Digital transformation of cardiologic care for rural population: readiness of mid-level medical personnel

Introduction. Implementation of a long-term remote monitoring for rural patients’ health indicators with the diagnosed chronic heart failure (CHF) into digital healthcare practices offers significant managerial, economic, and preventative benefits for early detection of their condition aggravation. The managerial solution for this process is to expand the nursing staff functions.

Purpose of the study. To analyze differences in readiness in paramedics and nurses to participate in digital support of CHF patients living in rural areas.

Materials and methods. Diagnostic methodology: questionnaire “Readiness of medical specialists to implement remote monitoring technologies for cardiovascular parameters in CHF patients living in rural areas at the primary care level” (n = 1519). Cross-tables were used as a mathematical and statistical method for comparing two groups of respondents (nurses and paramedics) based on indicators of medical specialists’ readiness to provide care to patients using remote monitoring technologies; the significance of differences was assessed using the obtained Pearson χ² value.

Results. Nurses and paramedics rate their computer proficiency levels almost identically (15.5% and 15.4%, respectively). Respondents in both groups prefer using a phone app to communicate with patients in real time (41.9% and 39.6%, respectively). Nurses were less willing than paramedics to participate in remote digital monitoring of patients with CHF (χ² = 24.27, df = 3, p < 0.001). However, they noted the need for oversight by general practitioners and cardiologists in district hospitals and clinics.

Research limitations. This study was conducted only among mid-level medical personnel and applies to the population of rural areas.

Conclusion. The study revealed equal unwilling of the respondents (paramedics and nurses) to participate in remote monitoring on a voluntary basis (9.9% paramedics/8.5% nurses). However, 23.6% of paramedics/15.5% of nurses were willing to participate in monitoring on a compensated basis. Respondents believed the monitoring to be the responsibility of separate specialists (32.6% paramedics/43.0% nurses).

Compliance with ethical standards. The study was approved by Ethical Committee of Saratov State Medical University (Protocol No. 11, dated May 2, 2023). All participants signed informed consent to participate in the study.

Contribution of the authors:
Bogdanova T.M. — research concept and design, writing the text, compilation of the list of literature, statistical data processing;
Andrianova E.A. — writing the text, statistical data processing, editing;
Gorbunova L.A. — collection and processing of material;
Akimova O.V. — collection and processing of material;
Fedonnikov A.S. — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Funding. The study had no sponsorship.

Conflict of interest. The authors declare no clear and potential conflicts of interest in connection with the publication of this article.

Received: December 29, 2024 / Revised: February 14, 2025 / Accepted: February 19, 2026 / Published: April 30, 2026

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