Factors Influencing The Implementation Of Digital Health Technologies In Stroke And Neurological Rehabilitation: The Clinicians Perspective

Introduction: Clinicians are important stakeholders in the adoption of digital health technologies (DHTs) in rehabilitation. This study explored clinicians’ views on the factors that influence the use and non-use of DHTs in stroke and neurological rehabilitation in the UK. Method: Following ethical approval, clinicians were recruited from participating NHS organisations using purposive and snowball sampling. Semi-structured interviews were conducted online using an interview schedule underpinned by the normalisation process theory. Transcribed interviews were analysed using constant comparison. Results: Eleven clinicians, who had been involved in the adoption of DHTs for stroke and neurological rehabilitation, from five NHS organisations in England and Scotland, participated in an interview. The adopted DHTs included apps, sensors, robotics, virtual reality and audio-video platforms. The analysis identified processes for implementation and the influencers (barriers and facilitators) on these. Key influencers included time, willingness and skills to use the technology, championing the technology, funding, and information technology support. Conclusions: Implementing DHTs is complex and time consuming for clinicians to navigate. Strategies that appeared to positively influence adoption included securing funding, developing working relationships with local information technology teams, developing staff skills through training, practice and support, and having team members championing the use of the technology, acknowledging that all strategies require an investment in time. The findings from this study will be synthesised with views of other stakeholder groups (including service users, project leads, service managers, information technologists and digital developers), and reviews of related literature to generate a comprehensive framework to guide DHT implementation in rehabilitation.