Uptake and Scalability of a Peritoneal Dialysis Virtual Care Solution: Qualitative Study

Lianne Jeffs; Trevor Jamieson; Marianne Saragosa; Geetha Mukerji; Arsh K Jain; Rachel Man; Laura Desveaux; James Shaw; Payal Agarwal; Jennifer M Hensel; Maria Maione; Nike Onabajo; Megan Nguyen; R Bhatia

doi:10.2196/humanfactors.9720

Uptake and Scalability of a Peritoneal Dialysis Virtual Care Solution: Qualitative Study

JMIR Hum Factors. 2019 Apr 16;6(2):e9720. doi: 10.2196/humanfactors.9720.

Authors

Lianne Jeffs^{1

2}, Trevor Jamieson^{3

4}, Marianne Saragosa⁴, Geetha Mukerji^{2

4}, Arsh K Jain⁵, Rachel Man⁵, Laura Desveaux^{2

4}, James Shaw^{2

4}, Payal Agarwal^{4

6}, Jennifer M Hensel^#⁴, Maria Maione⁷, Nike Onabajo⁴, Megan Nguyen⁴, R Bhatia^{2

4}

Affiliations

¹ Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada.
² Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada.
³ St. Michael's Hospital, Toronto, ON, Canada.
⁴ Institute for Health System Solutions and Virtual Care, Women's College Hospital, Toronto, ON, Canada.
⁵ London Health Sciences Centre, London, ON, Canada.
⁶ Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.
⁷ St. Michael's Hospital, Toronto ON, ON, Canada.

^# Contributed equally.

Abstract

Background: Early research in the area of virtual care solutions with peritoneal dialysis (PD) patients has focused on evaluating the outcomes and impact of these solutions. There has been less attention focused on understanding the factors influencing the uptake, usability, and scalability of virtual care for chronic kidney disease (CKD) patients receiving PD at home.

Objective: In this context, a study was undertaken to (1) assess and understand the factors influencing the uptake of a virtual care solution and (2) provide recommendations for the scalability of a virtual care solution aimed at enhancing CKD patients' outcomes and experiences.

Methods: This study used a qualitative design with semistructured interviews and a thematic analysis approach. A total of 25 stakeholders-6 patients and 3 caregivers, 6 health care providers, 2 vendors, and 8 health system decision makers-participated in this study.

Results: The following three primary mechanisms emerged to influence the usability of the virtual care solution: (1) receiving hands-on training and ongoing communication from a supportive team, (2) adapting to meet user needs and embedding them into workflow, and (3) being influenced by patient and caregiver characteristics. Further, two overarching recommendations were developed for considerations around scalability: (1) co-design locally, embed into the daily workflow, and deploy over time and (2) share the benefits and build the case.

Conclusions: Study findings can be used by key stakeholders in their future efforts to enhance the implementation, uptake, and scalability of virtual care solutions for CKD and managing PD at home.

Keywords: chronic kidney disease; patient-centric care; peritoneal dialysis; qualitative research; virtual care solutions.

©Lianne Jeffs, Trevor Jamieson, Marianne Saragosa, Geetha Mukerji, Arsh K Jain, Rachel Man, Laura Desveaux, James Shaw, Payal Agarwal, Jennifer M Hensel, Maria Maione, Nike Onabajo, Megan Nguyen, R Bhatia. Originally published in JMIR Human Factors (http://humanfactors.jmir.org), 16.04.2019.