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23
July, 2014
Wednesday

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

Abstract

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.

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 analysed using a framework derived from Normalization Process Theory (NPT).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 organizational 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.

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.

Murray E, Burns J, May C, Finch T, O'Donnell C, Wallace P, et al. Why is it difficult to implement e-health initiatives? A qualitative study. Implement Sci. 2011 Jan 19;6(1):6.

23 January 2011

Bibliographic Data

Title:

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

Author(s):

Murray, Elizabeth; Burns, Joanne; May, Carl R.; Finch, Tracy; O'Donnell, Catherine; Wallace, Paul; Mair, Frances S.

Journal

Implementation Science, 6(1), pp. 6
(2011-01-19)

URL:

Full article

DOI:

10.1186/1748-5908-6-6

Keyword(s):

e-Health, Implementation, UK

Citation:
Murray E, Burns J, May C, Finch T, O'Donnell C, Wallace P, et al. Why is it difficult to implement e-health initiatives? A qualitative study. Implement Sci. 2011 Jan 19;6(1):6.

Other Publications

In ICMCC Database

All Implementation Science articles (3).

Other article(s) by

Elizabeth Murray (2).

Paul Wallace (1).

Frances S. Mair (2).

Carl R. May (2).

Discussion




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Miscellaneous

Affiliated University Institutes

University of Newcastle - Institute of Health and Society, UK

University of Southampton - Faculty of Health Sciences, UK

London South Bank University - Primary Care Research Network for Greater London, UK

University College London - Research Department of Primary Care and Population Health - E-Health Unit, UK

University of Glasgow - Centre for Population and Health Sciences - Section of General Practice & Primary Care, UK

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PubMed

Elizabeth Murray
Paul Wallace
Frances S. Mair
Catherine O'Donnell
Joanne Burns
Carl R. May
Tracy Finch

Google Scholar

Elizabeth Murray
Paul Wallace
Frances S. Mair
Catherine O'Donnell
Joanne Burns
Carl R. May
Tracy Finch

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