Abdi, Sarah;
Patel, Dilisha;
Carmichael, Josie;
Balaskas, Konstantinos;
Blandford, Ann;
(2025)
Implementing a teleophthalmology referral platform in routine practice: Understanding a digital health intervention implementation using normalisation process theory.
Digital Health
, 11
, Article 20552076241303812. 10.1177/20552076241303812.
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Abstract
Objective: Digital health interventions have the potential to improve clinical processes and patient outcomes; however, many face challenges during the adoption and implementation stages, hindering their overall impact. Our study uses normalisation process theory (NPT) as a theoretical approach to explore the facilitators and barriers to the implementation of a teleophthalmology referral platform in the United Kingdom, as an illustrative case of the implementation of a digital health intervention in routine practice. Methods: Semistructured interviews were conducted with 24 health professionals (18 optometrists and 6 ophthalmologists) involved in the implementation of a teleophthalmology referral platform. NPT guided data collection and analysis. Results: Most participants were ready to engage with the teleophthalmology referral platform, recognising its potential value and benefits. However, during implementation, participants’ perceptions varied; a major factor was whether their expectations from the technology were met, particularly regarding the feedback from the secondary eye care component of the referral platform. Several additional factors were identified that would influence the adoption of the platform. These included individual aspects (e.g. participants’ IT skills), technology-related factors (e.g. the time required to complete referrals) and organisational factors (e.g. investment in community optometry services). Conclusions: To successfully implement the teleophthalmology platform into routine practice, particularly on a large scale, multiple factors at different levels must be considered. This study highlights the complexity associated with implementing digital health interventions in routine practice and the contribution of NPT in untangling some of these complexities.
| Type: | Article |
|---|---|
| Title: | Implementing a teleophthalmology referral platform in routine practice: Understanding a digital health intervention implementation using normalisation process theory |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1177/20552076241303812 |
| Publisher version: | https://doi.org/10.1177/20552076241303812 |
| Language: | English |
| Additional information: | © The Author(s) 2025. Creative Commons License (CC BY 4.0) This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
| Keywords: | Science & Technology, Life Sciences & Biomedicine, Health Care Sciences & Services, Health Policy & Services, Public, Environmental & Occupational Health, Medical Informatics, Teleophthalmology, normalisation process theory, community optometrists, opthalmologists, primary eye care, clinical referral, CARE, SERVICES, MODELS |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > UCL BEAMS UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Institute of Ophthalmology UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Computer Science UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Med Phys and Biomedical Eng |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10206566 |
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