Understanding the implementation and adoption of an information technology intervention to support medicine optimisation in primary care: qualitative study using strong structuration theory

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 a...

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Main Authors: Jeffries, Mark, Phipps, Denham, Howard, Rachel L., Avery, Anthony, Rodgers, Sarah, Ashcroft, Darren
Format: Article
Published: BMJ Publishing Group Ltd 2017
Online Access:https://eprints.nottingham.ac.uk/42823/
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author Jeffries, Mark
Phipps, Denham
Howard, Rachel L.
Avery, Anthony
Rodgers, Sarah
Ashcroft, Darren
author_facet Jeffries, Mark
Phipps, Denham
Howard, Rachel L.
Avery, Anthony
Rodgers, Sarah
Ashcroft, Darren
author_sort Jeffries, Mark
building Nottingham Research Data Repository
collection Online Access
description 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.
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spelling nottingham-428232020-05-04T18:44:03Z https://eprints.nottingham.ac.uk/42823/ 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 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. BMJ Publishing Group Ltd 2017-05-01 Article PeerReviewed Jeffries, Mark, Phipps, Denham, Howard, Rachel L., Avery, Anthony, Rodgers, Sarah and Ashcroft, Darren (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). e014810/1-e014810/10. ISSN 2044-6055 http://bmjopen.bmj.com/content/7/5/e014810 doi:10.1136/bmjopen-2016-014810 doi:10.1136/bmjopen-2016-014810
spellingShingle Jeffries, Mark
Phipps, Denham
Howard, Rachel L.
Avery, Anthony
Rodgers, Sarah
Ashcroft, Darren
Understanding the implementation and adoption of an information technology intervention to support medicine optimisation in primary care: qualitative study using strong structuration theory
title Understanding the implementation and adoption of an information technology intervention to support medicine optimisation in primary care: qualitative study using strong structuration theory
title_full Understanding the implementation and adoption of an information technology intervention to support medicine optimisation in primary care: qualitative study using strong structuration theory
title_fullStr Understanding the implementation and adoption of an information technology intervention to support medicine optimisation in primary care: qualitative study using strong structuration theory
title_full_unstemmed Understanding the implementation and adoption of an information technology intervention to support medicine optimisation in primary care: qualitative study using strong structuration theory
title_short Understanding the implementation and adoption of an information technology intervention to support medicine optimisation in primary care: qualitative study using strong structuration theory
title_sort understanding the implementation and adoption of an information technology intervention to support medicine optimisation in primary care: qualitative study using strong structuration theory
url https://eprints.nottingham.ac.uk/42823/
https://eprints.nottingham.ac.uk/42823/
https://eprints.nottingham.ac.uk/42823/