Investing in E-Health (eBook)

Table of Contents 6
Foreword 8
List of Contributors 10
Patient-Focused Technology and the Health Care Delivery System 12
1.1. Where Does Patient-Focused Technology Fit in Health Care Delivery? 13
1.2. Achieving Success with Interactive Health Communications Systems 15
1.3. Readiness for Implementation Scale 16
References 17
CHESS: Translating Research into Practice 18
2.1. The CHESS System 19
2.2. Research and Development Process 22
2.3. Dissemination and Implementation of CHESS 24
References 28
Theory and Literature Review 29
3.1. Theories that Guide and Explain Implementation of IHCS 30
3.2. Applying These Theories to IHCS Implementation in Health Care Organizations 36
References 37
Considerations for Successful Implementation of Newly Adopted Technologies 39
4.1. Diffusion of Innovation Theory: Characterizing IHCS and Key Participants 40
4.2. Organizational Change Theory 42
4.3. Implementation Theories 45
References 48
Implementation Model Development and Testing 49
5.1. The IHCS Implementation Context 49
5.2. Creating Models of Implementation 50
5.3. Development of a Model to Predict IHCS Implementation Success 51
5.4. Factors of a Model to Predict IHCS Implementation Success 61
Summary 63
References 63
Introduction to Case Studies 65
Associated Practice, 1992–1997 75
7.1. Description of the Environment at the Site 75
7.2. Timing of the Implementation in the History of Chess 77
7.3. Early Exposure and Decision to Adopt 77
7.4. Implementation of Breast Cancer and HIV/ AIDS Modules 79
7.5. Termination of CHESS at Associated Practice 87
7.6. Analysis 89
Conclusion 97
Union Hospital, 1993–2001 99
8.1. Description of the Environment at the Site 99
8.2. Timing of the Implementation in the History of CHESS 102
8.3. Early Exposure and the Decision to Adopt CHESS 102
8.4. Implementation of the Breast Cancer Module 106
8.5. Analysis of the Breast Cancer Module Implementation 110
8.6. Implementation of the Heart Disease Module 116
8.7. Analysis of the Heart Disease Module Implementation 120
Conclusion 123
Strand Hardin Health Care, 1995–2002 124
9.1. Description of Environment at the Site 124
9.2. Timing of the Implementation in the History of Chess 127
9.3. Early Exposure and Decision to Adopt 127
9.4. Implementation of the Breast Cancer Module 129
9.5. Analysis of the Breast Cancer Module Implementation 131
9.6. Implementation of the Heart Disease Module 134
9.7. Analysis of the Heart Disease Module Implementation 135
9.8. Exposure to Other Chess Modules 136
9.9. Implementation Through Community Health 137
9.10. Analysis of the Community Health Implementation 141
Conclusion 143
Grace Hospital, 1996–2000 145
10.1. Description of the Environment at the Site 145
10.2. Timing in the History of CHESS 147
10.3. Early Exposure and the Decision to Adopt CHESS 148
10.4. Implementation of the Heart Disease Module 150
10.5. Implementation of Other CHESS Modules 153
10.6. Analysis 155
10.7. Conclusion 162
Simpson Hospital, 1997–2000 163
11.1. Description of the Environment at the Site 163
11.2. Timing of Implementation in the History of Chess 165
11.3. Implementation of Chess 168
11.4. Implementation of Other CHESS Modules 170
11.5. Analysis of the CHESS Implementations 172
Conclusion 179
Caregiver Resource Center Network, 1999– 2002 180
12.1. Description of Environment at the Site 180
12.2. Timing of the Implementation in the History of CHESS 183
12.3. The Decision to Create DementiaCare 183
12.4. The Development of DementiaCare 184
12.5. Initial Implementation of DementiaCare 186
12.6. Redesign and Re-implementation of DementiaCare 189
12.7. Analysis 193
Conclusion 198
References 199
Key Learning and Advice for Implementers 200
13.1. A Model for Implementation 201
13.2. Vision and Direction for This Chapter 203
13.3. Gestalt: Implementation Success Depends on the Whole Set of Factors 213
13.4. Special Considerations for Research-based Innovations 213
13.5. Using the Readiness for Implementation Scale for IHCS Implementation 214
13.6. Improving Implementation Efforts 217
Conclusion 221
References 222
Index 227