Abstract
This paper presents managerial attempts at implementing telehealthcare. Our longitudinal, ethnographic case studies document both successful and failed implementations across five health and social care organisations in England. We draw on theories of organisational identity, sensemaking and sensegiving to highlight how managerial organisational identities can inhibit the uptake of digital health technologies. Managers who strongly identified with their current role at work felt threatened by the intended change; a telehealthcare mode of care delivery. When a strongly identified workforce agrees with this assessment, managerial and employee sensemaking and sensegiving coalesce, forming a united front of resistance that prevents further adoption of the innovation.
Highlights
A key agenda for governments worldwide is how best to care for older people, whilst limiting the demand for expensive hospital and nursing home beds
In an attempt to understand what may explain these differential levels of adoption across our five sites, the sections discuss how the strength of managerial organisational identity, experiences of work process control through participation in decision making and a sense of possessiveness towards the organisation frames what constitutes “success” and determines local adoption rates of telehealthcare
Crucial to the process of achieving acceptance of digital health technologies is the process of negotiation, of sensemaking and sensegiving between managers and members
Summary
A key agenda for governments worldwide is how best to care for older people, whilst limiting the demand for expensive hospital and nursing home beds. One solution is the development of digital technologies that support care remotely, often in the patient’s own home; commonly called telehealthcare. Despite a strong policy push and the espoused potential of this technology, uptake has Societies 2014, 4 been slow with health services yet to show that implementation of digital health technologies can result in a significant and sustainable shift in care services from hospital to home [1]. In terms of understanding and changing this position, the UK has taken a strong lead, with the commissioning of the largest randomised controlled trial of telehealthcare services; called the Whole System Demonstrator programme [4]. The findings presented here represent another untold facet in telehealth story by considering how staff tasked with adopting this new technology responded to this demand
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