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Remote monitoring may help in avoiding emergencies and prolong users\u2019 independence. To understand how to design systems which support older adults, we studied a large-scale remote health monitoring system. The system used fitness-grade smartwatches to monitor the vital signs of more than 2000 users constantly. To probe the lived experience of using RHM, we conducted an explorative interview study (<jats:italic>N<\/jats:italic> = 41) with operators, carers, and users of the RHM system. Our thematic analysis reveals that personalisation of care ecology is crucial for developing users\u2019 confidence and trust in the system. We found that participation in RHM may catalyse positive changes in older adults\u2019 lifestyles. Based on our findings, we formulate five recommendations for designing future health monitoring systems. 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