Why and How New Technologies Fail or Succeed to Embed in Routine Health Services: Lessons from the Introduction of Telehealth Home Monitoring

Title: Why and how new technologies fail or succeed to embed in routine health services: Lessons from the introduction of telehealth home monitoring. Background: New technologies were introduced in Doncaster to enable people with long-term illness self-manage their conditions and to reduce health care costs. Aim: To investigate why telehealth home monitoring embeds in routine healthcare setting. Methods: A case-study research method was used, drawing on lessons from (1) a randomised controlled trial; (2) observational study (before and after uncontrolled evaluation); and (3) qualitative study capturing the views of the stakeholders using semi-structured interviews. The study was informed by Normalisation Process Theory (NPT). The case-study research was carried out in accordance with approach advocated by Yin (2009). Results: The evidence shows that factors related to evaluation design, the technology, and staff could not be excluded as possible explanations for the performances of telehealth home monitoring. There was limited evidence to support the fact that factors related to geographical setting and patient groups provided possible explanation for the difference in the uptake of the new technology. Randomised controlled trial (RCT) showed poor uptake of telehealth, while evidence from service evaluation showed that telehealth was embedding in routine healthcare use in Doncaster. Conclusions: The interaction of factors related to evaluation design, technology, and staff cannot be rejected as causal factors for success or failure of new technologies to embed in routine healthcare setting. On the other hand, the evidence available could not allow the hypotheses related to setting and patients’ group to be accepted as to why new technologies fail or succeed in routine practice. The evidence suggests that telehealth home monitoring was embedding in routine healthcare use in Doncaster.