Illustration: the process of implementing new technology in health care units

Implementation Research

Integrating IT-tools Into Regular Practice

Project period

2009–2014

Funding

The Norwegian Research Council

Original abstract

A growing research literature documents the effectiveness of Internet support and online patient-provider communication (OPPC) to improve patient-centred care and health outcomes. However, lack of knowledge and attention to factors important to implement efficacious interventions into the organizational contexts of clinical practice hampers translation into routine practice and highlights the need for studying real world use.

This international collaboration study will implement and evaluate the effects and use of an OPPC service as part of regular care where patients can ask questions and receive advice and support from care providers and social counsellors from NAV.

In Phase I we will identify patients needs, care providers requirements, organizational infrastructure, and use participatory design methods to adapt the OPPC service to the context of clinical practice. In Phase II two sequential cohorts will be followed with 5 repeated measures over 8 months to test the effectiveness of OPPC in regular care. Cohort 1 will receive usual care; Cohort 2 the OPPC service. We will include 260 patients per cohort with various diagnoses from heterogeneous practices to increase external validity.

Outcome measures are:

  1. participation rates and frequency of OPPC use
  2. symptom distress, self-efficacy, anxiety, depression and patient satisfaction with care
  3. health care utilization and cost-effectiveness of the OPPC service
  4. characteristics of high/low volume OPPC users, patient-caregiver communication and OPPC use patterns
  5. patients and care providers perceived usefulness and ease of use
  6. impacts on organizational change and interdisciplinary collaboration, including NAV
  7. OPPC maintenance

This study significantly contributes to the next step of research translation into practice by demonstrating and evaluating the real-world implementation of an innovative technology that can improve patient-provider communication, care quality and patient outcomes.

Papers

Wibe T, Hellesø R, Varsi C, Ruland CM, and Ekstedt M, (2012) “How Does an Online Patient-Nurse Communication Service Meet the Information Needs of Men with Recently Diagnosed Testicular Cancer?,” ISRN Nursing, 260975. http://dx.doi.org/10.5402/2012/260975

Varsi C, Gammon D, Wibe T, Ruland CM, (2013) “Patients’ Reported Reasons for Non-Use of an Internet-Based Patient-Provider Communication Service: Qualitative Interview Study”. J Med Internet Res, 15(11):e246. http://www

Collaborators

  • Kreftklinikken

    Cancer Clinic, Radiumhospitalet, Oslo University Hospital, by Sigbjørn Smeland

  • Seksjon for fordøyelsessykdommer

    Division of Medicine, Rikshospitalet, by unit senior nursing officer Kjerstin Mordal and unit head physician Erik Schrumpf

  • Endokrinologisk avdeling

    Unit of Endocrinology, Aker Hosptial, by unit head physician Kåre Birkeland

  • HELFO

    by assistant director Knut-Rino Amundsen