Stakeholder Readiness for Telehomecare: Implications for Implementation

Abstract

Numerous pilot studies have demonstrated that telehomecare technology may improve client outcomes through timely intervention and health crises prevention, thereby reducing return visits to hospitals and physician offices. Although the potential of telehomecare to increase access to services and improve quality of care and health outcomes is recognized, expectations for its widespread adoption have not been realized. Factors affecting diffusion of innovations include, among other things, perceptions of the technology, organizational characteristics, and communication. These require further exploration for telehealth applications because evidence alone will not automatically produce large-scale conversions in practice. This 12-month study was designed to assess the readiness of clients, health care professionals, and organizations to adopt telehomecare services for adult diabetic clients within the Calgary Health Region. A qualitative approach was used to collect data through focus groups with clients and home care nurses along with interviews with family physicians and key informants responsible for planning and resource allocation in diabetic homecare and telehealth programs. The transcripts of these interviews were analyzed for themes, which were categorized with respect to their effect on quality of care (including structure, process or outcome of care), including those related to the individual client, the health care provider, and the organization as a whole. The study findings identified differences in stakeholder conceptions of the technology, including common themes among clients, providers, and organizations. Implications of study results for developing a strategy to incorporate telehomecare into routine community care are discussed.

Prevalence and characteristics of home Internet access in patients with cardiovascular disease from diverse geographical locations

“…While government-led telehealth initiatives tend to focus on video conferencing, a number of small studies and pilot projects delivering health services via the Internet have been reported in patients with breast cancer (21,22), asthma (23), chronic obstructive pulmonary disease (24,25), diabetes (26)(27)(28)(29)(30)(31)(32), lung transplantation (33), overweight (34)(35)(36)(37)(38)(39)(40), smokers (41), chronic heart failure (25,(42)(43)(44) and CVD (45)(46)(47)(48). These studies demonstrated that patients were willing to enter self-measured data online and communicate with health care providers via e-mail and/or chat/video conferencing.…”

Analysis of Barriers to the Deployment of Health Information Systems: a Stakeholder Perspective

“…There is also a limited consensus on identified barriers and categories. This limited agreement about what can be expected from the adoption of those systems could be one of the reasons for the delay in the adoption of HIS (Hebert and Korabek 2004;Gruber et al 2009;Williams et al 2003). There is also a large number of studies that focus on a particular set of stakeholders' groups, namely, healthcare professionals, GPs, managers and policymakers.…”

Telehomecare for Vulnerable Populations: The Evaluation of New Models of Care

“…It is thus important for project managers to assess telehomecare readiness within all groups of stakeholders in order to identify potential barriers to the integration of the technology into current practices. 7,29 Healthcare organizations Assessment of the particular characteristics of organizations involved in telehomecare projects and their environment is needed to prepare and to support changes. This requires a close look at the various constraints related to real-life settings.…”

“…[3][4][5][6] Although the potential of telehomecare to increase access to services and improve quality of care and health outcomes is recognized, its widespread adoption has not been realized yet. 7 Telehealth seems particularly appropriate for vulnerable populations. Vulnerable populations consist of, but are not limited to, citizens who face particular risks for their health and well-being because of economic, sociodemographic, ethnic, cultural, geographical, physical, and/or mental health status.…”