Implementing digital respiratory technologies: a CONNECT CRC systematic scoping review

Résumé fourni par la source

Background: Implementation of digital healthcare is complex and challenging. Harmonising implementation strategies can promote safe and equitable digital healthcare, but guidance for implementation is lacking. Methods: CONNECT colleagues(17 countries) identified published literature using Arksey's methodology. We searched ten databases using key terms relating to digital, respiratory and implementation, included studies embedding digital respiratory technologies in routine clinical practice and used implementation frameworks(e.g.NASSS,NPT,REAIM,TDF) to categorise results. The technology used, implementation strategies employed, barriers faced, and outcomes achieved were extracted. Results: We found 85 studies(Dec 2013-2023) including video conferencing, text messaging for remote consultation and rehabilitation training, chatbots and apps/platforms and devices for remote monitoring, self-management and education, vDOT to monitor medication adherence. Government policy shaped the programme and evaluation focus. CFIR,REAIM and TDF were the most widely used frameworks. Co-developing with end users and building initial relationships were key, helping patients and clinicians build trust. Adopters' motivation and belief about the programme’s usefulness determined their adoption and ongoing engagement. Leader commitment, involvement, group cohesion, and good communication facilitated successful implementation. Insufficient resources(time, staff, funding, devices) and technical support, poor interoperability, and lack of reimbursement were implementation barriers. Conclusion: We identified enablers and barriers for implementation. Findings will inform policy statements to promote a harmonised framework for digital respirtory.

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