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      Barriers to Recruiting and Engaging End-Users in Large-Scale Digital Health & Wellbeing Technologies and Services

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      BCS Health Informatics Scotland (HIS) (HIS)

      BCS Health Informatics Scotland (HIS)

      2 - 3 September 2014

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          Health and social care services in the U.K. are increasingly looking towards digital technologies and services as a way to support those with chronic illness to better manage their disease and to allow older people to continue living independently for longer. The Delivering Assisted Living Lifestyles at Scale (dallas) programme aims to address these two issues. However implementing a large-scale digital health innovation programme is a hugely complex process. This paper reports preliminary qualitative findings from the analysis of project documentation and interviews with the four consortia of the dallas programme. It presents an overview of the difficulties experienced when engaging and attempting to recruit individuals to participate in the dallas related services. A number of barriers – such as the use of co-design methodologies, branding and partnership constraints and unsustainable recruitment targets – hindered initial engagement strategies when trying to reach and enrol large numbers of end-users. The recruitment strategies of the consortia within this digital health innovation programme have hence continued to evolve in order to adapt to the emerging realities on the ground.

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          Qualitative Data Analysis for Applied Policy Research

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            Using a sociotechnical framework to understand adaptations in health IT implementation.

            When barcode medication administration (BCMA) is implemented nurses are required to integrate not only a new set of procedures or artifacts into everyday work, but also an orientation to medication safety itself that is sometimes at odds with their own. This paper describes how the nurses' orientation (the Practice Frame) can collide with the orientation that is represented by the technology and its implementation (the System Frame), resulting in adaptations at the individual and organization levels. The paper draws on two qualitative research studies that examined the implementation of BCMA in inpatient settings using observation and ethnographic fieldwork, content analysis of email communications, and interviews with healthcare professionals. Two frames of reference are described: the System Frame and the Practice Frame. We found collisions of these frames that prompted adaptations at the individual and organization levels. The System Frame was less integrated and flexible than the Practice Frame, less able to account for all of the dimensions of everyday patient care to which medication administration is tied. Collisions in frames during implementation of new technology result in adaptations at the individual and organization level that can have a variety of effects. We found adaptations to be a means of evolving both the work routines and the technology. Understanding the frames of clinical workers when new technology is being designed and implemented can inform changes to technology or organizational structure and policy that can preclude unproductive or unsafe adaptations. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

              Author and article information

              September 2014
              September 2014
              : 1-3
              General Practice & Primary Care,

              Institute of health & Well-Being

              University of Glasgow
              Dept. of Computer &

              Information Science,

              University of Strathclyde,

              © Siobhan O’Connor et al. Published by BCS Learning and Development Ltd. BCS Health Informatics Scotland (HIS), Glasgow, UK

              This work is licensed under a Creative Commons Attribution 4.0 Unported License. To view a copy of this license, visit

              BCS Health Informatics Scotland (HIS)
              Glasgow, UK
              2 - 3 September 2014
              Electronic Workshops in Computing (eWiC)
              BCS Health Informatics Scotland (HIS)
              Product Information: 1477-9358BCS Learning & Development
              Self URI (journal page):
              Electronic Workshops in Computing


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