• Tanja Prlac Jessen
2 year, Master of Health Informatics (Continuing education) (Continuing Education Programme (Master))
Use of healthcare informatics in patient care is a prioritised development area in Central Denmark Region. Video consultations in particular are seen as a means to flexible, purposeful and economic patient treatment. This has led to the development of a treatment supporting technology, ReMind,which enables video consultations between patients and therapists. It has been decided to implement this technology in several psychiatric outpatient units.
The literature argues, however, that the implementation of healthcare technology in patient treatment is a challenge. Several reasons for this are mentioned, but one particular barrier for implementation is considered to be a lack of technology acceptance in healthcare professionals.

The decision to implement a treatment supporting healthcare technology in Central Denmark Region poses a dilemma, because the technology only becomes supportive if it is adopted amongst those who are to use it in their daily practice. This study seeks to establish the expectations of and experience with the ReMind application as a digital tool to patient treatment among healthcare professionals. The purpose of this is to create an understanding of the matters at stake when a new technology is implemented in a clinical psychiatric practice.

Method and theoretic references
The study's focus is the healthcare professionals' perspective on the implementation of new technology. Their perceptions of and experiences with ReMind were conducted through semi-structured qualitative research interviews. A total of 10 interviews were carried out: five pre-deployment and five post-implementation. The material was analyzed and discussed through a hermeneutic understanding.
The data interpretation process was supported by the socio-technical systems theory (STST) as well as the expanded technology concept and Technucation project that positions itself scientifically within Science, Technology and Society Studies (STS).
STST and STS theories relate to direct and indirect impacts of technologies on a field and its agents. The theories thus functioned as horizon broadening tools supporting the identification of interaction between healthcare professionals and technology.

The study identified four key themes with a total of 11 sub-themes related to the research question: “What are the healthcare professionals’ perspectives on implementation of the treatment supporting technology ReMind”. The central themes are expectation, perception, use and possible barriers.
The expectations to ReMind as a treatment supporting technology are that the system 1) helps reduce the large geographical distances, 2) increases patient involvement and patient empowerment and 3) increases the flexibility of the cooperation between patient and healthcare professionals.
Sub-themes related to perception are 1) a lacked familiarity with the system, 2) a change of practice and 3) that ReMind is not applicable with all patients.
The study does not render the investigation of the healthcare professionals’ experiences with the use of ReMind possible, as four of those interviewed had not yet used ReMind and one had only tried using part of the application. Findings under the theme associated with use are 1) that ReMind is compared with the use of other communications platforms and 2) that technology should contribute positively from implementation start.
The main barriers to using ReMind as a supportive treatment technology have been identified as 1) lack of time, 2) lack of management involvement and a vision for implementation and 3) the need for local IT support.

The study concludes that healthcare professionals generally consider ReMind as valuable to patients. In particular, they point to the importance of the technology in relation to increasing the involvement of patients in their own treatment and health. Healthcare professionals find it harder to mention technology benefits for themselves.

The biggest barrier to implementation is described as a lack of time to apply ReMind, as treatment is the core task and very important in everyday life. This suggests that healthcare professionals do not consider technology as an integrated part of treatment. Moreover, it is found that the technology’s paths into the organization seem 'invisible' to healthcare professionals. Professionals who had positive experiences with the previous iPad project and helped developing the project can more easily than others see the purpose of ReMind. Lack of integration with existing systems is seen as a barrier related to workflow and patient safety.

The study has identified a need for a future study of the patient perspective to clarify what an application like ReMind must contain to enhance patientempowerment.
Publication date10 Jun 2015
Number of pages80
ID: 213948952