J. Med. Internet Res. - Interpretive flexibility in mobile health: lessons from a government-sponsored home care program.

Tópicos

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Resumo

CKGROUND: Mobile technologies have emerged as important tools that health care personnel can use to gain easy access to client data anywhere. This is particularly useful for nurses and care workers in home health care as they provide services to clients in many different settings. Although a growing body of evidence supports the use of mobile technologies, the diverse implications of mobile health have yet to be fully documented.OBJECTIVE: Our objective was to examine a large-scale government-sponsored mobile health implementation program in the Danish home care sector and to understand how the technology was used differently across home care agencies.METHODS: We chose to perform a longitudinal case study with embedded units of analysis. We included multiple data sources, such as written materials, a survey to managers across all 98 Danish municipalities, and semistructured interviews with managers, care workers, and nurses in three selected home care agencies. We used process models of change to help analyze the overall implementation process from a longitudinal perspective and to identify antecedent conditions, key events, and practical outcomes.RESULTS: Strong collaboration between major stakeholders in the Danish home care sector (government bodies, vendors, consultants, interest organizations, and managers) helped initiate and energize the change process, and government funding supported quick and widespread technology adoption. However, although supported by the same government-sponsored program, mobile technology proved to have considerable interpretive flexibility with variation in perceived nature of technology, technology strategy, and technology use between agencies. What was first seen as a very promising innovation across the Danish home care sector subsequently became the topic of debate as technology use arrangements ran counter to existing norms and values in individual agencies.CONCLUSIONS: Government-sponsored programs can have both positive and negative results, and managers need to be aware of this and the interpretive flexibility of mobile technology. Mobile technology implementation is a complex process that is best studied by combining organization-level analysis with features of the wider sociopolitical and interorganizational environment.

Resumo Limpo

ckground mobil technolog emerg import tool health care personnel can use gain easi access client data anywher particular use nurs care worker home health care provid servic client mani differ set although grow bodi evid support use mobil technolog divers implic mobil health yet fulli documentedobject object examin largescal governmentsponsor mobil health implement program danish home care sector understand technolog use differ across home care agenciesmethod chose perform longitudin case studi embed unit analysi includ multipl data sourc written materi survey manag across danish municip semistructur interview manag care worker nurs three select home care agenc use process model chang help analyz overal implement process longitudin perspect identifi anteced condit key event practic outcomesresult strong collabor major stakehold danish home care sector govern bodi vendor consult interest organ manag help initi energ chang process govern fund support quick widespread technolog adopt howev although support governmentsponsor program mobil technolog prove consider interpret flexibl variat perceiv natur technolog technolog strategi technolog use agenc first seen promis innov across danish home care sector subsequ becam topic debat technolog use arrang ran counter exist norm valu individu agenciesconclus governmentsponsor program can posit negat result manag need awar interpret flexibl mobil technolog mobil technolog implement complex process best studi combin organizationlevel analysi featur wider sociopolit interorganiz environ

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