Increased mortality following telemonitoring in frail elderly patients: look before you leap!

Failure mode and effects analysis of telehealth service of minority elderly for sustainable digital transformation

BACKGROUND

Telehealth services are time- and cost-saving solutions for disease management for older adults. Minority older individuals with multiple risk factors have an increasing demand for telehealth services. There are insufficient data on patient safety in telehealth services. This study aimed to enhance the quality of telehealth services by reducing errors and creating a safe user environment for low-income older adults. Failure mode and effects analysis tool (FMEA) was adopted to manage potential risks for sustainable digital transformation.

METHOD

An eight-member multidisciplinary team conducted telehealth FMEA to determine risk priority numbers (RPNs). The process included identifying the potential cause and effect failure mode of each step; measuring severity, probability, and detectability scores for RPNs; and generating strategies to decrease potential failures.

RESULTS

This study identified 24 risk factors and 34 causes in four major phases with a mean RPN of 90.7: preparation to measure biosignals, measurement of biosignals following instructions from a personal device, confirmation of measurement results, and intervention based on disease or condition type. Risk prioritization revealed four high failure modes and a total RPN of 362.7. Based on fundamental causes, risks were categorized as oblivescence, economic issues, and technology literacy.

CONCLUSIONS

To correct these failure modes, stabilization of the platform, adding to the providers' manpower, and support for government policies are recommended. FMEA identifies and evaluates the potential risks of telehealth services. The selected priorities reduce the clinical risks of low-income elders who use telehealth services by weighting clinical actions.