Key Processes And People In Rehabilitation Technology Adoption: A Qualitative Interview Study

Abstract

Background: Despite promise to improve outcomes for patients, many technologies are not sustainably adopted into clinical practice. Adoption of technologies into stroke rehabilitation can be particularly challenging because there are multiple users (patients, carers and clinicians) with varying impairments and digital literacy. This qualitative study explored the factors that influence the adoption of technologies into rehabilitation to highlight the key processes and people in the adoption process.

Method: Stakeholders in NHS rehabilitation services were interviewed using schedules based on normalisation process theory. Participants included: service users, clinicians, service managers, project and innovation leads, information technologists and digital developers. Transcribed interviews were analysed using constant comparison.

Results: 32 individuals from 13 UK NHS sites, five service users and eight digital developers participated. NHS sites had adopted a range of technologies, most commonly apps (5|13), sensors with an app (4|13), online group therapy (4|13) and video consultations (2|13). Technology adoption took considerable time and required knowledge of a variety of
local processes and stakeholders. Processes included funding and procurement, fulfilling operational demands, resource planning and staff training and support. Early engagement with key stakeholders was perceived to positively influence adoption; these included the clinical team, information technologists, managers and technology support.

Conclusions: Early engagement with stakeholders and knowledge of local processes appeared important influencers of technology adoption; adoption processes were often unclear, took time, and required resilience and motivation from adopters. Our research aims to develop a framework and practical resources to support timely and successful rehabilitation technology adoption into stroke rehabilitation.