Development and formative evaluation of the e-Health Implementation Toolkit (e-HIT).

Elizabeth Murray,Carl May,Frances Mair

doi:10.1186/1472-6947-10-61

Abstract

BackgroundThe use of Information and Communication Technology (ICT) or e-Health is seen as essential for a modern, cost-effective health service. However, there are well documented problems with implementation of e-Health initiatives, despite the existence of a great deal of research into how best to implement e-Health (an example of the gap between research and practice). This paper reports on the development and formative evaluation of an e-Health Implementation Toolkit (e-HIT) which aims to summarise and synthesise new and existing research on implementation of e-Health initiatives, and present it to senior managers in a user-friendly format.ResultsThe content of the e-HIT was derived by combining data from a systematic review of reviews of barriers and facilitators to implementation of e-Health initiatives with qualitative data derived from interviews of "implementers", that is people who had been charged with implementing an e-Health initiative. These data were summarised, synthesised and combined with the constructs from the Normalisation Process Model. The software for the toolkit was developed by a commercial company (RocketScience). Formative evaluation was undertaken by obtaining user feedback.There are three components to the toolkit - a section on background and instructions for use aimed at novice users; the toolkit itself; and the report generated by completing the toolkit. It is available to download from http://www.ucl.ac.uk/pcph/research/ehealth/documents/e-HIT.xlsConclusionsThe e-HIT shows potential as a tool for enhancing future e-Health implementations. Further work is needed to make it fully web-enabled, and to determine its predictive potential for future implementations.

Highlights

The use of Information and Communication Technology (ICT) or e-Health is seen as essential for a modern, cost-effective health service
The aim of this paper is to describe the process of development and formative evaluation, and describe the final toolkit, in line with recent calls for more detailed descriptions of the processes and content of complex interventions [16,17]
We included chief executives of trusts, clinical directors, senior managers, ICT staff, and staff working for private companies contracted to supply, deliver or facilitate specific e-health implementations

Summary

Introduction

The use of Information and Communication Technology (ICT) or e-Health is seen as essential for a modern, cost-effective health service. This paper reports on the development and formative evaluation of an e-Health Implementation Toolkit (e-HIT) which aims to summarise and synthesise new and existing research on implementation of e-Health initiatives, and present it to senior managers in a user-friendly format. There are many reasons for the difficulties encountered with implementation of e-health Some of these are likely to parallel those contributing to the gap between research findings and routine clinical care, including a perceived lack of relevance of research to practitioner needs [13]; managers, or other senior staff charged with e-Health implementations not having the time or inclination to read the large body of literature [14]; inadequacies in the existing research [12]; and the poor permeability of the managerial: research interface[15]. The e-HIT was developed explicitly to bridge the managerial:research interface, by making the results of a large body of research into e-Health implementation accessible to senior managers in a simple, user-friendly format. The aim of this paper is to describe the process of development and formative evaluation, and describe the final toolkit, in line with recent calls for more detailed descriptions of the processes and content of complex interventions [16,17]

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Conclusion