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Delivering digital health and well-being at scale: lessons learned during the implementation of the dallas program in the United Kingdom

Devlin, Alison M; McGee-Lennon, Marilyn; O�Donnell, Catherine A; Bouamrane, Matt-Mouley; Agbakoba, Ruth; O�Connor, Siobhan; Grieve, Eleanor; Finch, Tracy; Wyke, Sally; Watson, Nicholas; Browne, Susan; Mair, Frances S

Authors

Alison M Devlin

Marilyn McGee-Lennon

Catherine A O�Donnell

Matt-Mouley Bouamrane

Ruth Agbakoba

Siobhan O�Connor

Eleanor Grieve

Tracy Finch

Sally Wyke

Nicholas Watson

Susan Browne

Frances S Mair



Abstract

OBJECTIVE:
To identify implementation lessons from the United Kingdom Delivering Assisted Living Lifestyles at Scale (dallas) program-a large-scale, national technology program that aims to deliver a broad range of digital services and products to the public to promote health and well-being.

MATERIALS AND METHODS:
Prospective, longitudinal qualitative research study investigating implementation processes. Qualitative data collected includes semi-structured e-Health Implementation Toolkit-led interviews at baseline/mid-point (n = 38), quarterly evaluation, quarterly technical and barrier and solutions reports, observational logs, quarterly evaluation alignment interviews with project leads, observational data collected during meetings, and ethnographic data from dallas events (n > 200 distinct pieces of qualitative data). Data analysis was guided by Normalization Process Theory, a sociological theory that aids conceptualization of implementation issues in complex healthcare settings.

RESULTS:
Five key challenges were identified: 1) The challenge of establishing and maintaining large heterogeneous, multi-agency partnerships to deliver new models of healthcare; 2) The need for resilience in the face of barriers and set-backs including the backdrop of continually changing external environments; 3) The inherent tension between embracing innovative co-design and achieving delivery at pace and at scale; 4) The effects of branding and marketing issues in consumer healthcare settings; and 5) The challenge of interoperability and information governance, when commercial proprietary models are dominant.

CONCLUSIONS:
The magnitude and ambition of the dallas program provides a unique opportunity to investigate the macro level implementation challenges faced when designing and delivering digital health and wellness services at scale. Flexibility, adaptability, and resilience are key implementation facilitators when shifting to new digitally enabled models of care.

Citation

Devlin, A. M., McGee-Lennon, M., O’Donnell, C. A., Bouamrane, M., Agbakoba, R., O’Connor, S., …Mair, F. S. (2016). Delivering digital health and well-being at scale: lessons learned during the implementation of the dallas program in the United Kingdom. Journal of the American Medical Informatics Association, 23(1), 48-59. https://doi.org/10.1093/jamia/ocv097

Journal Article Type Article
Acceptance Date Jun 5, 2015
Online Publication Date Aug 8, 2015
Publication Date 2016-01
Deposit Date Oct 17, 2016
Journal Journal of the American Medical Informatics Association; J Am Med Inform Assoc
Print ISSN 1067-5027
Electronic ISSN 1527-974X
Publisher Oxford University Press
Peer Reviewed Peer Reviewed
Volume 23
Issue 1
Pages 48-59
DOI https://doi.org/10.1093/jamia/ocv097
Keywords Health Informatics; eHealth; digital health; implementation;
Public URL http://researchrepository.napier.ac.uk/Output/387355






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