Lessons Learned From a Living Lab on the Broad Adoption of eHealth in Primary Health Care

Ilse Catharina Sophia Swinkels (Corresponding Author), Martine Wilhelmina Johanna Huygens, Tim M. Schoenmakers, Wendy Oude Nijeweme-d'Hollosy, Lex van Velsen, Joan Vermeulen, Marian Schoone-Harmsen, Yvonne J.F.M. Jansen, Onno C.P. Van Schayck, Roland Friele, Luc de Witte

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Abstract

Background: Electronic health (eHealth) solutions are considered to relieve current and future pressure on the sustainability of primary health care systems. However, evidence of the effectiveness of eHealth in daily practice is missing. Furthermore, eHealth solutions are often not implemented structurally after a pilot phase, even if successful during this phase. Although many studies on barriers and facilitators were published in recent years, eHealth implementation still progresses only slowly. To further unravel the slow implementation process in primary health care and accelerate the implementation of eHealth, a 3-year Living Lab project was set up. In the Living Lab, called eLabEL, patients, health care professionals, small- and medium-sized enterprises (SMEs), and research institutes collaborated to select and integrate fully mature eHealth technologies for implementation in primary health care. Seven primary health care centers, 10 SMEs, and 4 research institutes participated.

Objective: This viewpoint paper aims to show the process of adoption of eHealth in primary care from the perspective of different stakeholders in a qualitative way. We provide a real-world view on how such a process occurs, including successes and failures related to the different perspectives.

Methods: Reflective and process-based notes from all meetings of the project partners, interview data, and data of focus groups were analyzed systematically using four theoretical models to study the adoption of eHealth in primary care.

Results: The results showed that large-scale implementation of eHealth depends on the efforts of and interaction and collaboration among 4 groups of stakeholders: patients, health care professionals, SMEs, and those responsible for health care policy (health care insurers and policy makers). These stakeholders are all acting within their own contexts and with their own values and expectations. We experienced that patients reported expected benefits regarding the use of eHealth for self-management purposes, and health care professionals stressed the potential benefits of eHealth and were interested in using eHealth to distinguish themselves from other care organizations. In addition, eHealth entrepreneurs valued the collaboration among SMEs as they were not big enough to enter the health care market on their own and valued the collaboration with research institutes. Furthermore, health care insurers and policy makers shared the ambition and need for the development and implementation of an integrated eHealth infrastructure.

Conclusions: For optimal and sustainable use of eHealth, patients should be actively involved, primary health care professionals need to be reinforced in their management, entrepreneurs should work closely with health care professionals and patients, and the government needs to focus on new health care models stimulating innovations. Only when all these parties act together, starting in local communities with a small range of eHealth tools, the potential of eHealth will be enforced.
Original languageEnglish
Article numbere83
JournalJournal of medical internet research
Volume20
Issue number3
DOIs
Publication statusPublished - 29 Mar 2018

Keywords

  • telemedicine
  • primary health care
  • implementation
  • patient involvement
  • entrepreneurship
  • health personnel
  • policy makers

Cite this

Swinkels, Ilse Catharina Sophia ; Huygens, Martine Wilhelmina Johanna ; Schoenmakers, Tim M. ; Oude Nijeweme-d'Hollosy, Wendy ; van Velsen, Lex ; Vermeulen, Joan ; Schoone-Harmsen, Marian ; Jansen, Yvonne J.F.M. ; Van Schayck, Onno C.P. ; Friele, Roland ; de Witte, Luc. / Lessons Learned From a Living Lab on the Broad Adoption of eHealth in Primary Health Care. In: Journal of medical internet research. 2018 ; Vol. 20, No. 3.
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title = "Lessons Learned From a Living Lab on the Broad Adoption of eHealth in Primary Health Care",
abstract = "Background: Electronic health (eHealth) solutions are considered to relieve current and future pressure on the sustainability of primary health care systems. However, evidence of the effectiveness of eHealth in daily practice is missing. Furthermore, eHealth solutions are often not implemented structurally after a pilot phase, even if successful during this phase. Although many studies on barriers and facilitators were published in recent years, eHealth implementation still progresses only slowly. To further unravel the slow implementation process in primary health care and accelerate the implementation of eHealth, a 3-year Living Lab project was set up. In the Living Lab, called eLabEL, patients, health care professionals, small- and medium-sized enterprises (SMEs), and research institutes collaborated to select and integrate fully mature eHealth technologies for implementation in primary health care. Seven primary health care centers, 10 SMEs, and 4 research institutes participated.Objective: This viewpoint paper aims to show the process of adoption of eHealth in primary care from the perspective of different stakeholders in a qualitative way. We provide a real-world view on how such a process occurs, including successes and failures related to the different perspectives.Methods: Reflective and process-based notes from all meetings of the project partners, interview data, and data of focus groups were analyzed systematically using four theoretical models to study the adoption of eHealth in primary care.Results: The results showed that large-scale implementation of eHealth depends on the efforts of and interaction and collaboration among 4 groups of stakeholders: patients, health care professionals, SMEs, and those responsible for health care policy (health care insurers and policy makers). These stakeholders are all acting within their own contexts and with their own values and expectations. We experienced that patients reported expected benefits regarding the use of eHealth for self-management purposes, and health care professionals stressed the potential benefits of eHealth and were interested in using eHealth to distinguish themselves from other care organizations. In addition, eHealth entrepreneurs valued the collaboration among SMEs as they were not big enough to enter the health care market on their own and valued the collaboration with research institutes. Furthermore, health care insurers and policy makers shared the ambition and need for the development and implementation of an integrated eHealth infrastructure.Conclusions: For optimal and sustainable use of eHealth, patients should be actively involved, primary health care professionals need to be reinforced in their management, entrepreneurs should work closely with health care professionals and patients, and the government needs to focus on new health care models stimulating innovations. Only when all these parties act together, starting in local communities with a small range of eHealth tools, the potential of eHealth will be enforced.",
keywords = "telemedicine, primary health care, implementation, patient involvement, entrepreneurship, health personnel, policy makers",
author = "Swinkels, {Ilse Catharina Sophia} and Huygens, {Martine Wilhelmina Johanna} and Schoenmakers, {Tim M.} and {Oude Nijeweme-d'Hollosy}, Wendy and {van Velsen}, Lex and Joan Vermeulen and Marian Schoone-Harmsen and Jansen, {Yvonne J.F.M.} and {Van Schayck}, {Onno C.P.} and Roland Friele and {de Witte}, Luc",
year = "2018",
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doi = "10.2196/jmir.9110",
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Swinkels, ICS, Huygens, MWJ, Schoenmakers, TM, Oude Nijeweme-d'Hollosy, W, van Velsen, L, Vermeulen, J, Schoone-Harmsen, M, Jansen, YJFM, Van Schayck, OCP, Friele, R & de Witte, L 2018, 'Lessons Learned From a Living Lab on the Broad Adoption of eHealth in Primary Health Care' Journal of medical internet research, vol. 20, no. 3, e83. https://doi.org/10.2196/jmir.9110

Lessons Learned From a Living Lab on the Broad Adoption of eHealth in Primary Health Care. / Swinkels, Ilse Catharina Sophia (Corresponding Author); Huygens, Martine Wilhelmina Johanna; Schoenmakers, Tim M.; Oude Nijeweme-d'Hollosy, Wendy; van Velsen, Lex; Vermeulen, Joan; Schoone-Harmsen, Marian; Jansen, Yvonne J.F.M.; Van Schayck, Onno C.P.; Friele, Roland; de Witte, Luc.

In: Journal of medical internet research, Vol. 20, No. 3, e83, 29.03.2018.

Research output: Contribution to journalReview articleAcademicpeer-review

TY - JOUR

T1 - Lessons Learned From a Living Lab on the Broad Adoption of eHealth in Primary Health Care

AU - Swinkels, Ilse Catharina Sophia

AU - Huygens, Martine Wilhelmina Johanna

AU - Schoenmakers, Tim M.

AU - Oude Nijeweme-d'Hollosy, Wendy

AU - van Velsen, Lex

AU - Vermeulen, Joan

AU - Schoone-Harmsen, Marian

AU - Jansen, Yvonne J.F.M.

AU - Van Schayck, Onno C.P.

AU - Friele, Roland

AU - de Witte, Luc

PY - 2018/3/29

Y1 - 2018/3/29

N2 - Background: Electronic health (eHealth) solutions are considered to relieve current and future pressure on the sustainability of primary health care systems. However, evidence of the effectiveness of eHealth in daily practice is missing. Furthermore, eHealth solutions are often not implemented structurally after a pilot phase, even if successful during this phase. Although many studies on barriers and facilitators were published in recent years, eHealth implementation still progresses only slowly. To further unravel the slow implementation process in primary health care and accelerate the implementation of eHealth, a 3-year Living Lab project was set up. In the Living Lab, called eLabEL, patients, health care professionals, small- and medium-sized enterprises (SMEs), and research institutes collaborated to select and integrate fully mature eHealth technologies for implementation in primary health care. Seven primary health care centers, 10 SMEs, and 4 research institutes participated.Objective: This viewpoint paper aims to show the process of adoption of eHealth in primary care from the perspective of different stakeholders in a qualitative way. We provide a real-world view on how such a process occurs, including successes and failures related to the different perspectives.Methods: Reflective and process-based notes from all meetings of the project partners, interview data, and data of focus groups were analyzed systematically using four theoretical models to study the adoption of eHealth in primary care.Results: The results showed that large-scale implementation of eHealth depends on the efforts of and interaction and collaboration among 4 groups of stakeholders: patients, health care professionals, SMEs, and those responsible for health care policy (health care insurers and policy makers). These stakeholders are all acting within their own contexts and with their own values and expectations. We experienced that patients reported expected benefits regarding the use of eHealth for self-management purposes, and health care professionals stressed the potential benefits of eHealth and were interested in using eHealth to distinguish themselves from other care organizations. In addition, eHealth entrepreneurs valued the collaboration among SMEs as they were not big enough to enter the health care market on their own and valued the collaboration with research institutes. Furthermore, health care insurers and policy makers shared the ambition and need for the development and implementation of an integrated eHealth infrastructure.Conclusions: For optimal and sustainable use of eHealth, patients should be actively involved, primary health care professionals need to be reinforced in their management, entrepreneurs should work closely with health care professionals and patients, and the government needs to focus on new health care models stimulating innovations. Only when all these parties act together, starting in local communities with a small range of eHealth tools, the potential of eHealth will be enforced.

AB - Background: Electronic health (eHealth) solutions are considered to relieve current and future pressure on the sustainability of primary health care systems. However, evidence of the effectiveness of eHealth in daily practice is missing. Furthermore, eHealth solutions are often not implemented structurally after a pilot phase, even if successful during this phase. Although many studies on barriers and facilitators were published in recent years, eHealth implementation still progresses only slowly. To further unravel the slow implementation process in primary health care and accelerate the implementation of eHealth, a 3-year Living Lab project was set up. In the Living Lab, called eLabEL, patients, health care professionals, small- and medium-sized enterprises (SMEs), and research institutes collaborated to select and integrate fully mature eHealth technologies for implementation in primary health care. Seven primary health care centers, 10 SMEs, and 4 research institutes participated.Objective: This viewpoint paper aims to show the process of adoption of eHealth in primary care from the perspective of different stakeholders in a qualitative way. We provide a real-world view on how such a process occurs, including successes and failures related to the different perspectives.Methods: Reflective and process-based notes from all meetings of the project partners, interview data, and data of focus groups were analyzed systematically using four theoretical models to study the adoption of eHealth in primary care.Results: The results showed that large-scale implementation of eHealth depends on the efforts of and interaction and collaboration among 4 groups of stakeholders: patients, health care professionals, SMEs, and those responsible for health care policy (health care insurers and policy makers). These stakeholders are all acting within their own contexts and with their own values and expectations. We experienced that patients reported expected benefits regarding the use of eHealth for self-management purposes, and health care professionals stressed the potential benefits of eHealth and were interested in using eHealth to distinguish themselves from other care organizations. In addition, eHealth entrepreneurs valued the collaboration among SMEs as they were not big enough to enter the health care market on their own and valued the collaboration with research institutes. Furthermore, health care insurers and policy makers shared the ambition and need for the development and implementation of an integrated eHealth infrastructure.Conclusions: For optimal and sustainable use of eHealth, patients should be actively involved, primary health care professionals need to be reinforced in their management, entrepreneurs should work closely with health care professionals and patients, and the government needs to focus on new health care models stimulating innovations. Only when all these parties act together, starting in local communities with a small range of eHealth tools, the potential of eHealth will be enforced.

KW - telemedicine

KW - primary health care

KW - implementation

KW - patient involvement

KW - entrepreneurship

KW - health personnel

KW - policy makers

U2 - 10.2196/jmir.9110

DO - 10.2196/jmir.9110

M3 - Review article

VL - 20

JO - Journal of medical internet research

JF - Journal of medical internet research

SN - 1439-4456

IS - 3

M1 - e83

ER -