Effectiveness of local support for the adoption of a national programme--a descriptive study.

Christopher Pearce, Jenny Bartlett, Adam Mcleod, Paula Eustace, Rod Amos, Marianne Shearer
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引用次数: 10

Abstract

Background: Change management in health care is a complex and time-consuming endeavour, and no less so in implementing technological systems. In deploying a nationwide programme, the personally controlled electronic health record (PCEHR), the Australian Government employed a number of national and local change management programmes.

Objective: This article describes the processes undertaken and the experiences of introducing the PCEHR into 74 general practices across a specific area of metropolitan Melbourne.

Method: An online survey was developed by an independent evaluator and offered to all participating practices. The response rate was 82%.

Results: The deployment and testing of the eHealth infrastructure and the roll-out of the PCEHR were deeply supported through face-to-face, locally contextualised support processes. The area Medicare Local (ML), an organisation that provides support services to general practice and allied health in the community, provided support and programme coordination. This support occurred in the environment of a number of other initiatives to improve adoption.

Conclusion: The impact and value of this support in the registration and adoption process was explored in an online survey and found to be the key factor in practice engagement and success. ML support was seen as instrumental in improving adoption and was more effective than other activities. This article highlights the role of local support, in this case, MLs, in the effective implementation of eHealth programmes across a range of stakeholder groups, in particular, general practice, and the potential for the lessons learned from the engagement model of such an entity to be more generally applied.

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地方支持采用国家方案的有效性——一项描述性研究。
背景:卫生保健的变革管理是一项复杂而耗时的工作,在实施技术系统方面同样如此。在部署个人控制的电子健康记录(PCEHR)这一全国性方案时,澳大利亚政府采用了若干国家和地方变革管理方案。目的:本文描述了将PCEHR引入墨尔本大都市特定区域的74个一般实践的过程和经验。方法:由独立评估人员进行在线调查,并提供给所有参与的实践。应答率为82%。结果:电子卫生基础设施的部署和测试以及PCEHR的推出通过面对面的、当地情境化的支持过程得到了深入的支持。当地医疗保险(ML)是一个为社区的全科医疗和联合医疗提供支持服务的组织,它提供了支持和方案协调。这种支持发生在许多其他改进采用的倡议的环境中。结论:在一项在线调查中,我们探讨了这种支持在注册和采用过程中的影响和价值,并发现这是实践参与和成功的关键因素。ML支持被视为有助于提高采用率,并且比其他活动更有效。本文强调了地方支持(在本例中是MLs)在一系列利益相关者群体中有效实施电子卫生保健方案方面的作用,特别是一般做法,以及从这种实体的参与模式中吸取的经验教训更普遍应用的潜力。
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