Key factors influencing the implementation success of a home telecare application

RATIONALE The introduction of home telecare in healthcare organizations has shown mixed results in practice. The aim of this study is to arrive at a set of key factors that can be used in further implementation of video communication. We argue that key factors are mainly found in the organizational climate for home telecare implementation, the characteristics of the implementation strategy and the available technology. METHODS Interviews were conducted in three care organizations with 27 respondents of different levels within and outside the organization. Implementation determinants, based on earlier research, were used as a categorization framework for the interviews. RESULTS We found that most prominent factors influencing implementation outcomes relate to the stability of the technical and the external environment and the alignment of organization, goals and implementation strategy. CONCLUSION Because of the experimental nature of implementing video communication, attention to telecare influencers has been inconsistent and disorganized but it is becoming increasingly important. According to the respondents, a champion-led roll-out is imperative for implementation in order to advance to the next stage in home telecare and to organize services for substitution of care.

[1]  Mark C. Paulk,et al.  The Capability Maturity Model , 1991 .

[2]  Ton A. M. Spil,et al.  Success of IT based innovation in healthcare: the art of implementation and use of an electronic patient record , 2005 .

[3]  David Hailey,et al.  A profile of success and failure in telehealth – evidence and opinion from the Successes and Failures in Telehealth conferences , 2003, Journal of telemedicine and telecare.

[4]  S. Finkelstein,et al.  Home telehealth improves clinical outcomes at lower cost for home healthcare. , 2006, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[5]  Marie-Pierre Gagnon,et al.  A systematic review of the key indicators for assessing telehomecare cost-effectiveness. , 2008, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[6]  Vasiliki Mantzana,et al.  Identifying healthcare actors involved in the adoption of information systems , 2007, Eur. J. Inf. Syst..

[7]  이훈,et al.  지각된 유용성(Perceived Usefulness)의 영향분석 , 2004 .

[8]  Albert Boonstra,et al.  Does telehomeconsultation lead to substitution of home visits? Analysis and implications of a telehomecare program. , 2010, Studies in health technology and informatics.

[9]  Fred D. Davis Perceived Usefulness, Perceived Ease of Use, and User Acceptance of Information Technology , 1989, MIS Q..

[10]  Claude Sicotte,et al.  A cost-effectiveness analysis of interactive paediatric telecardiology , 2004, Journal of telemedicine and telecare.

[11]  Christiaan P. Katsma,et al.  IT based innovation success in healthcare: The art of implementation and use of an electronic patient record , 2005 .

[12]  Elske Ammenwerth,et al.  Evaluation of health information systems - problems and challenges , 2003, Int. J. Medical Informatics.

[13]  T. Paulussen,et al.  Determinants of innovation within health care organizations: literature review and Delphi study. , 2004, International journal for quality in health care : journal of the International Society for Quality in Health Care.

[14]  Brian D. Janz,et al.  Information Systems and Healthcare XVI: Physician Adoption of Electronic Medical Records: Applying the UTAUT Model in a Healthcare Context , 2007, Commun. Assoc. Inf. Syst..

[15]  E. Rogers,et al.  Diffusion of innovations , 1964, Encyclopedia of Sport Management.

[16]  P Jacklin,et al.  A randomized controlled trial assessing the health economics of realtime teledermatology compared with conventional care: an urban versus rural perspective , 2001, Journal of telemedicine and telecare.

[17]  K. Bowles,et al.  Cost analysis of telehomecare. , 2001, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[18]  David R. Firth,et al.  Communications of the Association for Information Systems , 2011 .

[19]  Kathryn H Bowles,et al.  Lessons learned from a telehomecare project. , 2002, Caring : National Association for Home Care magazine.

[20]  J. Barlow,et al.  Implementing complex innovations in fluid multi-stakeholder environments: Experiences of ‘telecare’ , 2006 .

[21]  David R. Seibold,et al.  Innovation Modification During Intraorganizational Adoption , 1993 .

[22]  D. R. Dixon,et al.  Adoption of information technology enabled innovations by primary care physicians: model and questionnaire development. , 1994, Proceedings. Symposium on Computer Applications in Medical Care.

[23]  Sunyoung Cho,et al.  A Contextualist Approach to Telehealth Innovations , 2007 .

[24]  Cheryl Dellasega,et al.  Qualitative analysis of telehomecare nursing activities. , 2003, The Journal of nursing administration.

[25]  Richard E. Scott,et al.  Moving research into practice: A decision framework for integrating home telehealth into chronic illness care , 2006, Int. J. Medical Informatics.

[26]  Richard Curry,et al.  Assessing the impact of a care innovation: telecare , 2007 .

[27]  Christian Nøhr,et al.  Comparing Approaches to Measuring the Adoption and Usability of Electronic Health Records: Lessons Learned from Canada, Denmark and Finland , 2013, MedInfo.

[28]  Robert Mittman,et al.  Diffusion of Innovation in Health Care , 2002 .

[29]  Anneke L. Francke,et al.  Ervaringen van verpleegkundigen en verzorgenden met nieuwe technologieën in de zorg: resultaten van de peiling onder de leden van het panel Verpleging en Verzorging. , 2009 .

[30]  J. Barlow,et al.  Flexible Homes, Flexible Care, Inflexible Organisations? The Role of Telecare in Supporting Independence , 2005 .

[31]  K. Dansky,et al.  Is there a business case for telehealth in home health agencies? , 2006, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.