The Last Mile Problem and Beyond in HIT - The Role of Context-Sensitive Digital Integrators

Area of Science:

• Health Informatics
• Digital Health Implementation
• Socio-technical Systems

Background:

• The non-use of available health information technology (HIT) presents a significant barrier, termed the 'last mile problem,' hindering the full realization of HIT's potential.
• Addressing this challenge requires understanding the complexities of integrating technology into diverse healthcare practices.

Purpose of the Study:

• To identify essential competencies for overcoming the 'last mile problem' in HIT implementation.
• To advocate for the development of context-sensitive digital integrators who bridge the gap between technology and practice.

Main Methods:

• A reflective approach analyzing the socio-technical aspects of HIT implementation.
• Conceptualizing the role and necessary competencies of 'digital integrators' within healthcare settings.

Main Results:

• The 'last mile problem' necessitates specialized competencies for context-sensitive implementation of HIT.
• Digital integrators are identified as key personnel capable of navigating the interface between technological systems and clinical practice.
• Required competencies are often acquired through lifelong, situated learning rather than formal education.

Conclusions:

• Successful HIT adoption hinges on fostering digital integrators with context-sensitive skills.
• Addressing the 'last mile problem' requires acknowledging and nurturing these unique competencies.
• Further discussion is needed on how to develop and support digital integrators to ensure effective HIT integration.