Why does the NHS struggle to adopt eHealth innovations? A review of macro, meso and micro factors.
Barriers to eHealth
Digital policy
Innovation
NHS
eHealth
Journal
BMC health services research
ISSN: 1472-6963
Titre abrégé: BMC Health Serv Res
Pays: England
ID NLM: 101088677
Informations de publication
Date de publication:
21 Dec 2019
21 Dec 2019
Historique:
received:
08
03
2019
accepted:
29
11
2019
entrez:
23
12
2019
pubmed:
23
12
2019
medline:
28
3
2020
Statut:
epublish
Résumé
Having a tax-funded and supposedly 'National' Health Service (NHS), one might assume that the UK is well-positioned to roll out eHealth innovations at scale. Yet, despite a strong policy push, the English NHS has been limited in the extent to which it has exploited the potential of eHealth. This paper considers a range of macro, meso and micro factors influencing eHealth innovation in the English NHS. While barriers to eHealth innovation exist at all scales, the fragmentation of the NHS is the most significant factor limiting adoption and diffusion. Rather than addressing problems of fragmentation, national policy seems to have intensified the digital divide. As the recently published NHS Long Term Plan places great emphasis on the role of digital transformation in helping health and care professionals communicate better and enabling people to access the care they need quickly and easily, the implications for the digital divide are likely to be significant for effectiveness, efficiency and equity.
Sections du résumé
BACKGROUND
BACKGROUND
Having a tax-funded and supposedly 'National' Health Service (NHS), one might assume that the UK is well-positioned to roll out eHealth innovations at scale. Yet, despite a strong policy push, the English NHS has been limited in the extent to which it has exploited the potential of eHealth.
MAIN BODY
METHODS
This paper considers a range of macro, meso and micro factors influencing eHealth innovation in the English NHS.
CONCLUSIONS
CONCLUSIONS
While barriers to eHealth innovation exist at all scales, the fragmentation of the NHS is the most significant factor limiting adoption and diffusion. Rather than addressing problems of fragmentation, national policy seems to have intensified the digital divide. As the recently published NHS Long Term Plan places great emphasis on the role of digital transformation in helping health and care professionals communicate better and enabling people to access the care they need quickly and easily, the implications for the digital divide are likely to be significant for effectiveness, efficiency and equity.
Identifiants
pubmed: 31864370
doi: 10.1186/s12913-019-4790-x
pii: 10.1186/s12913-019-4790-x
pmc: PMC6925468
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
984Subventions
Organisme : European Regional Development Fund
ID : 05R16P00385
Références
BMJ. 2013 Jun 28;346:f4130
pubmed: 23810959
BMC Med Inform Decis Mak. 2016 Jan 27;16:10
pubmed: 26818464
BMJ. 2018 Jan 2;360:j5554
pubmed: 29295813
J Med Internet Res. 2006 Mar 31;8(1):e4
pubmed: 16585029
Soc Sci Med. 2005 Jul;61(2):417-30
pubmed: 15893056
J Med Internet Res. 2017 Feb 16;19(2):e42
pubmed: 28209558
JMIR Res Protoc. 2015 Mar 12;4(1):e29
pubmed: 25768939
BMJ. 2010 Sep 01;341:c4564
pubmed: 20813822
Nurse Educ Pract. 2008 Sep;8(5):299-301
pubmed: 18692016
Int J Health Policy Manag. 2017 Sep 19;7(3):286-287
pubmed: 29524961
PLoS One. 2018 Nov 14;13(11):e0207292
pubmed: 30427924
Sci Eng Ethics. 2012 Jun;18(2):247-61
pubmed: 21327723
Telemed J E Health. 2011 May;17(4):262-8
pubmed: 21476924
Soc Sci Med. 2008 May;66(9):1909-14
pubmed: 18299169
Health Econ Policy Law. 2020 Jan;15(1):1-17
pubmed: 30070199
J Med Internet Res. 2005 Nov 10;7(5):e54
pubmed: 16403718
Lancet. 2018 Jul 14;392(10142):95
pubmed: 30017135
Lancet. 2017 Nov 18;390(10109):2216
pubmed: 29165258
J Med Internet Res. 2005 Feb 24;7(1):e1
pubmed: 15829471
BMC Health Serv Res. 2013 Apr 30;13:158
pubmed: 23631517
J Med Internet Res. 2005 Mar 31;7(1):e9
pubmed: 15829481
J Med Internet Res. 2017 Nov 01;19(11):e367
pubmed: 29092808
BMC Health Serv Res. 2012 Apr 30;12:105
pubmed: 22545646
BMJ. 2018 Jul 20;362:k3201
pubmed: 30030239
J Am Med Inform Assoc. 2013 Jun;20(e1):e9-e13
pubmed: 23599226
Health Serv Manage Res. 2017 Feb;30(1):2-9
pubmed: 28166675