Large Scale Digital Health Deployments - How Ready Are We?: Lessons From the UK Delivering Assistive Living Lifestyles at Scale (dallas) Programme

Mair, F. S. , Lennon, M., Bouamrane, M.-M., Devlin, A. M. , O'Connor, S., Chetty, U., Agbakoba, R., Bikker, A. and O'Donnell, C. (2016) Large Scale Digital Health Deployments - How Ready Are We?: Lessons From the UK Delivering Assistive Living Lifestyles at Scale (dallas) Programme. In: 44th Annual Meeting of the North American Primary Care Research Group. (NAPCRG), Colorado Springs, CO, USA, 12-16 Nov 2016,

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Publisher's URL: http://www.napcrg.org/Conferences/AnnualMeeting/SearchEducationalSessions-2016?m=6&s=18196

Abstract

Context: Digital health has great potential but has proven slow to become accepted, integrated and routinized at scale. Here we have examined factors affecting readiness to implement digital health at scale, through the evaluation of a national digital health and wellbeing programme called ‘Delivering Assisted Living Lifestyles at Scale’ (dallas, 2012-2015, $52M). Objective: To identify barriers and facilitators to digital health and to make recommendations about how to promote uptake of digital health. Design: Longitudinal (3 years) qualitative study involving Interviews (n=126) with key stakeholders; Focus groups (n= 7) with professionals/public using dallas services; dallas leads meetings (N=12); ethnographic field work/participant observation in one community (n=16); and cross programme documentary evidence (N=215) used to evaluate the implementation of the dallas programme. Normalisation Process Theory underlying conceptual framework. Framework approach to analysis. Setting: UK wide general population. Participants: Key stakeholders: health professionals, managers, IT staff, industry, voluntary sector, and the public. Results: Issues influencing readiness for digital health were noted at three levels: Macro (market; infrastructure; policy), Meso (organisational) and Micro (professional/public). Factors hindering implementation included: lack of IT infrastructure both locally and nationally; uncertainty around information governance; lack of incentives to prioritise interoperability; lack of precedence on accountability within commercial sector; a market perceived as difficult to navigate; inadequate implementation resources; low IT skills and access across users (professional and lay); and concerns surrounding security and safety. Factors enabling implementation included: clinical endorsement; digital health champions; and public and professional willingness to embrace digital health. Conclusions: There is receptiveness to digital health, but substantial barriers to widespread use remain. Recommendations include: greater investment in national and local infrastructure, implementation of clear systems for accreditation and quality assurance, incentivisation of interoperability, and investment in upskilling of professionals and public would help support normalisation of digital health.

Item Type:Conference Proceedings
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Devlin, Dr Alison and Chetty, Dr Ula and O'Donnell, Professor Catherine and Bouamrane, Dr Matt-Mouley and Mair, Professor Frances and Bikker, Ms Annemieke
Authors: Mair, F. S., Lennon, M., Bouamrane, M.-M., Devlin, A. M., O'Connor, S., Chetty, U., Agbakoba, R., Bikker, A., and O'Donnell, C.
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 > MRC/CSO Unit
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