Why is it difficult to implement e-health initiatives? A qualitative study

Autor: Catherine A. O'Donnell, Frances S. Mair, Joanne Burns, Tracy Finch, Elizabeth Murray, Carl May, Paul J Wallace
Jazyk: angličtina
Rok vydání: 2011
Předmět:
P900
Health Informatics
Choice Behavior
Health informatics
Health administration
Interviews as Topic
Nursing
Information-technology
care
systems
service
methodology
acceptance
innovation
adoption
model
PACS
Health care
Humans
Medicine
Medical Informatics Applications
Referral and Consultation
Qualitative Research
Health policy
Medicine(all)
lcsh:R5-920
Primary Health Care
Attitude to Computers
business.industry
Data Collection
Health Policy
Public Health
Environmental and Occupational Health
Health services research
Information technology
General Medicine
Models
Theoretical
Public relations
Community Health Nursing
United Kingdom
B900
Radiology Information Systems
Information and Communications Technology
Organizational Case Studies
Diffusion of Innovation
lcsh:Medicine (General)
business
RA
Research Article
Qualitative research
Zdroj: Implementation Science : IS
Implementation Science, 6, Article 6. (2011)
Implementation Science, Vol 6, Iss 1, p 6 (2011)
ISSN: 1748-5908
Popis: Background The use of information and communication technologies in healthcare is seen as essential for high quality and cost-effective healthcare. However, implementation of e-health initiatives has often been problematic, with many failing to demonstrate predicted benefits. This study aimed to explore and understand the experiences of implementers - the senior managers and other staff charged with implementing e-health initiatives and their assessment of factors which promote or inhibit the successful implementation, embedding, and integration of e-health initiatives.\ud \ud Methods We used a case study methodology, using semi-structured interviews with implementers for data collection. Case studies were selected to provide a range of healthcare contexts (primary, secondary, community care), e-health initiatives, and degrees of normalization. The initiatives studied were Picture Archiving and Communication System (PACS) in secondary care, a Community Nurse Information System (CNIS) in community care, and Choose and Book (C&B) across the primary-secondary care interface. Implementers were selected to provide a range of seniority, including chief executive officers, middle managers, and staff with 'on the ground' experience. Interview data were analyzed using a framework derived from Normalization Process Theory (NPT).\ud \ud Results Twenty-three interviews were completed across the three case studies. There were wide differences in experiences of implementation and embedding across these case studies; these differences were well explained by collective action components of NPT. New technology was most likely to 'normalize' where implementers perceived that it had a positive impact on interactions between professionals and patients and between different professional groups, and fit well with the organisational goals and skill sets of existing staff. However, where implementers perceived problems in one or more of these areas, they also perceived a lower level of normalization.\ud \ud Conclusions Implementers had rich understandings of barriers and facilitators to successful implementation of e-health initiatives, and their views should continue to be sought in future research. NPT can be used to explain observed variations in implementation processes, and may be useful in drawing planners' attention to potential problems with a view to addressing them during implementation planning.
Databáze: OpenAIRE
Externí odkaz: