Readiness for delivering digital health at scale: lessons from a longitudinal qualitative evaluation of a national digital health innovation program in the United Kingdom

摘要: Background: Digital health has the potential to support care delivery for chronic illness. Despite positive evidence from localized implementations, new technologies have proven slow become accepted, integrated, and routinized at scale. Objective: The aim of our study was examine barriers facilitators implementation digital scale through evaluation a £37m national program: ‟Delivering Assisted Living Lifestyles Scale” (dallas) 2012-2015. Methods: longitudinal qualitative, multi-stakeholder, study. methods included interviews (n=125) with key implementers, focus groups consumers patients (n=7), project meetings (n=12), field work or observation in communities (n=16), professional survey responses (n=48), cross program documentary on (n=215). We used sociological theory called normalization process (NPT) (3 years) qualitative framework analysis approach. This did not single intervention population. Instead, we evaluated processes (of designing delivering health), outcomes were identified mainstreaming services products within mixed sector ecosystem. Results: three main levels issues influencing readiness health: macro (market, infrastructure, policy), meso (organizational), micro (professional public). Factors hindering included: lack information technology (IT) uncertainty around governance, incentives prioritize interoperability, precedence accountability commercial sector, market perceived as difficult navigate. enabling were: clinical endorsement, champions who promoted health, public willingness. Conclusions: Although there is receptiveness remain. Our findings suggest greater investment local guidelines safe transparent use assessment incentivization upskilling professionals would help health. These will enable researchers, practitioners, policy makers understand current landscape actions required order prepare accelerate uptake, wellness context [J Med Internet Res 2017;19(2):e42]