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

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Date
2020-09-29
Authors
McCarthy, Stephen
Fitzgerald, Ciara
Sahm, Laura
Bradley, Colin
Walsh, Elaine K.
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Taylor & Francis Group
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Abstract
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.
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Keywords
Health information systems , Electronic personal record , Electronic medical record , Implementation , Diffusion , Health information exchange , Normalisation Process Theory
Citation
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. https://doi.org/10.1080/20476965.2020.1822146
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© 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: https://doi.org/10.1080/20476965.2020.1822146