Table 2 Ethical lessons

Shifting responsibilities

Ensure explicit and realistic allocation of responsibilities

Embed telemonitoring in a trusting care relation

Beware of (unwarranted) big sister conceptions. Avoid expectations that monitoring is more direct and continuous than it actually is

Empowerment and self-management

Create opportunities for optimal form of self-management—in particular for patients with chronic conditions—and as an explicit aim of telemonitoring

Create possibilities for meaningful conversations (i.e. about the interpretation & implication of the data, shared decision making, end of life)

Value of f2f consultations

Integrate telemonitoring in good clinical care practices, and preferably within an established HCP – patient trust relation

Stimulate further research on the importance of and conditions for F2F consultations

Appraise and determine the golden standard of quality of telemonitoring care

Equal access and inclusivity

Take into account vulnerability in inclusion/exclusion criteria, beware of noncompliance

Involve patients in design and implementation processes, and consider implementation as an iterative process requiring continuous adjustment

Stimulate careful upscaling: What works for one patient population does not automatically work for another

Privacy and big data

Identify the risks of the dependency on commercial companies; concerns of collection of data are beyond privacy; power of commercial parties over data collection tools and the infrastructure of clinical studies and clinical care may negatively impact the quality of care