TY - JOUR
T1 - Delivering digital health and well-being at scale
T2 - lessons learned during the implementation of the dallas program in the United Kingdom
AU - Devlin, Alison M
AU - McGee-Lennon, Marilyn
AU - O'Donnell, Catherine A
AU - Bouamrane, Matt-Mouley
AU - Agbakoba, Ruth
AU - O'Connor, Siobhan
AU - Grieve, Eleanor
AU - Finch, Tracy
AU - Wyke, Sally
AU - Watson, Nicholas
AU - Browne, Susan
AU - Mair, Frances S
PY - 2016/1/31
Y1 - 2016/1/31
N2 - To identify implementation lessons from the United Kingdom Delivering Assisted Living Lifestyles at Scale (dallas) program—alarge-scale, national technology program that aims to deliver a broad range of digital services and products to the publicto promote health and well-being. Prospective, longitudinal qualitative research study investigating implementation processes. Qualitativedata collected includes semi-structured e-Health Implementation Toolkit–led interviews at baseline/mid-point (n ¼ 38), quarterlyevaluation, quarterly technical and barrier and solutions reports, observational logs, quarterly evaluation alignment interviews withproject leads, observational data collected during meetings, and ethnographic data from dallas events (n > 200 distinct pieces ofqualitative data). Data analysis was guided by Normalization Process Theory, a sociological theory that aids conceptualization of implementationissues in complex healthcare settings. Five key challenges were identified: 1) The challenge of establishing and maintaining large heterogeneous, multi-agencypartnerships to deliver new models of healthcare; 2) The need for resilience in the face of barriers and set-backs including thebackdrop of continually changing external environments; 3) The inherent tension between embracing innovative co-design andachieving 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. The magnitude and ambition of the dallas program provides a unique opportunity to investigate the macro level implementationchallenges faced when designing and delivering digital health and wellness services at scale. Flexibility, adaptability, andresilience are key implementation facilitators when shifting to new digitally enabled models of care.
AB - To identify implementation lessons from the United Kingdom Delivering Assisted Living Lifestyles at Scale (dallas) program—alarge-scale, national technology program that aims to deliver a broad range of digital services and products to the publicto promote health and well-being. Prospective, longitudinal qualitative research study investigating implementation processes. Qualitativedata collected includes semi-structured e-Health Implementation Toolkit–led interviews at baseline/mid-point (n ¼ 38), quarterlyevaluation, quarterly technical and barrier and solutions reports, observational logs, quarterly evaluation alignment interviews withproject leads, observational data collected during meetings, and ethnographic data from dallas events (n > 200 distinct pieces ofqualitative data). Data analysis was guided by Normalization Process Theory, a sociological theory that aids conceptualization of implementationissues in complex healthcare settings. Five key challenges were identified: 1) The challenge of establishing and maintaining large heterogeneous, multi-agencypartnerships to deliver new models of healthcare; 2) The need for resilience in the face of barriers and set-backs including thebackdrop of continually changing external environments; 3) The inherent tension between embracing innovative co-design andachieving 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. The magnitude and ambition of the dallas program provides a unique opportunity to investigate the macro level implementationchallenges faced when designing and delivering digital health and wellness services at scale. Flexibility, adaptability, andresilience are key implementation facilitators when shifting to new digitally enabled models of care.
KW - consumer health informatics
KW - eHealth implementation
KW - assistive living technologies
KW - electronic health records
KW - mhealth
UR - http://jamia.oxfordjournals.org/content/early/2015/08/07/jamia.ocv097
U2 - 10.1093/jamia/ocv097
DO - 10.1093/jamia/ocv097
M3 - Article
VL - 23
SP - 48
EP - 59
JO - Journal of the American Medical Informatics Association
JF - Journal of the American Medical Informatics Association
SN - 1067-5027
IS - 1
ER -
