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An organisational analysis of the implementation of telecare and telehealth: the whole systems demonstrator

An organisational analysis of the implementation of telecare and telehealth: the whole systems demonstrator
An organisational analysis of the implementation of telecare and telehealth: the whole systems demonstrator
Background

To investigate organisational factors influencing the implementation challenges of redesigning services for people with long term conditions in three locations in England, using remote care (telehealth and telecare).

Methods

Case-studies of three sites forming the UK Department of Health's Whole Systems Demonstrator (WSD) Programme. Qualitative research techniques were used to obtain data from various sources, including semi-structured interviews, observation of meetings over the course programme and prior to its launch, and document review. Participants were managers and practitioners involved in the implementation of remote care services.

Results

The implementation of remote care was nested within a large pragmatic cluster randomised controlled trial (RCT), which formed a core element of the WSD programme. To produce robust benefits evidence, many aspect of the trial design could not be easily adapted to local circumstances. While remote care was successfully rolled-out, wider implementation lessons and levels of organisational learning across the sites were hindered by the requirements of the RCT.

Conclusions

The implementation of a complex innovation such as remote care requires it to organically evolve, be responsive and adaptable to the local health and social care system, driven by support from front-line staff and management. This need for evolution was not always aligned with the imperative to gather robust benefits evidence. This tension needs to be resolved if government ambitions for the evidence-based scaling-up of remote care are to be realised.
1472-6963
403
Hendy, Jane
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Chrysanthaki, Theopisti
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Barlow, James
51253e7e-517c-48b6-98b0-ac82b00a600f
Knapp, Martin
39b0d60c-30b1-4b9b-bc7f-13c5bdc7e712
Rogers, Anne
105eeebc-1899-4850-950e-385a51738eb7
Sanders, Caroline
1121a9ec-e719-489a-9ffd-ae8cb6e49a78
Bower, Peter
ec553157-a170-4219-8b55-2df813846e44
Bowen, Robert
8a2fb064-d46c-4545-a6e5-ea07095721c5
Fitzpatrick, Ray
e8a93c39-1f5e-4a7d-bfc2-77cf6dd7435f
Bardsley, Martin
b0971145-6fe5-435f-99cf-5e32608f567d
Newman, Stanton
53c7fc63-1b0e-44a7-86bb-34c88c6e17e1
Hendy, Jane
4e0b4603-9184-4967-8168-05bc8f281e6c
Chrysanthaki, Theopisti
0fdef340-6542-4161-8de1-eb58d18b90b1
Barlow, James
51253e7e-517c-48b6-98b0-ac82b00a600f
Knapp, Martin
39b0d60c-30b1-4b9b-bc7f-13c5bdc7e712
Rogers, Anne
105eeebc-1899-4850-950e-385a51738eb7
Sanders, Caroline
1121a9ec-e719-489a-9ffd-ae8cb6e49a78
Bower, Peter
ec553157-a170-4219-8b55-2df813846e44
Bowen, Robert
8a2fb064-d46c-4545-a6e5-ea07095721c5
Fitzpatrick, Ray
e8a93c39-1f5e-4a7d-bfc2-77cf6dd7435f
Bardsley, Martin
b0971145-6fe5-435f-99cf-5e32608f567d
Newman, Stanton
53c7fc63-1b0e-44a7-86bb-34c88c6e17e1

Hendy, Jane, Chrysanthaki, Theopisti, Barlow, James, Knapp, Martin, Rogers, Anne, Sanders, Caroline, Bower, Peter, Bowen, Robert, Fitzpatrick, Ray, Bardsley, Martin and Newman, Stanton (2012) An organisational analysis of the implementation of telecare and telehealth: the whole systems demonstrator. BMC Health Services Research, 12 (1), 403. (doi:10.1186/1472-6963-12-403). (PMID:23153014)

Record type: Article

Abstract

Background

To investigate organisational factors influencing the implementation challenges of redesigning services for people with long term conditions in three locations in England, using remote care (telehealth and telecare).

Methods

Case-studies of three sites forming the UK Department of Health's Whole Systems Demonstrator (WSD) Programme. Qualitative research techniques were used to obtain data from various sources, including semi-structured interviews, observation of meetings over the course programme and prior to its launch, and document review. Participants were managers and practitioners involved in the implementation of remote care services.

Results

The implementation of remote care was nested within a large pragmatic cluster randomised controlled trial (RCT), which formed a core element of the WSD programme. To produce robust benefits evidence, many aspect of the trial design could not be easily adapted to local circumstances. While remote care was successfully rolled-out, wider implementation lessons and levels of organisational learning across the sites were hindered by the requirements of the RCT.

Conclusions

The implementation of a complex innovation such as remote care requires it to organically evolve, be responsive and adaptable to the local health and social care system, driven by support from front-line staff and management. This need for evolution was not always aligned with the imperative to gather robust benefits evidence. This tension needs to be resolved if government ambitions for the evidence-based scaling-up of remote care are to be realised.

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More information

e-pub ahead of print date: 15 November 2012
Organisations: Faculty of Health Sciences

Identifiers

Local EPrints ID: 346337
URI: http://eprints.soton.ac.uk/id/eprint/346337
ISSN: 1472-6963
PURE UUID: 007e715a-803d-4fb9-bba6-3b64d6748540

Catalogue record

Date deposited: 17 Dec 2012 16:33
Last modified: 14 Mar 2024 12:35

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Contributors

Author: Jane Hendy
Author: Theopisti Chrysanthaki
Author: James Barlow
Author: Martin Knapp
Author: Anne Rogers
Author: Caroline Sanders
Author: Peter Bower
Author: Robert Bowen
Author: Ray Fitzpatrick
Author: Martin Bardsley
Author: Stanton Newman

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