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Integrating telecare for chronic disease management in the community: What needs to be done?
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Background: Telecare could greatly facilitate chronic disease management in the community, but despite government promotion and positive demonstrations its implementation has been limited. This study aimed to identify factors inhibiting the implementation and integration of telecare systems for chronic disease management in the community. Methods: Large scale comparative study employing qualitative data collection techniques: semi-structured interviews with key informants, task-groups, and workshops; framework analysis of qualitative data informed by Normalization Process Theory. Drawn from telecare services in community and domestic settings in England and Scotland, 221 participants were included, consisting of health professionals and managers; patients and carers; social care professionals and managers; and service suppliers and manufacturers. Results: Key barriers to telecare integration were uncertainties about coherent and sustainable service and business models; lack of coordination across social and primary care boundaries, lack of financial or other incentives to include telecare within primary care services; a lack of a sense of continuity with previous service provision and self-care work undertaken by patients; and general uncertainty about the adequacy of telecare systems. These problems led to poor integration of policy and practice. Conclusion: Telecare services may offer a cost effective and safe form of care for some people living with chronic illness. Slow and uneven implementation and integration do not stem from problems of adoption. They result from incomplete understanding of the role of telecare systems and subsequent adaption and embeddedness to context, and uncertainties about the best way to develop, coordinate, and sustain services that assist with chronic disease management. Interventions are therefore needed that (i) reduce uncertainty about the ownership of implementation processes and that lock together health and social care agencies; and (ii) ensure user centred rather than biomedical/service-centred models of care.
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“However, a number of studies have demonstrated that these types of interventions often fail to be successfully implemented and adopted within routine healthcare [5].”
From Exploring barriers to participation and adoption of telehealth and telecare within the Whole System Demonstrator trial: a qualitative study (2012) · cites this paper as [5]
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Metadata
- Authors
- May, C. R., Finch, T. L., Cornford, J., Exley, C., Gately, C., Kirk, S., Jenkings, K. N., Osbourne, J., Robinson, A. L., Rogers, A., Wilson, R., & Mair, F. S.
- Affiliations
- University of Southampton (GB)
- Newcastle University (GB)
- University of East Anglia (GB)
- University of Manchester (GB)
- Cranfield University (GB)
- University of Glasgow (GB)
- Corresponding author
- Finch, Tracy L
- Venue
- BMC Health Services Research
- Published
- 2011-05-27
- Volume
- 11
- Issue
- 1
- Pages
- 131-131
- ISSN
- 1472-6963 (ISSN-L)
- PMC
- PMC3116473
- OpenAlex
- W2146384540
- Cited by
- 220
- References
- 149
- Citations by year
- 2026: 1 · 2025: 8 · 2024: 13 · 2023: 11 · 2022: 11 · 2021: 9 · 2020: 22 · 2019: 17 · 2018: 18 · 2017: 11 · 2016: 22 · 2015: 20 · 2014: 14 · 2013: 20 · 2012: 16
- FWCI
- 17.93
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Health Services Research (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (publishedVersion, other-oa)
- Northumbria Research Link (Northumbria University) (acceptedVersion)
- UEA Digital Repository (University of East Anglia) (acceptedVersion)
- e-space (Manchester Metropolitan University) (acceptedVersion)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (acceptedVersion)
- ePrints Soton (University of Southampton) (acceptedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Newcastle University ePrints (Newcastle Univesity) (cc-by)
- Funders
- National Institute for Health and Care Research
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Health Sciences › Medicine › Geriatrics and Gerontology › Technology Use by Older Adults
- Keywords
- telecare, chronic disease management, implementation barriers, Normalization Process Theory, primary care, social care, health and social care coordination, service model, continuity of care, user-centred care, community-based care
- MeSH terms
- Chronic Disease, Community Health Services, Cooperative Behavior, Education, England, Humans, Scotland, Social Work, Negotiating, Telemedicine, Disease Management, Uncertainty, Qualitative Research
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