Patient's Perceptions of a Centralized Virtual Ward for Remote Patient Monitoring in Primary Care: Qualitative Study.

Background: Remote patient monitoring (RPM) has the potential to reduce in-clinic visits and promote proactive and preventive care for patients with chronic diseases in primary care. However, a decentralized approach to RPM in a primary health care (PHC) setting has not met stakeholders' expectations regarding scalability. This study introduces a centralized virtual ward (CVW)-led RPM, utilizing a multidisciplinary team approach to monitor patients with chronic diseases by clinicians who do not belong to the patients' PHC center. Objective: This study aimed to gain a better understanding of patients' perceptions of CVW-led RPM for managing chronic diseases in a PHC setting. Methods: In-depth interviews were conducted with 22 patients with chronic diseases enrolled at a PHC center in Stockholm, Sweden. The RPM project ran between October 2018 and April 2019 and included a total of 395 patients. Interviews followed a semistructured interview guide and were analyzed using qualitative content analysis. Results: Primary care patients with chronic diseases expressed that their contact with the CVW felt impersonal but at the same time secure and accessible. They noted a lack of coordination and communication between the clinicians of the CVW and their PHC providers. Captured data resulted in 1 overarching theme "Sense of security and accessibility, but impersonal and uncoordinated" based on 5 categories: sense of security, care and self-care, accessibility, quality of care, and communication. Conclusions: Our findings suggest that by addressing patients' needs for new organizational routines for patient-caregiver communication, RPM via centralized virtual wards can better realize the potential of this technology.