Managing the Change Needed

Implementing e-health is not anymore just about starting to use IT and changing processes: this is the easy stuff. The hard part is the soft part, the dynamics between people. In 2015 a novel scientific initiative was started within the SmartCare Project focusing specifically on this question: What is needed to facilitate people to transform and integrate health and social care, using IT while working in integrated teams?

 

The Soft Part = The Hard Part

Although the potency of e-health has been widely acknowledged and uncountable projects have initiated before, it is well known that many initiatives often fail to achieve long-lasting success. Many scientists and field-experts have investigated barriers and facilitators of implementation and provided guiding principles of sustainable implementation, some of which are widely used. However, these principles often relate to the dynamics of IT implementation, the technical aspects of e-health or process redesign. When it comes to changing habits and behavior of people and teams, historic professional cultural and other unwritten principles appear as determinants of sustainable implementation. IT can have unintended consequences on teams and people that are not yet fully understood. Experiences from many preceding projects as well as recent scientific literature call for deeper insights into human factors such as team dynamics and interprofessional collaboration during e-health implementation.

 

Synergies in Change

Coordinated by University of Twente’s Faculty of Behavioural, Management and Social Sciences, a team of experts and scientists on change management in the public domain embarked on a twelve month research project, entailing two systematic literature reviews, a series of expert interviews and a series of ten pan-European study visits at implementation sites of the BeyondSilos, CareWell and SmartCare projects. Hosted by local implementation teams, our research team aims for these objectives:

  1. Indicator Set and Toolkit
  2. Local Change Management Support
  3. Scientific Publication Dissemination Strategy

 

European Site Visits: First Experiences

With an estimated final total number of interviewees ranging between 150 and 200 individuals, first experiences provided fruitful data. Although local implementation efforts take into account specific characteristics, the first contours of collective best practices in human-factor focused implementation are emerging. As a result of excellent local coordinator support, before summer 2016, the researchers will start a rigorous analysis of the data from nearly 70 one-on-one interviews and 40 focus group sessions resulting in over 600 pages of transcribed dialogue. The sample of interviewees consists of:

  1.  Frontline professionals: social workers, GPs, medical specialists, district nurses, community nurses, call-centre operators, therapists, hospital clinicians
  2. End users: informal carers, patients.
  3. Management: health and social directors, implementation managers, regional policy makers.

 

Results

This research initiative will provide European Members States’ Regions with scientifically founded and field tested best practices focused on interdisciplinary collaboration for sustainable implementation of e-health enabled integrated care teams. The end result will be scientifically reported in peer-reviewed scientific journals, hence make the novel insights accessible to the health- and social care, as well as the broader scientific community. Furthermore, activities will be deployed to combine these best practices with assessment and implementation tools (in particular the Model for ASsessment of Telemedicine – MAST) to provide comprehensive implementation curriculum for regions engaging into the challenge of e-health enabled integrated care.