Observing the Challenges of Implementing New Health ICT

Abstract

Research into the development and adoption of new health technologies finds that information and communication technology (ICT) developers often fail to understand the clinical workplace, resulting in the implementation of costly systems that stakeholders reject. Here we report observations of the implementation of a well-designed new patient information system at a regional hospital. We used a combination of ethnographical and survey methods to assess stakeholders‘ uptake of and reactions to the new system. We found that even with a well-designed system, uptake can encounter challenges. We outline a number of important factors that may influence the success, or failure, of new ICT.

Lessons Learned Through Two Phases of Developing and Implementing a Technology Supporting Integrated Care: Case Study

“…The only way to scale a technology that may be used for research purposes (eg, understanding pre–post changes in participant outcomes or for general program evaluation) is to have a usable downloadable file (or way to develop summary reports), ideally one that can be converted into the appropriate file types for statistical software programs. Although this is not a common key learning in the literature in this field, other authors have emphasized the importance of being aware of concurrent changes to other systems when implementing a new ICT system [ 23 ]. Although these authors referred to technology systems, it is just as important to consider any system of work, including program versus research needs.…”

“…It is also important to implement ICT that is flexible enough to change per the local context, but neither the technology nor the end users can be too rigorous in the application of the technology. Although end users need to see value in adopting a new ICT [ 23 ], its developers and implementers cannot expect too many users and users cannot expect too much ICT. Steele Gray et al [ 24 ] recommended that adopting ICT into integrated care models requires a balance between a user-focused model and disruptive innovation, as ICT will inevitably introduce new ways of working for each user.…”

“…In Health TAPESTRY, the value of ICT is not only the TAP-App itself but also the program elements that the huddle can access with the TAP-App, which introduces an additional barrier to access, as the primary care team should see a great enough value in the information contained in the TAP-Report and in the work of volunteers who are following up with their patients. In observing the challenges of integrating new health ICT, Planitz et al [ 23 ] found that the adoption of health ICT relied on providers identifying the functionality of new systems and that they were reluctant to change work processes during adoption. Therefore, the consideration of how well human factors are considered in introducing new ICT, and how well the ICT’s functions are suited to end users may actually provide more value than the consideration of the interoperability of an ICT into an EMR.…”