Challenges faced in implementation of a telehealth enabled chronic wound care system

Barrett, Melissa; Larson, Ann; Carville, Keryln; Ellis, Isabelle

doi:10.22605/rrh1154

Cited by 13 publications

(10 citation statements)

References 8 publications

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“…Overall, the searches revealed several studies on cross‐sector TM interventions in chronic wound management, with the majority of them targeting wound healing, risk reductions, patient's quality of life, and cost‐effectiveness parameters. Only eight studies (see Table 2) explore broader or more comprehensive TM perspectives on quality improvement and integration of chronic wound management across sectors 27,33‐36,42,50,51 . Findings in three of these studies 42,50,51 are supported across databases and review methodologies applied in this article.…”

Section: Resultsmentioning

confidence: 89%

“…These searches revealed several cross-sector publications that address wound healing and reduction (in size), risk of amputation, the accuracy of pressure injury evaluation, quality-adjusted life-year resulting from TM interventions or applications, and cost-effectiveness perspectives. 13,[37][38][39][40][41] We found broader or more comprehensive TM perspectives on quality improvement and integration of chronic wound management across sectors-extending beyond wound healing, risk reduction, and cost-effectiveness-only in studies by Mills et al 42 and Barrett et al 27 These studies documented several TM-related systemic opportunities and barriers to holistic (inpatient and outpatient) service quality improvement. Barrett et al 27 identified barriers in terms of delays in installing the software and workforce shortages, where only about half of those who trained in using the software were still employed at the end of the study.…”

Section: Google Scholar Searchesmentioning

confidence: 99%

“…13,[37][38][39][40][41] We found broader or more comprehensive TM perspectives on quality improvement and integration of chronic wound management across sectors-extending beyond wound healing, risk reduction, and cost-effectiveness-only in studies by Mills et al 42 and Barrett et al 27 These studies documented several TM-related systemic opportunities and barriers to holistic (inpatient and outpatient) service quality improvement. Barrett et al 27 identified barriers in terms of delays in installing the software and workforce shortages, where only about half of those who trained in using the software were still employed at the end of the study. Mills et al 42 identified the benefits of health care provider, caregiver, and patient satisfaction with TM, the potential for technological advancement via TM, and the potential for virtual care/TM to improve health personnel safety and reduce virus spread (such as COVID-19).…”

Section: Google Scholar Searchesmentioning

confidence: 99%

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A cross‐sector systematic review and synthesis of knowledge on telemedicine interventions in chronic wound management—Implications from a system perspective

Høyland

Holte

Islam

et al. 2022

International Wound Journal

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Based on initially identified needs for further telemedicine (TM) and chronic wound management research, the objective of this article is twofold: to conduct a systematic review of existing knowledge on TM interventions in chronic wound management-including barriers and opportunities-across the specialist and primary care sectors, and to incorporate the review findings into a system framework that can be further developed and validated through empirical data. We conclude that there is a pressing need for broader and more comprehensive empirical explorations into quality improvement and integration of TM in chronic wound management, including using system frameworks that can capture cross-sector system perspectives and associated implications. Of practical consideration, we suggest that the design and execution of TM improvement interventions and associated research projects should be conducted in close cooperation with managers and practitioners knowledgeable about barriers and opportunities that can influence the implementation of important interventions within chronic wound management.chronic wound management, system framework, systematic review, telemedicine Key Messages• our systematic review indicates a pressing need for broader and more comprehensive empirical explorations into quality improvement and integration of telemedicine (TM) interventions in chronic wound management, including using the system framework explored in this article

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Section: Resultsmentioning

confidence: 89%

Section: Google Scholar Searchesmentioning

confidence: 99%

Section: Google Scholar Searchesmentioning

confidence: 99%

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A cross‐sector systematic review and synthesis of knowledge on telemedicine interventions in chronic wound management—Implications from a system perspective

Høyland

Holte

Islam

et al. 2022

International Wound Journal

View full text Add to dashboard Cite

show abstract

“…An eHealth solution can belong to one of these domains or contain elements from several domains. 3 Research on eHealth has focussed on changed roles for healthcare professionals, [4][5][6] the importance of alignment with care processes, [7][8][9] impact of staff turnover, 10 increased workload 11 and/or decreased workload, [12][13][14] changes in workflow [15][16][17][18] and changes in professional values. 5,7,19 Consequently, previous research shows that eHealth solutions influence the way healthcare professionals conduct their work and provide care.…”

Section: Introductionmentioning

confidence: 99%

Materiality and the mediating roles of eHealth: A qualitative study and comparison of three cases

et al. 2022

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Against the backdrop of eHealth solutions increasingly becoming a part of healthcare professionals’ ways of doing care work, this paper questions how the solutions mediate the experience of healthcare professionals when deployed. We undertook a qualitative study of three eHealth solutions, conducting qualitative interviews with a diverse sample of 102 healthcare professionals from different care settings across the south of Sweden. Materiality and postphenomenology serve as analytic tools for achieving an understanding of the mediating roles of eHealth solutions. The analysis emphasises the mediating roles consisting of interrelated paradoxes: (1) changing and perpetuating boundaries between patients and professional groups, (2) (dis)enabling augmented information and knowledge processes and (3) reconfiguring professional control over work. This contribution provides critical insights into materiality as a category of analysis in studies on the deployment of eHealth solutions, as these technologies have both intended and unintended consequences for care work. Our study identified general positive consequences of all three solutions, such as the increased feeling of closeness to patients and colleagues over time and space; increased ‘understanding’ of patients through patient-generated data; and increased autonomy, due to the fact that asynchronous communication makes it possible to decide when and which patient to attend to. We also identified general unintended consequences of the solutions, such as maintenance of power relations maintained due to organisational structures and professional relations, disabled information and knowledge processes due to the lack of non-verbal clues, reduced professional autonomy due to technical scripts determining what data is collected and how it is categorised, and uneven workload due to the dependency on patient input and compliance.

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“…al note: "Several prior studies in community health research involving rural areas have found that positive community health results from professional-layperson partnerships engaged in capacity building, diverse leadership development and comprehensive multi-sectoral planning (150)." Further, Barret notes: "Clinical drivers and telemedicine users must own their own systems (151)." Hybrid leadership, as seen through Lara's encouragement of her staff and the multiple roles rural individuals fill within the community, is important for creating accountability within an implementation and community ownership, enabling successful implementations.…”

Section: Collaborative Efforts Can Only Truly Thrive If the People Or...mentioning

confidence: 99%

Addressing Rural Health Access Inequity by Assessing Potential and Organizational Readiness for Antifragile Electronic Health Project Design in Rural Communities

Petrie¹

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There is a rural health access equity gap (especially for specialist care) within Canadian and international universal healthcare systems. Electronic health (eHealth) can address that gap, but pilot projects rarely scale to other contexts, or sustain in their original settings. Antifragile design and complexity informed principles can improve pilot project lifespans. Antifragile entities gain stability from uncertainty, rather than lose integrity. Antifragile operators include Chapter 1: Impact of the Novel Coronavirus (COVID-19) Pandemic on Doctoral Research ActivitiesSome problems are so complex that you must be highly intelligent and well informed just to be undecided about them.~Laurence J. PeterIn the winter of 2020, my research was following closely to the timelines outlined in the Carleton Health Sciences PhD stream table. Partnerships were being built with organizations who had interest in both electronic health (eHealth) and implementation. Chief among those institutional partners was the IWK health centre in Halifax, specializing in pediatrics and critical care. Through a CIHR funded health systems impact fellowship, I would have been embeddedwithin their organization for a year to assess the readiness of adopting a clinical information system at multiple sites across the province of Nova Scotia. Instead, that partnership, as well as a partnership with the Ontario Telehealth Network (OTN) and a local initiative out of the Ottawa Civic emergency department, were cut short as goals and resources shifted to combat the global COVID-19 pandemic.This has had a profound effect on my research, both positively and negatively, and has required adjustments regarding how I collected my data, the context of previously collected data, and how I should rectify my recommendations with the realities of a COVID-19 encumbered health system. Adverse effects of the pandemic are chiefly the break down of personal

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Challenges faced in implementation of a telehealth enabled chronic wound care system

Abstract: Challenges faced in implementation of a telehealth enabled chronic wound care system Rural and Remote Health 9: 1154. (Online), 2009

Cited by 13 publications

References 8 publications

A cross‐sector systematic review and synthesis of knowledge on telemedicine interventions in chronic wound management—Implications from a system perspective

A cross‐sector systematic review and synthesis of knowledge on telemedicine interventions in chronic wound management—Implications from a system perspective

Materiality and the mediating roles of eHealth: A qualitative study and comparison of three cases

Addressing Rural Health Access Inequity by Assessing Potential and Organizational Readiness for Antifragile Electronic Health Project Design in Rural Communities

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