A Self-help Tool to Facilitate Implementation of eHealth Initiatives in Health Care (E-Ready): Formative Evaluation

Petra Dannapfel; Kristin Thomas; Alexander Chakhunashvili; Jeanette Melin; Ylva Trolle Lagerros

doi:10.2196/17568

A Self-help Tool to Facilitate Implementation of eHealth Initiatives in Health Care (E-Ready): Formative Evaluation

JMIR Form Res. 2022 Jan 17;6(1):e17568. doi: 10.2196/17568.

Authors

Petra Dannapfel¹, Kristin Thomas², Alexander Chakhunashvili³, Jeanette Melin⁴, Ylva Trolle Lagerros^{5

6}

Affiliations

¹ Department of Clinical and Experimental Medicine, Faculty of Medicine, Linköping University, Linköping, Sweden.
² Department of Health, Medicine and Caring, Medical Faculty, Linköping University, Linköping, Sweden.
³ Karolinska University Hospital, Stockholm, Sweden.
⁴ Research Institutes of Sweden, Stockholm, Sweden.
⁵ Clinical Epidemiology Division, Department of Medicine, Karolinska Institute, Stockholm, Sweden.
⁶ Obesity Centre, Academic Specialist Centre, Stockholm Health Services, Stockholm, Sweden.

PMID: 35037884
PMCID: PMC8804954
DOI: 10.2196/17568

Abstract

Background: eHealth interventions have the potential to increase the efficiency and effectiveness of health care. However, research has shown that implementing eHealth in routine health care practice is difficult. Organizational readiness to change has been shown to be central to successful implementation. This paper describes the development and formative evaluation of a generic self-help tool, E-Ready, designed to be used by managers, project leaders, or others responsible for implementation in a broad range of health care settings.

Objective: The aim of this study is to develop and evaluate a tool that could facilitate eHealth implementation in, for example, health care.

Methods: A first version of the tool was generated based on implementation theory (E-Ready 1.0). A formative evaluation was undertaken through expert panels (n=15), cognitive interviews (n=17), and assessment of measurement properties on E-Ready items from 3 different workplaces (n=165) using Rasch analyses. E-Ready 1.0 was also field tested among the target population (n=29). Iterative revisions were conducted during the formative evaluation process, and E-Ready 2.0 was generated.

Results: The E-Ready Tool consists of a readiness assessment survey and a hands-on manual. The survey measures perceived readiness for change (willingness and capability) at individual and collective levels: perceived conditions for change at the workplace, perceived individual conditions for change, perceived support and engagement among management, perceived readiness among colleagues, perceived consequences on status quo, and perceived workplace attitudes. The manual contains a brief introduction, instructions on how to use the tool, information on the themes of E-Ready, instructions on how to create an implementation plan, brief advice for success, and tips for further reading on implementation theory. Rasch analyses showed overall acceptable measurement properties in terms of fit validity. The subscale Individual conditions for change (3 items) had the lowest person reliability (0.56), whereas Perceived consequences on status quo (5 items) had the highest person reliability (0.87).

Conclusions: E-Ready 2.0 is a new self-help tool to guide implementation targeting health care provider readiness and engagement readiness ahead of eHealth initiatives in, for example, health care settings. E-Ready can be improved further to capture additional aspects of implementation; improvements can also be made by evaluating the tool in a larger sample.

Keywords: health care sector; implementation science; organizational readiness for change; telemedicine.

©Petra Dannapfel, Kristin Thomas, Alexander Chakhunashvili, Jeanette Melin, Ylva Trolle Lagerros. Originally published in JMIR Formative Research (https://formative.jmir.org), 17.01.2022.