The e-health implementation toolkit: qualitative evaluation across four European countries

BackgroundImplementation researchers have attempted to overcome the research-practice gap in e-health by developing tools that summarize and synthesize research evidence of factors that impede or facilitate implementation of innovation in healthcare settings. The e-Health Implementation Toolkit (e-HIT) is an example of such a tool that was designed within the context of the United Kingdom National Health Service to promote implementation of e-health services. Its utility in international settings is unknown.MethodsWe conducted a qualitative evaluation of the e-HIT in use across four countries--Finland, Norway, Scotland, and Sweden. Data were generated using a combination of interview approaches (n = 22) to document e-HIT users' experiences of the tool to guide decision making about the selection of e-health pilot services and to monitor their progress over time.Resultse-HIT users evaluated the tool positively in terms of its scope to organize and enhance their critical thinking about their implementation work and, importantly, to facilitate discussion between those involved in that work. It was easy to use in either its paper- or web-based format, and its visual elements were positively received. There were some minor criticisms of the e-HIT with some suggestions for content changes and comments about its design as a generic tool (rather than specific to sites and e-health services). However, overall, e-HIT users considered it to be a highly workable tool that they found useful, which they would use again, and which they would recommend to other e-health implementers.ConclusionThe use of the e-HIT is feasible and acceptable in a range of international contexts by a range of professionals for a range of different e-health systems.

[1]  Anselm L. Strauss,et al.  Basics of qualitative research : techniques and procedures for developing grounded theory , 1998 .

[2]  E. Akl,et al.  NorthStar, a support tool for the design and evaluation of quality improvement interventions in healthcare , 2007, Implementation science : IS.

[3]  I. Winblad,et al.  Transnational comparison: A retrospective study on e-health in sparsely populated areas of the northern periphery. , 2010, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[4]  C. Helfrich,et al.  Implementation Science Organizational Readiness to Change Assessment (orca): Development of an Instrument Based on the Promoting Action on Research in Health Services (parihs) Framework , 2022 .

[5]  The Telemedicine Tool Kit; A workbook for NHS doctors, nurses and managers. , 2000 .

[6]  F. Sniehotta,et al.  Multiple goals and time constraints: perceived impact on physicians' performance of evidence-based behaviours , 2009, Implementation science : IS.

[7]  Robert P. Hawkins,et al.  Developing and validating a model to predict the success of an IHCS implementation: the Readiness for Implementation Model , 2010, J. Am. Medical Informatics Assoc..

[8]  Elizabeth Murray,et al.  Understanding the implementation and integration of e-health services , 2007 .

[9]  P. Shekelle,et al.  Systematic Review: Impact of Health Information Technology on Quality, Efficiency, and Costs of Medical Care , 2006, Annals of Internal Medicine.

[10]  J. Grimshaw,et al.  From best evidence to best practice: effective implementation of change in patients' care , 2003, The Lancet.

[11]  J. Kitzinger,et al.  Qualitative Research: Introducing focus groups , 1995 .

[12]  K. Hofman,et al.  Implementation Science , 2007, Science.

[13]  H. Graham,et al.  Evidence for public health policy on inequalities: 1: The reality according to policymakers , 2004, Journal of Epidemiology and Community Health.

[14]  R. Barbour Introducing Focus Groups , 2007 .

[15]  Elizabeth Murray,et al.  Development and formative evaluation of the e-Health Implementation Toolkit (e-HIT). , 2010, BMC medical informatics and decision making.

[16]  E. Keeler,et al.  Costs and benefits of health information technology. , 2006, Evidence report/technology assessment.

[17]  M. Berg,et al.  ICT in health care: sociotechnical approaches. , 2003, Methods of Information in Medicine.

[18]  C. May,et al.  Implementing, Embedding, and Integrating Practices: An Outline of Normalization Process Theory , 2009 .

[19]  E Monteiro,et al.  Big is Beautiful: Electronic Patient Records in Large Norwegian Hospitals 1980s – 2001 , 2003, Methods of Information in Medicine.

[20]  Robbert Huijsman,et al.  Short- and long-term effects of a quality improvement collaborative on diabetes management , 2010, Implementation science : IS.

[21]  R. Edwards,et al.  What Is Qualitative Interviewing , 2013 .

[22]  A. Hassey The National Programme for IT in the NHS. , 2005, The British journal of general practice : the journal of the Royal College of General Practitioners.

[23]  M. Patton,et al.  Qualitative evaluation and research methods , 1992 .

[24]  G. Gilbert,et al.  Researching Social Life , 1994 .

[25]  M Berg,et al.  Integrating Quantitative and Qualitative Methods in Patient Care Information System Evaluation , 2003, Methods of Information in Medicine.

[26]  Marc Berg,et al.  Implementing information systems in health care organizations: myths and challenges , 2001, Int. J. Medical Informatics.

[27]  C. Dowrick,et al.  Embedding effective depression care: using theory for primary care organisational and systems change , 2010, Implementation science : IS.

[28]  Octavio Gómez Dantés,et al.  The World Health Report 1999. Making a Difference , 1999 .

[29]  N. Britten,et al.  Using Reflexivity to Optimize Teamwork in Qualitative Research , 1999, Qualitative health research.

[30]  Jo Rycroft-Malone,et al.  Evaluating the successful implementation of evidence into practice using the PARiHS framework: theoretical and practical challenges , 2008, Implementation science : IS.

[31]  E. Fess,et al.  Determining sample size. , 1995, Journal of hand therapy : official journal of the American Society of Hand Therapists.

[32]  E Balka,et al.  Getting the Big Picture , 2003, Methods of Information in Medicine.