@article{37e4628728be4fa4bec2e52d5eec72df,
title = "The National Coordinated Citrien eHealth Program to Scale Up Telemonitoring: Protocol for a Before-and-After Evaluation Study",
abstract = "Background: Sustainable implementation of telemonitoring in health care is challenging, especially if one aims to scale up telemonitoring initiatives nationwide. The National collaborative eHealth program in the Netherlands is supporting the nationwide upscaling of telemonitoring in 3 clinical domains by implementing telemonitoring in all Dutch university medical centers (UMCs). The chosen telemonitoring concepts are (1) telemonitoring solutions in the domain of cardiology, (2) telemonitoring solutions providing care from a distance in obstetrics, and (3) telemonitoring solutions monitoring vital functions in hospital wards. Objective: The aim of this study is to evaluate the upscaling of telemonitoring in Dutch university hospitals in order to gain a better knowledge of the process, methods, and outcomes of nationwide upscaling strategies. Our hypothesis is that by the completion of the Citrien program{\textquoteright}s scale-up, telemonitoring will be operational in all UMCs but not normalized in routine care. Methods: A before-and-after study will be conducted to assess upscaling. The theoretical frameworks used are the framework for nonadoption, abandonment, scale-up, spread, and sustainability; the Normalization Process Theory; and a project management tool Project Canvas. The primary outcome of the study is the degree of normalization to which health care providers at UMCs consider telemonitoring a part of their routine practice, measured using the Normalization MeAsurement Development tool (NoMAD). Our secondary outcome is the uptake of telemonitoring at the Dutch UMCs, using management data from UMCs{\textquoteright} business intelligence systems query. Results: Data will be collected between May 2020 and December 2022. Results were retrieved in June 2023. UMCs{\textquoteright} business intelligence systems are queried for data for the secondary outcome measures. There is a risk that the UMCs will not be able to provide this management information. The laws and regulations governing telemonitoring in the Netherlands are changing, with the Electronic Data Exchange in Health Care Act (Wet elektronische gegevensuitwisseling in de zorg) and the European Health Data Space Act expected to positively influence implementation and upscaling. Conclusions: The Citrien program is a nationally coordinated change management program that is scaling up telemonitoring across contexts and settings. This study will produce original data on the uptake and upscaling of telemonitoring at Dutch UMCs. Future initiatives to implement eHealth in the health care sector may be guided by the wide range of success factors, obstacles, and experiences collected through this program. The network itself may be of great value impacting future acceleration of eHealth initiatives.",
keywords = "e-health, eHealth, health care, healthcare, implementation, study protocol, telemedicine, telemonitoring, upscaling",
author = "Harm Gijsbers and Azam Nurmohamed and {van de Belt}, {Tom H.} and Marlies Schijven and Bekker, {Mireille N.} and Buijs, {Marit A.} and Erik Buskens and Chavannes, {Niels H.} and {van Dam}, Debora and {van Eldik}, Nicole and Goossens, {Jelle M.} and Mark Janssen and Kasteleyn, {Marise J.} and Kool, {Rudolf B.} and Tarik Lachkar and Lahr, {Maarten M. H.} and Herm Martens and Metting, {Esther I.} and Silven, {Anna V.} and Miranda Snoeren and {van der Steen}, {Marije K. J.} and Verdonck, {Irma M.} and Nynke Venema and Mar{\'i}a Villalobos-Quesada and Visser, {Jacob J.} and Willems, {Sofie H.} and {The Citrien 2 Project Leaders and Steering Group} and {van Zwieten}, Valesca",
note = "Funding Information: The authors wish to thank the following Citrien Project Leaders and Steering Group members for their valuable contribution: Mireille N Bekker, Department of Obstetrics and Gynaecology, UMC Utrecht, The Netherlands; Marit A Buijs, Erasmus MC, University Medical Center Rotterdam, The Netherlands; Erik Buskens, Department of Epidemiology, University Medical Centre Groningen, The Netherlands; Niels H Chavannes, Department of Public Health and Primary Care, Leiden University Medical Center, The Netherlands; Debora van Dam, Department of Surgery, Amsterdam UMC, location University of Amsterdam, The Netherlands; Nicole van Eldik, Maastricht University Medical Centre+, The Netherlands; Jelle M Goossens, Digital Health Department, Strategy and Policy, University Medical Center Utrecht, The Netherlands; Mark Janssen, Radboud University Medical Center, The Netherlands; Marise J Kasteleyn, Department of Public Health and Primary Care, Leiden University Medical Center, The Netherlands; Rudolf B Kool, Department of IQ Healthcare, Radboud University Medical Center, Radboud Institute for Health Sciences, The Netherlands; Tarik Lachkar, Department of Surgery, Amsterdam UMC, location University of Amsterdam, The Netherlands; Maarten M H Lahr, Department of Epidemiology, University Medical Centre Groningen, Groningen, The Netherlands; Herm Martens, Department of Dermatology, Maastricht University Medical Centre+, The Netherlands; Esther I Metting, Department of General Practice and Elderly Medicine, University Medical Center, University of Groningen, The Netherlands; Anna V Silven, Department of Public Health and Primary Care, Leiden University Medical Centre, The Netherlands; Miranda Snoeren, Department of Medical Imaging, Radboud University Medical Center, The Netherlands; Marije K J van der Steen, Department of Strategy and Innovation, Amsterdam UMC, location Vrije Universiteit Amsterdam, The Netherlands; Irma M Verdonck, Department Otolaryngology-Head and Neck Surgery, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Nynke Venema, EvA Servicecentrum, Amsterdam UMC, location University of Amsterdam, The Netherlands; Mar{\'i}a Villalobos-Quesada, Department of Public Health and Primary Care, Leiden University Medical Centre, The Netherlands; Jacob J. Visser, Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, The Netherlands; Sofie H Willems, Department of Public Health and Primary Care, Leiden University Medical Centre, The Netherlands; Valesca van Zwieten, Department Otolaryngology-Head and Neck Surgery, Amsterdam UMC location Vrije Universiteit Amsterdam, The Netherlands. Publisher Copyright: {\textcopyright}Harm Gijsbers, Azam Nurmohamed, Tom H van de Belt, Marlies Schijven, The Citrien 2 Project Leaders and Steering Group.",
year = "2023",
doi = "https://doi.org/10.2196/45201",
language = "English",
volume = "12",
journal = "JMIR research protocols",
issn = "1929-0748",
publisher = "JMIR Publications",
}