TY - JOUR AU - Lennon, Marilyn R AU - Bouamrane, Matt-Mouley AU - Devlin, Alison M AU - O'Connor, Siobhan AU - O'Donnell, Catherine AU - Chetty, Ula AU - Agbakoba, Ruth AU - Bikker, Annemieke AU - Grieve, Eleanor AU - Finch, Tracy AU - Watson, Nicholas AU - Wyke, Sally AU - Mair, Frances S PY - 2017 DA - 2017/02/16 TI -为大规模提供数字健康做好准备:JO - J Med Internet Res SP - e42 VL - 19 IS - 2kw -远程医疗KW -健康计划实施KW -社区卫生服务KW -卫生服务研究KW -电子健康记录KW -仪器仪表KW -定性研究KW -创新扩散KW -医疗信息学AB -背景:数字卫生具有支持慢性病护理提供的潜力。尽管本地化实现提供了积极的证据，但新技术被大规模接受、集成和常规化的速度很慢。目的:我们的研究目的是通过对2012-2015年期间3700万英镑的国家数字卫生计划“大规模提供辅助生活方式”(达拉斯)的评估，审查大规模实施数字卫生的障碍和促进因素。方法:本研究为纵向定性、多利益相关者实施研究。方法包括与主要执行者的面谈(n=125)、与消费者和患者的焦点小组(n=7)、项目会议(n=12)、在社区的实地工作或观察(n=16)、卫生专业人员调查答复(n=48)和跨项目执行的文件证据(n=215)。我们使用了一种称为正常化过程理论(NPT)的社会学理论和一种纵向(3年)定性框架分析方法。这项工作没有研究单一的干预措施或人群。相反，我们评估了(设计和提供数字卫生的)过程，我们的成果是在混合部门的数字卫生生态系统中提供和主流化服务和产品的确定障碍和促进因素。 Results: We identified three main levels of issues influencing readiness for digital health: macro (market, infrastructure, policy), meso (organizational), and micro (professional or public). Factors hindering implementation included: lack of information technology (IT) infrastructure, uncertainty around information governance, lack of incentives to prioritize interoperability, lack of precedence on accountability within the commercial sector, and a market perceived as difficult to navigate. Factors enabling implementation were: clinical endorsement, champions who promoted digital health, and public and professional willingness. Conclusions: Although there is receptiveness to digital health, barriers to mainstreaming remain. Our findings suggest greater investment in national and local infrastructure, implementation of guidelines for the safe and transparent use and assessment of digital health, incentivization of interoperability, and investment in upskilling of professionals and the public would help support the normalization of digital health. These findings will enable researchers, health care practitioners, and policy makers to understand the current landscape and the actions required in order to prepare the market and accelerate uptake, and use of digital health and wellness services in context and at scale. SN - 1438-8871 UR - //www.mybigtv.com/2017/2/e42/ UR - https://doi.org/10.2196/jmir.6900 UR - http://www.ncbi.nlm.nih.gov/pubmed/28209558 DO - 10.2196/jmir.6900 ID - info:doi/10.2196/jmir.6900 ER -