs as offering great additional value to their practice. 81% of respondents stated that they were “ready now to offer” or “would seriously consider offering” RMTs in their clinical practice. 18% stated that they could “see the value of RMTs” but would not offer them in their clinical practice at this time. 86% either currently offered RMTs in their practice or expected to offer them within the next five years. Age or current use of technologies in general by physicians (e.g., email, online banking, etc.) did not significantly impact results. Respondents who were less ready to adopt RMTs preferred to see patients in person, were skeptical that RMTs could improve the quality and efficiency of chronic disease management, and were less favorable toward increased patient engagement.

Conclusions: Results from this survey demonstrate that the vast majority of PCPs in a large Boston-area hospital system recognize the value of RMTs in management of chronic disease. Moreover, a significant majority reports being ready or almost ready to adopt these technologies. Concerns about increasing workload and reimbursement were associated with greater reluctance to adopt these technologies. These findings will help accelerate the implementation of RMTs in clinical practice, impacting greatly the efficiency and quality of care provided at these practices. The increasing evidence of the value of RMTs, coupled with changing reimbursement and primary care delivery models also present a potential to provide an impetus for this implementation.