Delivering digital health and well-being at scale: lessons learned during the implementation of the dallas program in the United Kingdom

Devlin, A. M. et al. (2015) Delivering digital health and well-being at scale: lessons learned during the implementation of the dallas program in the United Kingdom. Journal of the American Medical Informatics Association, 23(1), pp. 48-59. (doi:10.1093/jamia/ocv097) (PMID:26254480)

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Abstract

Objective: To identify implementation lessons from the United Kingdom Delivering Assisted Living Lifestyles at Scale (dallas) program—a large-scale, national technology program that aims to deliver a broad range of digital services and products to the public to promote health and well-being. Materials and Methods: Prospective, longitudinal qualitative research study investigating implementation processes. Qualitative data collected includes semi-structured e-Health Implementation Toolkit–led interviews at baseline/mid-point (n = 38), quarterly evaluation, quarterly technical and barrier and solutions reports, observational logs, quarterly evaluation alignment interviews with project leads, observational data collected during meetings, and ethnographic data from dallas events (n > 200 distinct pieces of qualitative data). Data analysis was guided by Normalization Process Theory, a sociological theory that aids conceptualization of implementation issues in complex healthcare settings. Results: Five key challenges were identified: 1) The challenge of establishing and maintaining large heterogeneous, multi-agency partnerships to deliver new models of healthcare; 2) The need for resilience in the face of barriers and set-backs including the backdrop of continually changing external environments; 3) The inherent tension between embracing innovative co-design and achieving delivery at pace and at scale; 4) The effects of branding and marketing issues in consumer healthcare settings; and 5) The challenge of interoperability and information governance, when commercial proprietary models are dominant. Conclusions: The magnitude and ambition of the dallas program provides a unique opportunity to investigate the macro level implementation challenges faced when designing and delivering digital health and wellness services at scale. Flexibility, adaptability, and resilience are key implementation facilitators when shifting to new digitally enabled models of care.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Wyke, Professor Sally and McGee-Lennon, Dr Marilyn and Watson, Professor Nicholas and Devlin, Dr Alison and Browne, Dr Susan and Finch, Dr Tracy and Bouamrane, Dr Matt-Mouley and Grieve, Miss Eleanor and Mair, Professor Frances and O'Connor, Dr Suzy and O'Donnell, Professor Catherine
Authors: Devlin, A. M., McGee-Lennon, M., O'Donnell, C. A., Bouamrane, M.-M., Agbakoba, R., O'Connor, S., Grieve, E., Finch, T., Wyke, S., Watson, N., Browne, S., and Mair, F. S.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > General Practice and Primary Care
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Health Economics and Health Technology Assessment
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > MRC/CSO Unit
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Social Scientists working in Health and Wellbeing
Journal Name:Journal of the American Medical Informatics Association
Publisher:Oxford University Press
ISSN:1067-5027
ISSN (Online):1527-974X
Copyright Holders:Copyright © 2015 The Authors
First Published:First published in Journal of the American Medical Informatics Association 23(1):48-59
Publisher Policy:Reproduced under a Creative Commons License

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