Developing an implementation strategy for a digital health intervention: an example in routine healthcare

Area of Science:

• Digital health interventions
• Healthcare implementation science
• Health services research

Background:

• Implementation evidence for new interventions in healthcare is often poorly reported, limiting its use.
• Digital interventions face challenges in routine healthcare settings.
• Transparent reporting of implementation plans is crucial for improving healthcare services.

Purpose of the Study:

• To provide a worked example of developing and reporting a theoretically based implementation plan for a digital health intervention.
• To highlight challenges encountered during the implementation of digital health tools in routine National Health Service (NHS) practice.
• To inform future initiatives for implementing digital health interventions in healthcare.

Main Methods:

• Utilized HeLP-Diabetes, a digital self-management program for Type 2 Diabetes, within an inner-city London NHS Clinical Commissioning Group.
• Employed evidence synthesis, stakeholder engagement, Normalization Process Theory, feedback, and qualitative interviews to develop the implementation plan.
• Collected usage data to inform strategy development and iterative adjustments.

Main Results:

• Developed a new implementation plan for HeLP-Diabetes, incorporating strategies informed by Normalization Process Theory.
• Key strategies included engaging opinion leaders, educational materials, visits, meetings, audit, feedback, and reminders.
• Identified resource allocation difficulties as a primary barrier to implementation in routine care.

Conclusions:

• This paper offers a practical example of digital health intervention implementation.
• Emphasizes the importance of theory-guided strategy selection, thorough implementation planning, and adaptive approaches to address barriers.
• Findings can guide others in planning and executing implementation activities in routine healthcare settings.