Patient-held health IT adoption across the primary-secondary care interface: a Normalisation Process Theory perspective

Thumbnail Image
thss_a_1822146_sm5134.docx(18.44 KB)
Supplemental Material
McCarthy, Stephen
Fitzgerald, Ciara
Sahm, Laura
Bradley, Colin
Walsh, Elaine K.
Journal Title
Journal ISSN
Volume Title
Taylor & Francis Group
Research Projects
Organizational Units
Journal Issue
Patient-held Health Information Technologies (HIT) can reduce medical error by improving communication between patients and the healthcare team. Despite the proposed benefits, the roll-out of patient-held HIT solutions remains nascent, leaving considerable gaps in our understanding of the adoption challenges inherent. This paper adopts Normalisation Process Theory to study the factors which support or impede the adoption and “normalisation” of patient-held HIT, particularly across the primary-secondary care interface. The authors conducted an in-depth case study of HIT adoption across four GP practices, and the wards of a 350 bed hospital. 35 semi-structured interviews were completed. Findings point towards both user-specific and network-specific factors as significant challenges to normalisation across primary-secondary care. This includes factors related to interactional workability, skill set workability, relational integration, and contextual integration. We also discuss challenges specific to patient-held HIT adoption e.g., understanding the patient/clinician experience, supporting informal clinician networks, and spanning across IT boundaries.
Health information systems , Electronic personal record , Electronic medical record , Implementation , Diffusion , Health information exchange , Normalisation Process Theory
McCarthy, S., Fitzgerald, C., Sahm, L., Bradley, C. and Walsh, E.K. (2022) ‘Patient-held health IT adoption across the primary-secondary care interface: a Normalisation Process Theory perspective’, Health Systems, 11(1), pp. 17–29.
Link to publisher’s version
© 2020, Operational Research Society. Published by Taylor & Francis Group. This is an Accepted Manuscript of an item published by Taylor & Francis in Health Systems on 29 September 2020, available online: