Abdi Sarah, Patel Dilisha, Carmichael Josie, Balaskas Konstantinos, Blandford Ann
UCL Interaction Centre, University College London, London, UK.
Global Disability Innovation Hub, University College London, London, UK.
Digit Health. 2025 Jan 31;11:20552076241303812. doi: 10.1177/20552076241303812. eCollection 2025 Jan-Dec.
Digital health interventions have the potential to improve clinical processes and patient outcomes; however, many face challenges during the adoption and implementation stages, hindering their overall impact. Our study uses normalisation process theory (NPT) as a theoretical approach to explore the facilitators and barriers to the implementation of a teleophthalmology referral platform in the United Kingdom, as an illustrative case of the implementation of a digital health intervention in routine practice.
Semistructured interviews were conducted with 24 health professionals (18 optometrists and 6 ophthalmologists) involved in the implementation of a teleophthalmology referral platform. NPT guided data collection and analysis.
Most participants were ready to engage with the teleophthalmology referral platform, recognising its potential value and benefits. However, during implementation, participants' perceptions varied; a major factor was whether their expectations from the technology were met, particularly regarding the feedback from the secondary eye care component of the referral platform. Several additional factors were identified that would influence the adoption of the platform. These included individual aspects (e.g. participants' IT skills), technology-related factors (e.g. the time required to complete referrals) and organisational factors (e.g. investment in community optometry services).
To successfully implement the teleophthalmology platform into routine practice, particularly on a large scale, multiple factors at different levels must be considered. This study highlights the complexity associated with implementing digital health interventions in routine practice and the contribution of NPT in untangling some of these complexities.
数字健康干预措施有改善临床流程和患者治疗效果的潜力；然而，许多措施在采用和实施阶段面临挑战，阻碍了其整体影响。我们的研究使用常态化过程理论（NPT）作为一种理论方法，以探索在英国实施远程眼科转诊平台的促进因素和障碍，作为在常规实践中实施数字健康干预措施的一个示例。
对参与远程眼科转诊平台实施的24名卫生专业人员（18名验光师和6名眼科医生）进行了半结构化访谈。NPT指导数据收集和分析。
大多数参与者愿意使用远程眼科转诊平台，认识到其潜在价值和益处。然而，在实施过程中，参与者的看法各不相同；一个主要因素是他们对该技术的期望是否得到满足，特别是关于转诊平台二级眼科护理部分的反馈。还确定了几个会影响该平台采用的其他因素。这些因素包括个人方面（如参与者的信息技术技能）、技术相关因素（如完成转诊所需的时间）和组织因素（如对社区验光服务的投入）。
要成功将远程眼科平台纳入常规实践，尤其是大规模纳入，必须考虑不同层面的多个因素。本研究突出了在常规实践中实施数字健康干预措施的复杂性以及NPT在梳理其中一些复杂性方面的作用。
