title: Effectiveness of local support for the adoption of a national programme--a descriptive study.
abstract: BACKGROUND
  Change management in health care is a complex and time-consuming endeavour, and no less so in implementing technological systems. In deploying a nationwide programme, the personally controlled electronic health record (PCEHR), the Australian Government employed a number of national and local change management programmes.
  
  
  OBJECTIVE
  This article describes the processes undertaken and the experiences of introducing the PCEHR into 74 general practices across a specific area of metropolitan Melbourne.
  
  
  METHODS
  An online survey was developed by an independent evaluator and offered to all participating practices. The response rate was 82%.
  
  
  RESULTS
  The deployment and testing of the eHealth infrastructure and the roll-out of the PCEHR were deeply supported through face-to-face, locally contextualised support processes. The area Medicare Local (ML), an organisation that provides support services to general practice and allied health in the community, provided support and programme coordination. This support occurred in the environment of a number of other initiatives to improve adoption.
  
  
  CONCLUSIONS
  The impact and value of this support in the registration and adoption process was explored in an online survey and found to be the key factor in practice engagement and success. ML support was seen as instrumental in improving adoption and was more effective than other activities. This article highlights the role of local support, in this case, MLs, in the effective implementation of eHealth programmes across a range of stakeholder groups, in particular, general practice, and the potential for the lessons learned from the engagement model of such an entity to be more generally applied.
authors.affiliation: Inner East Melbourne Medicare Local, 10 Lakeside Drive, Ringwood East, Victoria 3134, Australia. cpearce@iemml.org.au.
authors.forename: Christopher
authors.initials: C
authors.lastname: Pearce
authors.affiliation: South Melbourne, Victoria, Australia.
authors.forename: Jenny
authors.initials: J
authors.lastname: Bartlett
authors.affiliation: Inner East Melbourne Medicare Local, Victoria, Australia.
authors.forename: Adam
authors.initials: A
authors.lastname: Mcleod
authors.affiliation: Inner East Melbourne Medicare Local, Victoria, Australia.
authors.forename: Paula
authors.initials: P
authors.lastname: Eustace
authors.affiliation: Inner East Melbourne Medicare Local, Victoria, Australia.
authors.forename: Rod
authors.initials: R
authors.lastname: Amos
authors.affiliation: Inner East Melbourne Medicare Local, Victoria, Australia.
authors.forename: Marianne
authors.initials: M
authors.lastname: Shearer
mesh_terms: D001315:Australia; D003159:Community-Institutional Relations; D057286:Electronic Health Records / Q000458:organization & administration* / Q000592:standards / Q000639:trends; D058006:General Practice / Q000458:organization & administration* / Q000592:standards / Q000639:trends; D006284:Health Plan Implementation / Q000379:methods / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D009313:National Health Programs / Q000458:organization & administration* / Q000592:standards; D019982:Organizational Case Studies; D009936:Organizational Innovation; D015397:Program Evaluation; D014739:Victoria