Yes / Adoption of telehealth has been slower than anticipated, and little is known about the service
improvements that help to embed telehealth into routine practice or the role of frontline staff in improving
adoption. This paper reports on participatory action research carried out in four community health settings using
telehealth for patients with Chronic Obstructive Pulmonary Disease and Chronic Heart Failure.
Methods: To inform the action research, in-depth case studies of each telehealth service were conducted
(May 2012–June 2013). Each service was then supported by researchers through two cycles of action research to
implement changes to increase adoption of telehealth, completed over a seven month period (July 2013–April 2014).
The action research was studied via observation of multi-stakeholder workshops, analysis of implementation
plans, and focus groups.
Results: Action research participants included 57 staff and one patient, with between eight and 20 participants per
site. The case study findings were identified as a key source of information for planning change, with sites addressing
common challenges identified through this work. For example, refining referral criteria; standardizing how and when
patients are monitored; improving data sharing; and establishing evaluation processes. Sites also focused on raising
awareness of telehealth to increase adoption in other clinical teams and to help secure future financial investment for
telehealth, which was required because of short-term funding arrangements. Specific solutions varied due to local
infrastructures, resources, and opinion, as well as previous service developments. Local telehealth champions played an
important role in engaging multiple stakeholders in the study.
Conclusions: Action research enabled services to make planned changes to telehealth and share learning across
multiple stakeholders about how and when to use telehealth. However, adoption was impeded by continual changes
affecting telehealth and wider service provision, which also hindered implementation efforts and affected motivation
of staff to engage with the action research, particularly where local decision-makers were not engaged in the study.
Wider technological barriers also limited the potential for change, as did uncertainties about goals for telehealth
investment, thereby making it difficult to identify outcomes for demonstrating the added value over existing practice. / This study was funded by a grant from the Assisted Living Innovation Platform, with support from the Technology Strategy Board and the Economic and Social Research Council.
| Identifer | oai:union.ndltd.org:BRADFORD/oai:bradscholars.brad.ac.uk:10454/11028 |
| Date | 23 November 2015 |
| Creators | Taylor, J., Coates, E., Wessels, B., Mountain, Gail, Hawley, M.S. |
| Source Sets | Bradford Scholars |
| Language | English |
| Detected Language | English |
| Type | Article, Published version |
| Rights | © 2015 Taylor et al. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
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