Development of Guidelines for Hospital Adoption of Wearable Telemonitoring Systems in Chronic Disease Management: Protocol for a Multiphase Mixed Methods Study.

BACKGROUND

The integration of wearable device-based telemonitoring into hospital systems presents a transformative opportunity for chronic disease management, particularly in settings such as Indonesia facing a high burden of noncommunicable diseases. However, widespread adoption is hindered by multifaceted operational barriers, including workflow integration, data management, and unclear adoption pathways, highlighting a critical need for structured, evidence-based guidance.

OBJECTIVE

This study protocol aims to develop a role-specific adoption guideline for integrating wearable telemonitoring systems into routine workflow in Indonesian hospitals for chronic disease management.

METHODS

An exploratory sequential mixed methods design is employed across 3 phases. Phase 1 involves a critical interpretive synthesis of the literature to synthesize evidence on wearable technology adoption to populate the Domain-by-Actor matrix. Phase 2 comprises qualitative semistructured interviews with 32 to 44 key stakeholders (administrators, IT staff, and clinicians) from 4 purposively selected hospitals in Yogyakarta, Indonesia, to explore contextual barriers and facilitators. Phase 3 uses a modified nominal group technique with a panel of 12 experts to build consensus and finalize the guideline.

RESULTS

As of December 13, 2025, this study is in progress. Ethical approval has been obtained. The critical interpretive synthesis (phase 1) is completed, yielding preliminary thematic data on adoption factors. Data collection for the qualitative interviews (phase 2) has commenced, with interviews conducted at 1 hospital and administrative permissions secured for 2 sites. Recruitment and data collection are ongoing.

CONCLUSIONS

This protocol offers a systematic methodology to bridge the gap between digital health pilot studies and routine use in clinical operations. By mapping complex adoption factors onto an anticipated Domain-by-Actor matrix, the proposed study has the potential to guide sustainable, role-specific wearable telemonitoring integration across diverse hospital structures.