Bridgette Wessels

Factors affecting front line staff acceptance of telehealth technologies: a mixed‐method systematic review

AIM To synthesize qualitative and quantitative evidence of front-line staff acceptance of the use of telehealth technologies for the management of Chronic Obstructive Pulmonary Disease and Chronic Heart Failure. BACKGROUND The implementation of telehealth at scale is a governmental priority in countries including the UK, USA and Canada, but little research has been conducted to analyse the impact of implementation on front-line nursing staff. DATA SOURCES Six relevant data bases were searched between 2000-2012. DESIGN Mixed-method systematic review including all study designs. REVIEW METHODS Centre for Reviews and Dissemination approach with thematic analysis and narrative synthesis of results. RESULTS Fourteen studies met the review inclusion criteria; 2 quantitative surveys, 2 mixed-method studies and 10 using qualitative methods, including focus groups, interviews, document analysis and observations. Identified factors affecting staff acceptance centred on the negative impact of service change, staff-patient interaction, credibility and autonomy, and technical issues. Studies often contrasted staff and patient perspectives, and data about staff acceptance were collected as part of a wider study, rather than being the focus of data collection, meaning data about staff acceptance were limited. CONCLUSION If telehealth is to be implemented, studies indicate that the lack of acceptance of this new way of working may be a key barrier. However, recommendations have not moved beyond barrier identification to recognizing solutions that might be implemented by front-line staff. Such solutions are imperative if future roll-out of telehealth technologies is to be successfully achieved.

Mediating Voices: Community Participation in the Design of E-Enabled Community Care Services

In the United Kingdom, information and communication technologies are being used to e-enable multiagency community services for children. Public policy advocates that practitioners as well as users should be involved in the shaping of services including the information systems used in their delivery. This article discusses how a group of social and computer scientists developed the social formation methodology to facilitate nonexpert community participation in the design of e-enabled community care services. The longitudinal study adapts qualitative methods to understand community welfare and to foster participation in the design of communication systems. By exploring the perspectives of welfare practitioners and families, the importance of situated and mediated conversations in community care is identified. The facilitative conversation approach of the study then brings these community perspectives, as well as ICT perspectives, into design processes of e-enabled services.

Situated Innovation of e-Social Science: Integrating Infrastructure, Collaboration, and Knowledge in Developing e-Social Science

This article explores the relationships between academic knowledge and the practice of research in the construction of new computer-supported research tools for e-social science. The article draws on a U.K. e-social science pilot demonstrator project, “Collaborative Analysis of Offenders’ Personal and Area-based Social Exclusion,” that explores the relative impact of individual and neighborhood effects on geographical crime patterns. Three main dimensions of e-social science are addressed by the project: (1) identification of new social research foci, (2) adapting research processes, and (3) developing Grid-related research tools. The integration of these dimensions shows that research-driven and user-led development of computer-mediated research using the Grid can produce relevant and innovative tools for the social sciences.

Implementing solutions to improve and expand telehealth adoption: participatory action research in four community healthcare settings.

BackgroundAdoption of telehealth has been slower than anticipated, and little is known about the service improvements that help to embed telehealth into routine practice or the role of frontline staff in improving adoption. This paper reports on participatory action research carried out in four community health settings using telehealth for patients with Chronic Obstructive Pulmonary Disease and Chronic Heart Failure.MethodsTo inform the action research, in-depth case studies of each telehealth service were conducted (May 2012–June 2013). Each service was then supported by researchers through two cycles of action research to implement changes to increase adoption of telehealth, completed over a seven month period (July 2013–April 2014). The action research was studied via observation of multi-stakeholder workshops, analysis of implementation plans, and focus groups.ResultsAction research participants included 57 staff and one patient, with between eight and 20 participants per site. The case study findings were identified as a key source of information for planning change, with sites addressing common challenges identified through this work. For example, refining referral criteria; standardizing how and when patients are monitored; improving data sharing; and establishing evaluation processes. Sites also focused on raising awareness of telehealth to increase adoption in other clinical teams and to help secure future financial investment for telehealth, which was required because of short-term funding arrangements. Specific solutions varied due to local infrastructures, resources, and opinion, as well as previous service developments. Local telehealth champions played an important role in engaging multiple stakeholders in the study.ConclusionsAction research enabled services to make planned changes to telehealth and share learning across multiple stakeholders about how and when to use telehealth. However, adoption was impeded by continual changes affecting telehealth and wider service provision, which also hindered implementation efforts and affected motivation of staff to engage with the action research, particularly where local decision-makers were not engaged in the study. Wider technological barriers also limited the potential for change, as did uncertainties about goals for telehealth investment, thereby making it difficult to identify outcomes for demonstrating the added value over existing practice.

Issues in the development of open access to research data

This paper explores key issues in the development of open access to research data. The use of digital means for developing, storing and manipulating data is creating a focus on ‘data-driven science’. One aspect of this focus is the development of ‘open access’ to research data. Open access to research data refers to the way in which various types of data are openly available to public and private stakeholders, user communities and citizens. Open access to research data, however, involves more than simply providing easier and wider access to data for potential user groups. The development of open access requires attention to the ways data are considered in different areas of research. We identify how open access is being unevenly developed across the research environment and the consequences this has in terms of generating data gaps. Data gaps refer to the way data becomes detached from published conclusions. To address these issues, we examine four main areas in developing open access to research data: stakeholder roles and values; technological requirements for managing and sharing data; legal and ethical regulations and procedures; institutional roles and policy frameworks. We conclude that problems of variability and consistency across the open access ecosystem need to be addressed within and between these areas to ensure that risks surrounding a data gap are managed in open access.

EXPLORING HUMAN AGENCY AND DIGITAL SYSTEMS

The paper explores the relationship between human agency and digital services. The capacity of digital services to create knowledge from a range of sources has led some commentators to argue that digital services are a factor in redefining human agency because these services link, combine, and compute data to create new knowledge [Lyotard, J. (1984) The Postmodern Condition: A Report on Knowledge, Manchester University Press, Manchester; Lash, S. (1999) Another Modernity, A Different Rationality, Blackwell, Oxford]. This, they argue, is resulting in non-human knowledge systems rather than knowledge created by humans within cultural frameworks. The paper critically engages with these debates to explore the ways in which digital services are made meaningful through the way individuals interpret and use them. It focuses on three contexts in which agency and digital services interact to provide insights into the framework and characteristics of agency in these settings. The three areas that are addressed are: virtual city modelling, digital or electronic-assisted living technology, and Second Life. The conclusion points out that agency is influential in these services in that it is situated in particular spaces and contexts, reflects on the past, assesses the present, and looks to the future. The agency of individuals is important in generating knowledge in digital services, and is part of a personalized form of participation in consumer culture.

Open Data and the Knowledge Society

While there is a lot of talk about how we now live in a knowledge society, the reality has been less impressive: We have yet to truly transition to a knowledge society-in part, this book argues, because discussion mostly focuses on a knowledge economy and information society rather than on ways to mobilise to create an actual knowledge society. That all may change, however, with the rise of open data and big data. This book considers the role of the open data movement in fostering transformation, showing that at the heart of any successful mobilisation will be an emerging open data ecosystem and new ways for societal actors to effectively produce and use data.

How can libraries and other academic stakeholders engage in making data open

In this paper we will address the questions of what and where the value of open access to research data might be and how libraries and related stakeholders can contribute to achieve the benefits of freely sharing data. In particular, the emphasis is on how libraries need to acquire the competence for collaboration to train and encourage researchers and library staff to work with open data. The paper is based on the early results of the RECODE project, an EU FP7 project that addresses the drivers and barriers in developing open access to research data in Europe (http://www.recodeproject.eu).

Researcher-Led Development of E-Research in the Social Sciences: The Case of an E-Social Science Pilot Demonstrator Project

The introduction and use of information and communication technologies (ICT) in the process of research is extending beyond research management into research practice itself. This extension of the use of ICT in research is being termed as e-research. The characteristics of e-research are seen as the combination of three interrelated strands, which are: the increased computerization of the research process; research organized more predominantly in the form of distributed networks of researchers, and a strong emphasis on visualization. E-research has become established in the natural sciences but the development of e-research in relation to social sciences is variable and less pervasive. The richness of the social sciences and their variety of practices and engagement in diverse fields of study mean that e-research as utilized in the natural sciences cannot be easily migrated into the social sciences. This paper explores the development of e-research for the social sciences. The paper is based on an ESRC funded e-social science demonstrator project in which social scientists sought to shape the use of Grid ICT technologies in the research process. The project is called: ‘Collaborative Analysis of Offenders’ Personal and Area-based Social Exclusion’: it addresses social exclusion in relation to how individual and neighbourhood effects account for geographical variations of crime patterns and explores the opportunities and challenges offered by e-research to address the research problem. The paper suggests that if e-research is driven from the needs of social research then it can enhance the practice of social science.

Information and Communication Technologies and Policing: The Dynamics of Changing Police‐Public Communication in the East End of London

One of the problems the police face is how to maintain or improve levels of public access and communication within limited resources and a range of policing priorities. Policing multi-cultural areas with multiple deprivations, such as the East End of London, requires networked information and communication services. The development of information and communication technology (ICT) is potentially a new form of communication for community police services. To develop ICT for police work involves understanding and gaining knowledge about how these technologies fit into police services and with the needs of local residents.