dc.contributor.author
Mosch, Lina Katharina
dc.contributor.author
Poncette, Akira-Sebastian
dc.contributor.author
Spies, Claudia
dc.contributor.author
Weber-Carstens, Steffen
dc.contributor.author
Schieler, Monique
dc.contributor.author
Krampe, Henning
dc.contributor.author
Balzer, Felix
dc.date.accessioned
2022-09-07T08:31:17Z
dc.date.available
2022-09-07T08:31:17Z
dc.identifier.uri
https://refubium.fu-berlin.de/handle/fub188/36197
dc.identifier.uri
http://dx.doi.org/10.17169/refubium-35913
dc.description.abstract
Background: Digital health technologies such as continuous remote monitoring and artificial intelligence–driven clinical decision support systems could improve clinical outcomes in intensive care medicine. However, comprehensive evidence and guidelines for the successful implementation of digital health technologies into specific clinical settings such as the intensive care unit (ICU) are scarce. We evaluated the implementation of a remote patient monitoring platform and derived a framework proposal for the implementation of digital health technology in an ICU.
Objective: This study aims to investigate barriers and facilitators to the implementation of a remote patient monitoring technology and to develop a proposal for an implementation framework for digital health technology in the ICU.
Methods: This study was conducted from May 2018 to March 2020 during the implementation of a tablet computer–based remote patient monitoring system. The system was installed in the ICU of a large German university hospital as a supplementary monitoring device. Following a hybrid qualitative approach with inductive and deductive elements, we used the Consolidated Framework for Implementation Research and the Expert Recommendations for Implementing Change to analyze the transcripts of 7 semistructured interviews with clinical ICU stakeholders and descriptive questionnaire data. The results of the qualitative analysis, together with the findings from informal meetings, field observations, and previous explorations, provided the basis for the derivation of the proposed framework.
Results: This study revealed an insufficient implementation process due to lack of staff engagement and few perceived benefits from the novel solution. Further implementation barriers were the high staff presence and monitoring coverage in the ICU. The implementation framework includes strategies to be applied before and during implementation, targeting the implementation setting by involving all ICU stakeholders, assessing the intervention’s adaptability, facilitating the implementation process, and maintaining a vital feedback culture. Setting up a unit responsible for implementation, considering the guidance of an implementation advisor, and building on existing institutional capacities could improve the institutional context of implementation projects in the ICU.
Conclusions: Implementation of digital health in the ICU should involve a thorough preimplementation assessment of the ICU’s need for innovation and its readiness to change, as well as an ongoing evaluation of the implementation conditions. Involvement of all stakeholders, transparent communication, and continuous feedback in an equal atmosphere are essential, but leadership roles must be clearly defined and competently filled. Our proposed framework may guide health care providers with concrete, evidence-based, and step-by-step recommendations for implementation practice, facilitating the introduction of digital health in intensive care.
Trial Registration: ClinicalTrials.gov NCT03514173; https://clinicaltrials.gov/ct2/show/NCT03514173
en
dc.rights.uri
https://creativecommons.org/licenses/by/4.0/
dc.subject
digital health
en
dc.subject
patient monitoring
en
dc.subject
intensive care medicine
en
dc.subject
intensive care unit
en
dc.subject
technological innovation
en
dc.subject
user-centered
en
dc.subject
implementation
en
dc.subject
implementation science
en
dc.subject
qualitative research
en
dc.subject.ddc
600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit
dc.title
Creation of an Evidence-Based Implementation Framework for Digital Health Technology in the Intensive Care Unit: Qualitative Study
dc.type
Wissenschaftlicher Artikel
dcterms.bibliographicCitation.articlenumber
e22866
dcterms.bibliographicCitation.doi
10.2196/22866
dcterms.bibliographicCitation.journaltitle
JMIR Formative Research
dcterms.bibliographicCitation.number
4
dcterms.bibliographicCitation.originalpublishername
JMIR Publications
dcterms.bibliographicCitation.volume
6
refubium.affiliation
Charité - Universitätsmedizin Berlin
refubium.resourceType.isindependentpub
no
dcterms.accessRights.openaire
open access
dcterms.bibliographicCitation.pmid
35394445
dcterms.isPartOf.eissn
2561-326X