C.T. Lamont Primary Health Care Research Centre, Department of Family Medicine, University of Ottawa, Ottawa, Canada.
Bruyère Research Institute, Ottawa, Canada.
Health Res Policy Syst. 2020 Jun 3;18(1):57. doi: 10.1186/s12961-020-00574-0.
Expanding healthcare innovations from the local to national level is a complex pursuit requiring careful assessment of all relevant factors. In this study (a component of a larger eConsult programme of research), we aimed to identify the key factors involved in the spread and scale-up of a successful regional eConsult model across Canada.
We conducted a constant comparative thematic analysis of stakeholder discussions captured during a full-day National eConsult Forum meeting held in Ottawa, Canada, on 11 December 2017. Sixty-four participants attended, representing provincial and territorial governments, national organisations, healthcare providers, researchers and patients. Proceedings were recorded, transcribed and underwent qualitative analysis using the Framework for Applied Policy Research.
This study identified four main themes that were critical to support the intentional efforts to spread and scale-up eConsult across Canada, namely (1) identifying population care needs and access problems, (2) engaging stakeholders who were willing to roll up their sleeves and take action, (3) building on current strategies and policies, and (4) measuring and communicating outcomes.
Efforts to promote innovation in healthcare are more likely to succeed if they are based on an understanding of the forces that drive the spread and scale-up of innovation. Further research is needed to develop and strengthen the conceptual and applied foundations of the spread and scale-up of healthcare innovations, especially in the context of emergent learning health systems across Canada and beyond.
将医疗创新从地方扩展到全国层面是一项复杂的追求，需要仔细评估所有相关因素。在这项研究中（作为更大的电子咨询研究计划的一部分），我们旨在确定在加拿大范围内推广和扩大成功区域电子咨询模式所涉及的关键因素。
我们对 2017 年 12 月 11 日在加拿大渥太华举行的为期一天的全国电子咨询论坛会议上捕获的利益相关者讨论进行了持续比较的主题分析。64 名代表参加了会议，代表省级和地区政府、国家组织、医疗保健提供者、研究人员和患者。会议记录、转录，并使用应用政策研究框架进行了定性分析。
本研究确定了四个主要主题，这些主题对于支持在加拿大有意推广和扩大电子咨询至关重要，即（1）确定人口护理需求和获得问题，（2）吸引愿意采取行动的利益相关者，（3）利用当前的战略和政策，以及（4）衡量和交流成果。
如果基于对推动创新传播和扩大的力量的理解，促进医疗保健创新的努力更有可能取得成功。需要进一步研究来发展和加强医疗保健创新传播和扩大的概念和应用基础，特别是在加拿大和其他地区新兴的学习健康系统背景下。
