title: Examining the use of telehealth in community nursing: identifying the factors affecting frontline staff acceptance and telehealth adoption.
abstract: OBJECTIVE
  To examine frontline staff acceptance of telehealth and identify barriers to and enablers of successful adoption of remote monitoring for patients with Chronic Obstructive Pulmonary Disease and Chronic Heart Failure.
  
  
  BACKGROUND
  The use of telehealth in the UK has not developed at the pace and scale anticipated by policy. Many existing studies report frontline staff acceptance as a key barrier, however data are limited and there is little evidence of the adoption of telehealth in routine practice.
  
  
  METHODS
  Case studies of four community health services in England that use telehealth to monitor patients with Chronic Obstructive Pulmonary Disease and Chronic Heart Failure.
  
  
  METHODS
  Thematic analysis of qualitative interviews with 84 nursing and other frontline staff; and 21 managers and key stakeholders; data collected May 2012-June 2013.
  
  
  RESULTS
  Staff attitudes ranged from resistance to enthusiasm, with varied opinions about the motives for investing in telehealth and the potential impact on nursing roles. Having reliable and flexible technology and dedicated resources for telehealth work were identified as essential in helping to overcome early barriers to acceptance, along with appropriate staff training and a partnership approach to implementation. Early successes were also important, encouraging staff to use telehealth and facilitating clinical learning and increased adoption.
  
  
  CONCLUSIONS
  The mainstreaming of telehealth hinges on clinical 'buy-in'. Where barriers to successful implementation exist, clinicians can lose faith in using technology to perform tasks traditionally delivered in person. Addressing barriers is therefore crucial if clinicians are to adopt telehealth into routine practice.
authors: School of Health and Related Research, University of Sheffield, UK.
authors: Johanna
authors: J
authors: Taylor
authors: Elizabeth
authors: E
authors: Coates
authors: Liz
authors: L
authors: Brewster
authors: Gail
authors: G
authors: Mountain
authors: Bridgette
authors: B
authors: Wessels
authors: Mark S
authors: MS
authors: Hawley
mesh_terms: D001291:Attitude of Health Personnel; D020811:Biomedical Technology; D003152:Community Health Nursing / Q000706:statistics & numerical data*; D004059:Diffusion of Innovation; D006040:Goals; D006801:Humans; D009732:Nursing Care / Q000379:methods; D017216:Telemedicine / Q000706:statistics & numerical data*; D006113:United Kingdom
keywords: community health; innovation adoption; long-term conditions; nursing; technology; telehealth