Web based diabetes care planning - sociotechnical barriers to implementation in general practice.

BACKGROUND This research explored the sociotechnical barriers in the implementation of web based diabetes care plans in general practice from the perspective of implementing stakeholders. METHODS A qualitative case study design was use to explore the sociotechnical barriers. Twenty-one stakeholders were purposely recruited and interviewed. RESULTS Technological barriers included rudimentary IT applications in general practice; standardisation and interoperability issues; and 'bugs' in the system. The role of practice managers as gatekeepers influenced the uptake of the technology. General practitioners were noted to be time poor, while practice nurses preferred to stick with paper based ways of doing care plans. The relationship between allied health professionals and GPs also influenced the adoption process. DISCUSSION Implementers had significant insight into the sociotechnical barriers to diabetes web based care planning in general practice. Future research should examine the roles of the stakeholders involved in determining standards and the interoperability of systems.

[1]  D. Brailer Interoperability: the key to the future health care system. , 2005, Health affairs.

[2]  M. Harris,et al.  Do multidisciplinary care plans result in better care for patients with type 2 diabetes? , 2007, Australian family physician.

[3]  Jennifer Lai,et al.  Unintended Consequences of Information Technologies in Health Care—An Interactive Sociotechnical Analysis , 2007 .

[4]  Enrico W. Coiera,et al.  Putting the technical back into socio-technical systems research , 2007, Int. J. Medical Informatics.

[5]  J. Beilby Primary care reform using a layered approach to the Medicare Benefits Scheme: unpredictable and unmeasured , 2007, The Medical journal of Australia.

[6]  T. Greenhalgh,et al.  Introduction of shared electronic records: multi-site case study using diffusion of innovation theory , 2008, BMJ : British Medical Journal.

[7]  Andrew Georgiou,et al.  Model Formulation: Multimethod Evaluation of Information and Communication Technologies in Health in the Context of Wicked Problems and Sociotechnical Theory , 2007, J. Am. Medical Informatics Assoc..

[8]  Paul Turner,et al.  Patient safety and sociotechnical considerations for electronic handover tools in an Australian ehealth landscape. , 2010, Studies in health technology and informatics.

[9]  J. Proudfoot,et al.  Multidisciplinary care plans for diabetes: how are they used? , 2007, The Medical journal of Australia.

[10]  Jos Aarts,et al.  UK's National Programme for IT welcomes recommendation for a more sociotechnical approach to evaluation: a commentary on the Greenhalgh evaluation of the summary care record. , 2008, Informatics in primary care.