Integrating telecare for chronic disease management in the community: What needs to be done?

May, Carl R., Finch, Tracy L., Cornford, James, Exley, Catherine, Gately, Claire, Kirk, Sue, Jenkings, K. Neil, Osbourne, Janice, Robinson, A. Louise, Rogers, Anne, Wilson, Robert and Mair, Frances S. (2011) Integrating telecare for chronic disease management in the community: What needs to be done? BMC Health Services Research, 11. ISSN 1472-6963

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Abstract

Background: Telecare could greatly facilitate chronic disease management in the community, but despite government promotion and positive demonstrations its implementation has been limited. This study aimed to identify factors inhibiting the implementation and integration of telecare systems for chronic disease management in the community. Methods: Large scale comparative study employing qualitative data collection techniques: semi-structured interviews with key informants, task-groups, and workshops; framework analysis of qualitative data informed by Normalization Process Theory. Drawn from telecare services in community and domestic settings in England and Scotland, 221 participants were included, consisting of health professionals and managers; patients and carers; social care professionals and managers; and service suppliers and manufacturers. Results: Key barriers to telecare integration were uncertainties about coherent and sustainable service and business models; lack of coordination across social and primary care boundaries, lack of financial or other incentives to include telecare within primary care services; a lack of a sense of continuity with previous service provision and self-care work undertaken by patients; and general uncertainty about the adequacy of telecare systems. These problems led to poor integration of policy and practice. Conclusion: Telecare services may offer a cost effective and safe form of care for some people living with chronic illness. Slow and uneven implementation and integration do not stem from problems of adoption. They result from incomplete understanding of the role of telecare systems and subsequent adaption and embeddedness to context, and uncertainties about the best way to develop, coordinate, and sustain services that assist with chronic disease management. Interventions are therefore needed that (i) reduce uncertainty about the ownership of implementation processes and that lock together health and social care agencies; and (ii) ensure user centred rather than biomedical/service-centred models of care.

Item Type: Article
Additional Information: © May et al; licensee BioMed Central Ltd. 2011 This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://​creativecommons.​org/​licenses/​by/​2.​0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Faculty \ School: Faculty of Social Sciences > Norwich Business School
Depositing User: James Cornford
Date Deposited: 19 Aug 2011 09:33
Last Modified: 21 Jul 2020 23:31
URI: https://ueaeprints.uea.ac.uk/id/eprint/34301
DOI: 10.1186/1472-6963-11-131

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