The purpose of the readiness and cluster analyses is to inform eHealth adoption strategies so that the right interventions can be deployed at the right time for the right group of specialists. These decisions will depend on several factors including the type of eHealth application, the extent of the desired adoption (e.g. ubiquitous, specific specialties, specific geographies), the target adoption rate and profile over time, and the budget for change and adoption actions.
Available interventionsThe research indicates that a focus on educating and training individual practitioners will be insufficient because it does not address some fundamental barriers to adoption, such as the suitability or limitations of available eHealth solutions, and how they are delivered across the relevant health network. Actions to influence the use of eHealth applications by medical specialists must work along three complementary axes, being those that:
- Shape the eHealth products, i.e. the eHealth solutions as a whole, including any IT hardware, software, delivery and support
- Shape the demand for those products among medical specialists, and
- Shape the health ecosystems in which those specialists work
Shaping eHealth products
A number of barriers to adoption of eHealth stem from concerns about the eHealth ‘product’ itself, such as the security, privacy, suitability, interoperability, usability, reliability or cost (of installation and operation) of the solutions. Therefore an effective adoption strategy cannot be limited to engaging or shaping the demand. Interventions are needed to lower the product-related barriers (real or perceived), tailoring the product or its delivery to the differentiated needs of the medical specialists.
Shaping eHealth demand
The research identifies wide variations in the intended use of eHealth solutions, and in the attitudinal underpinnings of these variations. The clusters have markedly different perceptions of the benefits, costs and risks of eHealth. The effort to shape the demand for eHealth solutions must be grounded in the needs profiles identified in the research: by specialty and by cluster. Examples of demand-shaping interventions are outlined below, focused on defining and proving tailored value propositions, and stimulating awareness and early adoption.
Shaping health ecosystems
Introducing eHealth solutions that affect care delivery models requires coordinated approaches across the healthcare system. The research has confirmed that medical specialists are influenced by overall system changes and benefits. The eHealth adoption strategy therefore needs to help create the conditions in the ecosystem that influence and support adoption, within and across clusters. This includes a regulatory and incentive environment in which vendors, professional bodies and practitioners can develop and adopt the right solutions.
Across each of these three areas, some interventions will work better with some clusters than others, as we have seen above. Further, some interventions must be launched before others: in any adoption strategy, there will be an establishment period, a time in which momentum is built, and a time for consolidating real change. Our research suggests the following interventions may be appropriate for each cluster through the duration of the change and adoption effort. The nature and timing are discussed in more detail in Section 7 of this report.
Table 3: Interventions and target clusters
(6 m to 1 yr)
|Shaping the product||Clusters targeted|
|Establish basic standards and certification criteria||1, 2, 3||4, 5|
|Create incentives for product usability and functionality||3, 4||4, 5|
|Provide solutions and support to mitigate risk of malfunctions or downtime||3, 4||3, 4|
|Shaping the demand||Clusters targeted|
|Establish a measurement and evaluation framework||1, 2||1, 2, 3||1, 2, 3, 4, 5|
|Disseminate accurate information and education on product use and risks||1, 2||4, 5||4, 5|
|Recognise and promote successful use cases||1, 2, 3||3|
|Provide assurance on the intended use of practitioner performance data||4||4, 5|
|Embed eHealth solution deployment in the context of a broader initiative||1, 3||4, 5|
|Shaping the ecosystem||Clusters targeted|
|Cultivate eHealth pioneers as change champions||1||4|
|Identify and target critical adoption ‘nodes’ and specialists who frequently interact with others||2||2, 3||4, 5|
|Design and offer training workshops targeting support staff||1, 3, 5||3, 5|
|Offer incentives for use||1, 4|
|Create transparency on adoption levels||4, 5||4, 5|
|Require mandatory participation||4, 5|
Applying the interventions in a strategyIt is not the purpose of this report to determine final strategies to drive the adoption of particular eHealth solutions. However, it sets out a detailed example of how the findings of the eHealth readiness research may be applied in a comprehensive adoption strategy, with well-targeted interventions selected to meet practitioner and policy expectations and address the many barriers to adoption. In overview, the described strategy would:
- Describe the objectives and set the aspiration
- Develop and prioritise use- and business cases
- Identify the critical medical specialist sectors and their role in the use-case
- Highlight participant clusters and their role in adoption
- Prioritise clusters and their intervention drivers
- Integrate intervention levers to develop a coordinated strategy
- Measure performance and refine the approach
This strategic approach can be further developed for most eHealth solutions. The body of this report includes an example that illustrates this process in further detail for a national telestroke program.