Understanding the implementation and adoption of an information technology intervention to support medicine optimisation in primary care: qualitative study using strong structuration theory
Jeffries, Mark; Phipps, Denham; Howard, Rachel L.; Avery, Anthony; Rodgers, Sarah; Ashcroft, Darren
Rachel L. Howard
Professor TONY AVERY firstname.lastname@example.org
Professor of Primary Health Care
Objectives: Using strong structuration theory, we aimed to understand the adoption and implementation of an electronic clinical audit and feedback tool to support medicine optimisation for patients in primary care.
Design: This is a qualitative study informed by strong structuration theory. The analysis was thematic, using a template approach. An a priori set of thematic codes, based on strong structuration theory, was developed from the literature and applied to the transcripts. The coding template was then modified through successive readings of the data.
Setting: Clinical commissioning group in the south of England.
Participants: Four focus groups and five semi-structured interviews were conducted with 18 participants purposively sampled from a range of stakeholder groups (general practitioners, pharmacists, patients and commissioners).
Results: Using the system could lead to improved medication safety, but use was determined by broad institutional contexts; by the perceptions, dispositions and skills of users; and by the structures embedded within the technology. These included perceptions of the system as new and requiring technical competence and skill; the adoption of the system for information gathering; and interactions and relationships that involved individual, shared or collective use. The dynamics between these external, internal and technological structures affected the adoption and implementation of the system.
Conclusions: Successful implementation of information technology interventions for medicine optimisation will depend on a combination of the infrastructure within primary care, social structures embedded in the technology and the conventions, norms and dispositions of those utilising it. Future interventions, using electronic audit and feedback tools to improve medication safety, should consider the complexity of the social and organisational contexts and how internal and external structures can affect the use of the technology in order to support effective implementation.
Jeffries, M., Phipps, D., Howard, R. L., Avery, A., Rodgers, S., & Ashcroft, D. (2017). Understanding the implementation and adoption of an information technology intervention to support medicine optimisation in primary care: qualitative study using strong structuration theory. BMJ Open, 7(5), https://doi.org/10.1136/bmjopen-2016-014810
|Journal Article Type||Article|
|Acceptance Date||Apr 3, 2017|
|Online Publication Date||May 10, 2017|
|Deposit Date||May 12, 2017|
|Publicly Available Date||May 12, 2017|
|Publisher||BMJ Publishing Group|
|Peer Reviewed||Peer Reviewed|
|Related Public URLs||https://creativecommons.org/licenses/by/4.0/|
|Copyright Statement||Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by/4.0|
Jeffries BMJ Open 2017.pdf
Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by/4.0
You might also like
Processing of discharge summaries in general practice: a retrospective record review