Factors affecting the adoption of telehealthcare in the United Kingdom: the policy context and the problem of evidence

The adoption of telehealthcare in the United Kingdom has been slow and fragmented. This paper presents a structural explanation for this by contrasting contending themes in recent UK health policy. It is argued that the conflict between trends towards modernizationand demands for evidence-based practicehave made it difficult for a major policy agency to emerge that can sponsor service development, and so proponents of telehealthcare have been forced to situate their work within the domain of R&D. This has led to a fragmented field of practice characterized by short-term and small-scale projects.

ALIGNING PROCESS AND MEANING: INNOVATING IN COMPLEX HEALTHCARE DELIVERY SYSTEMS

For some time now, successive generations of more sophisticated information and communication technologies (ICTs) have been adopted by organisations to enhance or replace more traditional methods of accessing, recording and communicating information used in problem-solving activities. Professionals in most industries have had some experience of the impact of ICT innovation and might be expected to resist innovations which they perceive to have the potential to disrupt crucial processes. This appears particularly likely to occur where there is a substantial tacit knowledge component. In this paper, we report the perceptions of key groups of healthcare professionals of the barriers to adoption of videoconferencing into knowledge-intensive processes mediating high-level problem-solving. While there was some shared perception of the critical problems, the interpretations of the underlying issues differed. The findings give some insight into the conceptualisation issues surrounding innovation management within complex systems which are emerging in the adoption of ICTs. The nature of their impact on pre-existing core communication routines involving high level expertise and tacit knowledge is considered.

'CHEATS': a generic information communication technology (ICT) evaluation framework

This paper describes a generic framework for the evaluation of information communication technologies. This framework, CHEATS, utilises both qualitative and quantitative research methods and has proved appropriate in multiple clinical settings including telepsychiatry, teledermatology and teleeducation. The paper demonstrates how a multidisciplinary approach is essential when evaluating new and emerging technologies, particularly when such systems are implemented in real service as opposed to a research setting.