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Implementing New Technologies in a Context of Complexity to Improve Health and Healthcare Service

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Care Sciences & Services".

Deadline for manuscript submissions: closed (31 January 2022) | Viewed by 4636

Special Issue Editors

Public Service Research Group, School of Business, The University of New South Wales Canberra, Canberra, BC 2610, Australia
Interests: primary health care; primary care policy; performance management, continuous quality improvement; complex evaluation; evaluation theory; implementation; systems thinking
Public Service Research Group, School of Business, The University of New South Wales Canberra, Canberra BC 2610, Australia
Interests: public sector productivity; management; public services management
Melbourne School of Population and Global Health, University of Melbourne, Carlton VIC 3053, Australia
Interests: market-based reform of public services with particular focus on welfare-to-work and disability services

Special Issue Information

Dear Colleagues,

Innovation in technology is seen as an important means through which governments can improve the effectiveness and efficiency of health and social care. During 2020, the COVID-19 pandemic precipitated a rapid and unprecedented scaling up of technology in healthcare. For example, the adoption of digital health has reformed patient-facing services across the world, as well as the communications and educational initiatives that support it. In some cases, this has occurred within periods of mere weeks, and at the same time, a decrease in the number of patient no-shows has been observed [1].

Prior to 2020 however, new technologies, care pathways and service models designed to transform care rarely achieved widespread uptake, even where there was sound evidence of benefit [2]. Researchers argued that implementation tended to retain linear and mechanistic assumptions about change processes, paying little attention to the human tasks of adapting to shifting roles and professional norms and the need for technologies themselves to adapt to specific contexts of use [2,3]. Such proponents have argued that a fundamental rethink is needed when it comes to the way innovation is conceptualized and implementation is researched. Rather than conceptualizing innovation as an entity to be added into an organization and subsequently scaled up in other contexts, research should address the ecological aspects of change processes within place, and emphasize complexity and the emergent nature of innovation, as people, objects and systems interact and adapt to local circumstances.

The response of the health and social care sector to the adoption of new technology during the COVID-19 pandemic raises significant questions regarding this inside/out analysis and how to carry forward this “can-do” attitude to reforms, post-pandemic. Telehealth and other innovations will transform care delivery around the world and require a new digitally enabled health workforce and patient education to go with it [4]. How can this impetus for change be created and sustained from within? What can we learn from complexity approaches about change processes and the extent to which emergence and outside pressure can co-exist in creating new, more responsive approaches to the use of technologies in patient care?

The panel seeks papers concerned with technology implementation challenges in complex environments at service, cross-jurisdictional, national or local government levels such as digital services. Papers are particularly sought that address:

  • examples and case studies of successful technological implementation in complex systems;
  • new skills and/or capabilities required to support sustainable technological implementation in complex environments;
  • the strategic environment in which practitioners operate and the relationships they develop to deliver complex innovation;
  • experiences in complex technological innovation implementation and lessons learned along the way;
  • novel methods for studying implementation of technologies within complex systems;
  • the use of data to support complex implementation;
  • technology’s role and impact as a lever for change in health and social care systems.

References

  1. Dooley M. Building on innovation and lessons learned during the COVID-19 pandemic. J. Pharm. Pract. Res. 2020, 5, 373–376.
  2. Greenhalgh, T.; Papoutsi, C. Spreading and scaling up innovation and improvement. BMJ 2019, 365, l2068.
  3. Braithwaite, J.; Churruca, K.; Long, J.; Ellis, L.; Herkes, J. When complexity science meets implementation science: A theoretical and empirical analysis of systems change. BMC Med. 2018, 16, 63.
  4. Duckett, S.; Brooks, P.; Older, B. The Pandemic has Given Us a Chance to Reimagine Healthcare. Available online: https://grattan.edu.au/news/the-pandemic-has-given-us-a-chance-to-reimagine-healthcare/ (accessed on 4 March 2021).

Dr. Karen Gardner
Prof. Dr. Deborah Blackman
Dr. Sue Olney
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • innovation
  • complexity
  • systems thinking
  • implementation
  • technology

Published Papers (2 papers)

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Research

14 pages, 321 KiB  
Article
“We’re Still Struggling a Bit to Actually Figure Out What That Means for Government”: An Exploration of the Policy Capacity Required to Oversee Robot Technologies in Australia and New Zealand Care Services
by Helen Dickinson, Catherine Smith, Nicole Carey and Gemma Carey
Int. J. Environ. Res. Public Health 2022, 19(8), 4696; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19084696 - 13 Apr 2022
Viewed by 1682
Abstract
Many countries are experiencing a “care crisis” driven by increasing demand for care services alongside difficulties in recruiting and retaining an appropriate care workforce. One of the solutions offered to this is the use of robotic technologies. While there are several positives produced [...] Read more.
Many countries are experiencing a “care crisis” driven by increasing demand for care services alongside difficulties in recruiting and retaining an appropriate care workforce. One of the solutions offered to this is the use of robotic technologies. While there are several positives produced by robots, they are not without challenges and have the potential to be misused. History shows disruptive technologies require appropriate policy capacity for these to be effectively stewarded so that we can secure the positive gains of these without encountering potential harms. In this paper, we explore the types of policy capacity needed to oversee robotic technologies. Drawing on interviews with 35 key stakeholders involved with the implementation of robots in Australian and New Zealand care services, we identify the capabilities required at the individual, organisational, and systemic levels across the analytical, operational, and political domains. We found the respondents perceived a lack of policy capacity to oversee robotics in the government. However, these gaps are less in respect to technological skills and abilities and more in respect to the system’s impacts and effects of these technologies. We conclude by outlining a summary of the capabilities required to oversee robots in complex care systems. Full article
15 pages, 1270 KiB  
Article
User Perception of New E-Health Challenges: Implications for the Care Process
by María Esther González-Revuelta, Nuria Novas, Jose Antonio Gázquez, Manuel Ángel Rodríguez-Maresca and Juan Manuel García-Torrecillas
Int. J. Environ. Res. Public Health 2022, 19(7), 3875; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19073875 - 24 Mar 2022
Cited by 2 | Viewed by 2171
Abstract
Establishing new models of health care and new forms of professional health-patient communication are lines of development in the field of health care. The onset of the COVID-19 pandemic has accelerated the evolution of information systems and communication platforms to guarantee continuity of [...] Read more.
Establishing new models of health care and new forms of professional health-patient communication are lines of development in the field of health care. The onset of the COVID-19 pandemic has accelerated the evolution of information systems and communication platforms to guarantee continuity of care and compliance with social distancing measures. Our objective in this article was, firstly, to know the expectations of patients treated in the healthcare processes “cervical cancer” and “pregnancy, childbirth and puerperium” regarding online access to their clinical history and follow-up in the care process. Secondly, we analyzed times involved in the cervical cancer process to find points of improvement in waiting times when digital tools were used for communication with the patient. A descriptive cross-sectional study was carried out on 120 women included in any of the aforementioned processes using a hetero-administered questionnaire. The analysis of times was carried out using the Business Intelligence tool Biwer Analytics®. Patients showed interest in knowing their results before the appointment with the doctor and would avoid appointments with their doctor if the right conditions were met. Most recognized that this action would relieve their restlessness and anxiety. They were highly interested in receiving recommendations to improve their health status. It was estimated that there was room for improvement in the times involved in the care process, which could be shortened by 34.48 days if communication of results were through digital information access technologies. This would favor the optimization of time, resources and user perception. Full article
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