Work with four community health services in England that use telehealth to monitor patients with COPD and chronic heart failure has found that reliable and flexible technology, dedicated resources, staff training and a partnership approach are key.

Although frontline staff acceptance is an important factor in determining the successful adoption of new technologies, it has rarely been the central focus of study. This research was therefore designed to examine frontline staff acceptance of telehealth and identify barriers to and enablers of successful adoption of remote monitoring for patients with Chronic Obstructive Pulmonary Disease and Chronic Heart Failure. Through thematic analysis of qualitative interviews with 84 nursing and other frontline staff, and 21 managers and key stakeholders, the study provides insight into the challenges of introducing telehealth and identifies key barriers to and facilitators of telehealth adoption, which can be translated into practice.

Key findings include

• Frontline staff acceptance of telehealth is a slow and fragile process that can be hindered by negative perceptions and experiences of telehealth in practice.
• Experimentation and clinical learning are important facilitators for staff acceptance of telehealth, and frontline staff play a key role in overcoming barriers to implementation.
• Experiencing patient and clinical benefits helps to instil trust and confidence in telehealth among staff, which was found to be essential for successful adoption.

Researchers found that having reliable and flexible technology and dedicated resources for telehealth work were identified as essential in helping to overcome early barriers to acceptance, along with appropriate staff training and a partnership approach to implementation. Early successes were also important, encouraging staff to use telehealth and facilitating clinical learning and increased adoption.

The authors conclude that the mainstreaming of telehealth hinges on clinical ‘buy-in’. Where barriers to successful implementation exist, clinicians can lose faith in using technology to perform tasks traditionally delivered in person. Addressing barriers is therefore crucial if clinicians are to adopt telehealth into routine practice.