Factors that influence the implementation of e-health: a systematic review of systematic reviews (an update)

Abstract Background There is a significant potential for e-health to deliver cost-effective, quality health care, and spending on e-health systems by governments and healthcare systems is increasing worldwide. However, there remains a tension between the use of e-health in this way and implementatio...

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Main Authors: Jamie Ross, Fiona Stevenson, Rosa Lau, Elizabeth Murray
Format: Article
Language:English
Published: BMC 2016-10-01
Series:Implementation Science
Subjects:
Online Access:http://link.springer.com/article/10.1186/s13012-016-0510-7
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author Jamie Ross
Fiona Stevenson
Rosa Lau
Elizabeth Murray
author_facet Jamie Ross
Fiona Stevenson
Rosa Lau
Elizabeth Murray
author_sort Jamie Ross
collection DOAJ
description Abstract Background There is a significant potential for e-health to deliver cost-effective, quality health care, and spending on e-health systems by governments and healthcare systems is increasing worldwide. However, there remains a tension between the use of e-health in this way and implementation. Furthermore, the large body of reviews in the e-health implementation field, often based on one particular technology, setting or health condition make it difficult to access a comprehensive and comprehensible summary of available evidence to help plan and undertake implementation. This review provides an update and re-analysis of a systematic review of the e-health implementation literature culminating in a set of accessible and usable recommendations for anyone involved or interested in the implementation of e-health. Methods MEDLINE, EMBASE, CINAHL, PsycINFO and The Cochrane Library were searched for studies published between 2009 and 2014. Studies were included if they were systematic reviews of the implementation of e-health. Data from included studies were synthesised using the principles of meta-ethnography, and categorisation of the data was informed by the Consolidated Framework for Implementation Research (CFIR). Results Forty-four reviews mainly from North America and Europe were included. A range of e-health technologies including electronic medical records and clinical decision support systems were represented. Healthcare settings included primary care, secondary care and home care. Factors important for implementation were identified at the levels of the following: the individual e-health technology, the outer setting, the inner setting and the individual health professionals as well as the process of implementation. Conclusion This systematic review of reviews provides a synthesis of the literature that both acknowledges the multi-level complexity of e-health implementation and provides an accessible and useful guide for those planning implementation. New interpretations of a large amount of data across e-health systems and healthcare settings have been generated and synthesised into a set of useable recommendations for practice. This review provides a further empirical test of the CFIR and identifies areas where additional research is necessary. Trial registration PROSPERO, CRD42015017661
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spelling doaj.art-1b286568f3ea46b782588eb07369b4a92022-12-21T19:53:26ZengBMCImplementation Science1748-59082016-10-0111111210.1186/s13012-016-0510-7Factors that influence the implementation of e-health: a systematic review of systematic reviews (an update)Jamie Ross0Fiona Stevenson1Rosa Lau2Elizabeth Murray3e-Health Unit, Research Department of Primary Care and Population Health, University College Londone-Health Unit, Research Department of Primary Care and Population Health, University College Londone-Health Unit, Research Department of Primary Care and Population Health, University College Londone-Health Unit, Research Department of Primary Care and Population Health, University College LondonAbstract Background There is a significant potential for e-health to deliver cost-effective, quality health care, and spending on e-health systems by governments and healthcare systems is increasing worldwide. However, there remains a tension between the use of e-health in this way and implementation. Furthermore, the large body of reviews in the e-health implementation field, often based on one particular technology, setting or health condition make it difficult to access a comprehensive and comprehensible summary of available evidence to help plan and undertake implementation. This review provides an update and re-analysis of a systematic review of the e-health implementation literature culminating in a set of accessible and usable recommendations for anyone involved or interested in the implementation of e-health. Methods MEDLINE, EMBASE, CINAHL, PsycINFO and The Cochrane Library were searched for studies published between 2009 and 2014. Studies were included if they were systematic reviews of the implementation of e-health. Data from included studies were synthesised using the principles of meta-ethnography, and categorisation of the data was informed by the Consolidated Framework for Implementation Research (CFIR). Results Forty-four reviews mainly from North America and Europe were included. A range of e-health technologies including electronic medical records and clinical decision support systems were represented. Healthcare settings included primary care, secondary care and home care. Factors important for implementation were identified at the levels of the following: the individual e-health technology, the outer setting, the inner setting and the individual health professionals as well as the process of implementation. Conclusion This systematic review of reviews provides a synthesis of the literature that both acknowledges the multi-level complexity of e-health implementation and provides an accessible and useful guide for those planning implementation. New interpretations of a large amount of data across e-health systems and healthcare settings have been generated and synthesised into a set of useable recommendations for practice. This review provides a further empirical test of the CFIR and identifies areas where additional research is necessary. Trial registration PROSPERO, CRD42015017661http://link.springer.com/article/10.1186/s13012-016-0510-7Implementatione-HealthSystematic reviewUpdateSynthesis
spellingShingle Jamie Ross
Fiona Stevenson
Rosa Lau
Elizabeth Murray
Factors that influence the implementation of e-health: a systematic review of systematic reviews (an update)
Implementation Science
Implementation
e-Health
Systematic review
Update
Synthesis
title Factors that influence the implementation of e-health: a systematic review of systematic reviews (an update)
title_full Factors that influence the implementation of e-health: a systematic review of systematic reviews (an update)
title_fullStr Factors that influence the implementation of e-health: a systematic review of systematic reviews (an update)
title_full_unstemmed Factors that influence the implementation of e-health: a systematic review of systematic reviews (an update)
title_short Factors that influence the implementation of e-health: a systematic review of systematic reviews (an update)
title_sort factors that influence the implementation of e health a systematic review of systematic reviews an update
topic Implementation
e-Health
Systematic review
Update
Synthesis
url http://link.springer.com/article/10.1186/s13012-016-0510-7
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