Dyb Kari, Berntsen Gro Rosvold, Kvam Lisbeth
Norwegian Centre for E-health Research, University Hospital of North Norway, P.O. Box 35, N-9038, Tromsø, Norway.
Department of Mental Health, Faculty of Medicine and Health Sciences, Trondheim, Norway.
BMC Health Serv Res. 2021 Mar 17;21(1):240. doi: 10.1186/s12913-021-06262-1.
Technology support and person-centred care are the new mantra for healthcare programmes in Western societies. While few argue with the overarching philosophy of person-centred care or the potential of information technologies, there is less agreement on how to make them a reality in everyday clinical practice. In this paper, we investigate how individual healthcare providers at four innovation arenas in Scandinavia experienced the implementation of technology-supported person-centred care for people with long-term care needs by using the new analytical framework nonadoption, abandonment, and challenges to the scale-up, spread, and sustainability (NASSS) of health and care technologies. We also discuss the usability and sensitivity of the NASSS framework for those seeking to plan, implement, and evaluate technology-supported healthcare programmes. This study is part of an interdisciplinary research and development project called Patients and Professionals in Partnership (2016-2020). It originates at one of ten work packages in this project.
The main data consist of ethnographic field observations at the four innovation arenas and 29 interviews with involved healthcare providers. To ensure continuous updates and status on work in the four innovation arenas, we have also participated in a total of six annual network meetings arranged by the project.
While the NASSS framework is very useful for identifying and communicating challenges with the adoption and spread of technology-supported person-centred care initiatives, we found it less sensitive towards capturing the dedication, enthusiasm, and passion for care transformation that we found among the healthcare providers in our study. When it comes to technology-supported person-centred care, the point of no return has passed for the involved healthcare providers. To them, it is already a definite part of the future of healthcare services. How to overcome barriers and obstacles is pragmatically approached.
Increased knowledge about healthcare providers and their visions as potential assets for care transformation might be critical for those seeking to plan, implement, and evaluate technology-supported healthcare programmes.
技术支持和以患者为中心的护理是西方社会医疗保健项目的新口号。虽然很少有人反对以患者为中心的护理这一总体理念或信息技术的潜力，但对于如何在日常临床实践中将它们变为现实，人们的共识较少。在本文中，我们通过使用新的分析框架——健康与护理技术扩大、传播及可持续性的未采用、放弃和挑战（NASSS），研究了斯堪的纳维亚四个创新领域的个体医疗保健提供者如何体验对有长期护理需求的人实施技术支持的以患者为中心的护理。我们还讨论了NASSS框架对于那些寻求规划、实施和评估技术支持的医疗保健项目的人的可用性和敏感性。本研究是一个名为“患者与专业人员合作”（2016 - 2020年）的跨学科研发项目的一部分。它源自该项目的十个工作包之一。
主要数据包括在四个创新领域的人种学实地观察以及对相关医疗保健提供者的29次访谈。为确保对四个创新领域工作的持续更新和了解进展情况，我们还总共参加了该项目安排的六次年度网络会议。
虽然NASSS框架对于识别和交流技术支持的以患者为中心的护理举措采用和传播方面的挑战非常有用，但我们发现它对于捕捉我们在研究中发现的医疗保健提供者对护理变革的奉献精神、热情和激情不太敏感。对于技术支持的以患者为中心的护理，相关医疗保健提供者已经无法回头。对他们来说，这已经是医疗保健服务未来的一个确定部分。如何克服障碍和阻碍是以务实的方式处理的。
对于那些寻求规划、实施和评估技术支持的医疗保健项目的人来说，更多地了解医疗保健提供者及其作为护理变革潜在资产的愿景可能至关重要。
