Abstract
BackgroundThe number of public eHealth services that support patient self-management is rapidly increasing. However, the implementation of these eHealth services for self-management has encountered challenges.ObjectiveThe purpose of this paper was to analyze the challenges and opportunities of implementing eHealth services for self-management by focusing on the fit between the technical solution and clinical use.MethodsWe performed in-depth interviews with 10 clinical project coordinators and managers who were responsible for developing and implementing various eHealth services for self-management interventions in five university hospitals in Finland. The results were analyzed using content analysis and open coding. The Fit between Individuals, Task, and Technology (FITT) framework was used to interpret the findings.ResultsThe implementation of self-management services involved many challenges related to technical problems, health professional acceptance, patient motivation, and health organization and management. The implementers identified practices to manage the identified challenges, including improving the design of the technology, supporting health professionals in the adoption of the eHealth services, changing the work processes and tasks, involving patients, and collectively planning the implementation inside an organization. The findings could be mostly attributed to the dimensions of the FITT framework.ConclusionsThe FITT framework helped to analyze the challenges related to the implementation, and most of them were related to poor fit. The importance of patients as stakeholders in eHealth services for patient self-management needs to be highlighted. Thus, we propose that patients should be added as a different type of individual dimension to the FITT framework. In addition, the framework could be extended to include organization and management in a new context dimension.
Highlights
EHealth for Self-Management In many countries, the number of public eHealth services that support patient self-management is rapidly increasing
The FITT framework helped to analyze the challenges related to the implementation, and most of them were related to poor fit
We propose that patients should be added as a different type of individual dimension to the FITT framework
Summary
EHealth for Self-Management In many countries, the number of public eHealth services that support patient self-management is rapidly increasing. Barlow et al [1] define self-management as an individual’s ability to manage the symptoms, treatment, physical and psychosocial consequences, and life changes inherent in living with a chronic condition. 1 (page number not for citation purposes) interventions benefit participants’ well-being. Diabetes and heart failure interventions seem to be effective [2]. Many studies report that the implementation of eHealth services that support self-management has encountered challenges, such as motivating patients and health professionals [3-6]. The implementation challenges have led to limited adoption by patients and health professionals and their use of the services [3,4,7]. The number of public eHealth services that support patient self-management is rapidly increasing. The implementation of these eHealth services for self-management has encountered challenges
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