Describing digital nursing work in a remote patient monitoring application: Novel convergent mixed methods secondary analysis of feasibility trial data.

OBJECTIVES: Despite the prevalence of applications which offer remote patient monitoring (RPM) in chronic illness management, the use of RPM in healthcare systems remains low. There is limited use of data generated in an RPM, to describe the work of clinicians. The study's aim was the use a novel evaluation method to characterise the nurse work in an RPM intervention.

METHODS: A convergent mixed methods design was used to perform secondary analysis on feasibility trial data. Data sets: (1) RPM data set: data generated by usage, and (2) Interview data set: nurse user interviews. In the RPM data set, patient entered data, software data labelling, and nurse responses were defined as data strings. Quantitative variables were summarized using descriptive statistics. Both data sets were analysed using systematic text condensation. In the RPM data set themes were translated into quantitative data enabling reportable links to RPM functionality. Themes converged and narrative integration triangulated the data.

RESULTS: Seven patients (heart failure (n=4); colorectal cancer (n=3)) and eight nurses were selected. Their RPM intervention engagement generated a mean of 97 data strings. Converging themes included: (1) intervention technical and operational work, (2) digitally enabled care management and coordination, and (3) educational and relational work.

CONCLUSIONS: The evaluation method provided a detailed characterization of the digital nurse work performed in the RPM intervention. While data presented is foundational, it highlights the potential of how evaluation of nurse engagement with RPM application may provide essential feedback to refine digital interventions to ensure efficient integration in healthcare systems.