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Implementing a teleophthalmology referral platform in routine practice: Understanding a digital health intervention

Sarah Abdi¹, Dilisha Patel², Josie Carmichael^1,3,4

¹UCL Interaction Centre, University College London, London, UK.

|February 3, 2025

Summary

Implementing digital health tools like teleophthalmology requires addressing user expectations and technical factors. Successful adoption depends on individual, technological, and organizational support for seamless integration into routine practice.

Keywords:

KeywordsTeleophthalmology clinical referral community optometrists normalisation process theory opthalmologists primary eye care

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Area of Science:

Digital Health
Ophthalmology
Health Services Research

Background:

Digital health interventions offer potential for improved clinical processes and patient outcomes.
Challenges in adoption and implementation often hinder the impact of digital health tools.
Teleophthalmology is an example of a digital health intervention aiming to enhance eye care delivery.

Purpose of the Study:

To explore facilitators and barriers to implementing a teleophthalmology referral platform.
To utilize Normalisation Process Theory (NPT) as a framework for understanding implementation.
To provide insights into the successful integration of digital health interventions in routine practice.

Main Methods:

Conducted semistructured interviews with 24 health professionals (18 optometrists, 6 ophthalmologists).
Employed Normalisation Process Theory (NPT) to guide data collection and analysis.
Focused on professionals involved in the implementation of a teleophthalmology referral platform in the UK.

Main Results:

Participants recognized the value of the teleophthalmology platform, but expectations regarding feedback were crucial.
Key factors influencing adoption included individual IT skills, time investment for referrals, and organizational support.
Varied perceptions during implementation highlighted the need for alignment between technology and user expectations.

Conclusions:

Successful large-scale implementation necessitates consideration of multi-level factors.
Normalisation Process Theory (NPT) aids in understanding the complexities of digital health implementation.
Addressing individual, technological, and organizational aspects is vital for integrating teleophthalmology into routine care.