Harnessing mobile devices to support the delivery of community-based clinical care: a participatory evaluation

Abstract Background A large provider of community health services (an NHS Trust in England) deployed Apple iPads to its front-line community-based healthcare clinicians (predominantly nurses) to enable them to increase responsiveness to patients’ and their families’ needs. We conducted a participato...

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Main Authors: Jasmine Harvey, John Powell
Format: Article
Language:English
Published: BMC 2019-07-01
Series:BMC Medical Informatics and Decision Making
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12911-019-0869-x
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spelling doaj-e9ffcd06645c4b8384e10eec9211bef62020-11-25T03:07:19ZengBMCBMC Medical Informatics and Decision Making1472-69472019-07-011911910.1186/s12911-019-0869-xHarnessing mobile devices to support the delivery of community-based clinical care: a participatory evaluationJasmine Harvey0John Powell1Nuffield Department of Primary Care Health Sciences, University of OxfordNuffield Department of Primary Care Health Sciences, University of OxfordAbstract Background A large provider of community health services (an NHS Trust in England) deployed Apple iPads to its front-line community-based healthcare clinicians (predominantly nurses) to enable them to increase responsiveness to patients’ and their families’ needs. We conducted a participatory formative evaluation of this iPad initiative among different users and the informatics teams implementing it, to establish how such initiatives can sustain adoption and achieve their stated benefits. Methods We used a participatory approach involving a partnership between study investigators and key decision-makers of the initiative to engage stakeholders in the study. Methods included focus groups and group discussion, meetings with key personnel and analysis of documents related to the initiative. Using a participatory technique, members of the organisation identified practical challenges to inform the on-going process of implementation and adoption in the Trust. Results Healthcare professionals identified many benefits associated with having iPads to support care delivery, including streamlined workflows and accessible information at the point-of-care in the community. However, challenges that interfered with implementation were also reported by both the team implementing the initiative (IT team) and early users. Challenges reported by IT team are: adopter clinicians’ scepticism and suspicion; clinician non-compliance with training and operational guidance procedures; and managing adopter expectations. Challenges reported by users are: setting-up and maintaining the devices on a long-term basis; blurring of personal and professional boundaries; and disconnection from the IT team. Results show that these challenges could be overcome if there were more informal ‘socialised’ interactions between adopters and between adopters and the IT team. Conclusions We suggest that similar initiatives require increased ongoing dialogue between different levels of stakeholder groups, in the form of socialised engagements, to avoid common misunderstandings and to promote the processes involved in co-constructing the initiative on a generally-agreed and sustainable basis.http://link.springer.com/article/10.1186/s12911-019-0869-xMobile health systemsApple iPadsImplementationAdoptionParticipatory approachFocus groups
collection DOAJ
language English
format Article
sources DOAJ
author Jasmine Harvey
John Powell
spellingShingle Jasmine Harvey
John Powell
Harnessing mobile devices to support the delivery of community-based clinical care: a participatory evaluation
BMC Medical Informatics and Decision Making
Mobile health systems
Apple iPads
Implementation
Adoption
Participatory approach
Focus groups
author_facet Jasmine Harvey
John Powell
author_sort Jasmine Harvey
title Harnessing mobile devices to support the delivery of community-based clinical care: a participatory evaluation
title_short Harnessing mobile devices to support the delivery of community-based clinical care: a participatory evaluation
title_full Harnessing mobile devices to support the delivery of community-based clinical care: a participatory evaluation
title_fullStr Harnessing mobile devices to support the delivery of community-based clinical care: a participatory evaluation
title_full_unstemmed Harnessing mobile devices to support the delivery of community-based clinical care: a participatory evaluation
title_sort harnessing mobile devices to support the delivery of community-based clinical care: a participatory evaluation
publisher BMC
series BMC Medical Informatics and Decision Making
issn 1472-6947
publishDate 2019-07-01
description Abstract Background A large provider of community health services (an NHS Trust in England) deployed Apple iPads to its front-line community-based healthcare clinicians (predominantly nurses) to enable them to increase responsiveness to patients’ and their families’ needs. We conducted a participatory formative evaluation of this iPad initiative among different users and the informatics teams implementing it, to establish how such initiatives can sustain adoption and achieve their stated benefits. Methods We used a participatory approach involving a partnership between study investigators and key decision-makers of the initiative to engage stakeholders in the study. Methods included focus groups and group discussion, meetings with key personnel and analysis of documents related to the initiative. Using a participatory technique, members of the organisation identified practical challenges to inform the on-going process of implementation and adoption in the Trust. Results Healthcare professionals identified many benefits associated with having iPads to support care delivery, including streamlined workflows and accessible information at the point-of-care in the community. However, challenges that interfered with implementation were also reported by both the team implementing the initiative (IT team) and early users. Challenges reported by IT team are: adopter clinicians’ scepticism and suspicion; clinician non-compliance with training and operational guidance procedures; and managing adopter expectations. Challenges reported by users are: setting-up and maintaining the devices on a long-term basis; blurring of personal and professional boundaries; and disconnection from the IT team. Results show that these challenges could be overcome if there were more informal ‘socialised’ interactions between adopters and between adopters and the IT team. Conclusions We suggest that similar initiatives require increased ongoing dialogue between different levels of stakeholder groups, in the form of socialised engagements, to avoid common misunderstandings and to promote the processes involved in co-constructing the initiative on a generally-agreed and sustainable basis.
topic Mobile health systems
Apple iPads
Implementation
Adoption
Participatory approach
Focus groups
url http://link.springer.com/article/10.1186/s12911-019-0869-x
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