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Implementation Science
Published in: Implementation Science 1/2018

Open Access 01-12-2018 | Research

Using information communication technology in models of integrated community-based primary health care: learning from the iCOACH case studies

Authors: Carolyn Steele Gray, Jan Barnsley, Dominique Gagnon, Louise Belzile, Tim Kenealy, James Shaw, Nicolette Sheridan, Paul Wankah Nji, Walter P. Wodchis

Published in: Implementation Science | Issue 1/2018

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Abstract

Background

Information communication technology (ICT) is a critical enabler of integrated models of community-based primary health care; however, little is known about how existing technologies have been used to support new models of integrated care. To address this gap, we draw on data from an international study of integrated models, exploring how ICT is used to support activities of integrated care and the organizational and environmental barriers and enablers to its adoption.

Methods

We take an embedded comparative multiple-case study approach using data from a study of implementation of nine models of integrated community-based primary health care, the Implementing Integrated Care for Older Adults with Complex Health Needs (iCOACH) study. Six cases from Canada, three each in Ontario and Quebec, and three in New Zealand, were studied. As part of the case studies, interviews were conducted with managers and front-line health care providers from February 2015 to March 2017. A qualitative descriptive approach was used to code data from 137 interviews and generate word tables to guide analysis.

Results

Despite different models and contexts, we found strikingly similar accounts of the types of activities supported through ICT systems in each of the cases. ICT systems were used most frequently to support activities like care coordination by inter-professional teams through information sharing. However, providers were limited in their ability to efficiently share patient data due to data access issues across organizational and professional boundaries and due to system functionality limitations, such as a lack of interoperability.

Conclusions

Even in innovative models of care, managers and providers in our cases mainly use technology to enable traditional ways of working. Technology limitations prevent more innovative uses of technology that could support disruption necessary to improve care delivery. We argue the barriers to more innovative use of technology are linked to three factors: (1) information access barriers, (2) limited functionality of available technology, and (3) organizational and provider inertia.
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Metadata
Title
Using information communication technology in models of integrated community-based primary health care: learning from the iCOACH case studies
Authors
Carolyn Steele Gray
Jan Barnsley
Dominique Gagnon
Louise Belzile
Tim Kenealy
James Shaw
Nicolette Sheridan
Paul Wankah Nji
Walter P. Wodchis
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Implementation Science / Issue 1/2018
Electronic ISSN: 1748-5908
DOI
https://doi.org/10.1186/s13012-018-0780-3

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